Sleeping sickness in West Africa (1906-2006): changes in spatial repartition and lessons from the past.
OBJECTIVE
To review the geography and history of sleeping sickness (Human African trypanosomiasis; HAT) over the past 100 years in West Africa, to identify priority areas for sleeping sickness surveillance and areas where HAT no longer seems active.


METHODS
History and geography of HAT were summarized based on a review of old reports and recent publications and on recent results obtained from medical surveys conducted in West Africa up to 2006.


CONCLUSIONS
Active HAT foci seem to have moved from the North to the South. Endemic HAT presently appears to be limited to areas where annual rainfall exceeds 1200 mm, although the reasons for this remain unknown. There has also been a shift towards the south of the isohyets and of the northern distribution limit of tsetse. Currently, the most severely affected countries are Guinea and Ivory Coast, whereas the northern countries seem less affected. However, many parts of West Africa still lack information on HAT and remain to be investigated. Of particular interest are the consequences of the recent political crisis in Ivory Coast and the resulting massive population movements, given the possible consequences on HAT in neighbouring countries.
Courtin
F
F
Centre International de Recherche Développement sur l'Elevage en zone Subhumide (CIRDES), Institut de Recherche pour le Développement (IRD) UMR 177, Bobo-Dioulasso, Burkina Faso.
Jamonneau
V
V
Duvallet
G
G
Garcia
A
A
Coulibaly
B
B
Doumenge
J P
JP
Cuny
G
G
Solano
P
P
D000354:Africa, Western / Q000453:epidemiology; D002648:Child; D002980:Climate; D004641:Emigration and Immigration; D019353:Endemic Diseases / Q000266:history; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007223:Infant; D012307:Risk Factors; D018571:Sentinel Surveillance; D013029:Space-Time Clustering; D014353:Trypanosomiasis, African / Q000453:epidemiology* / Q000266:history