A geographical approach to identify sleeping sickness risk factors in a mangrove ecosystem.
OBJECTIVE
To provide a better understanding of sleeping sickness transmission and spread in mangrove areas to optimize its control.


METHODS
In the Forecariah mangrove area, Guinea, 19 sleeping sickness cases and 19 matched controls were followed up in their living areas (at home, in fields and at water points). All occupational sites and pathways were mapped and then placed in their environmental context.


RESULTS
The sleeping sickness cases displayed a significantly broader and more diverse spatial occupation than the controls. They covered double the daily walking distances of controls and had on average two more occupational sites, most of which were located in mangrove forests. Activities with a higher transmission risk (rice culture, attendance of pirogue jetties) were identified as well as high-risk areas and pathways.


CONCLUSIONS
An entomological control strategy targeting transmission risk areas is proposed. Its implementation in a control programme would reduce by 86% the efforts needed for a classical vector control programme throughout the area. Medical surveys set up at specific locations, such as pirogue jetties and high-risk paths, should also enable better targeting of the population at highest risk.
Courtin
F
F
Institut de Recherche pour le Développement, UMR 177 IRD-CIRAD, Centre International de Recherche Développement sur l'Elevage en zone Subhumide, Bobo-Dioulasso, Burkina Faso. courtinfabrice@yahoo.fr
Jamonneau
V
V
Camara
M
M
Camara
O
O
Coulibaly
B
B
Diarra
A
A
Solano
P
P
Bucheton
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000382:Agricultural Workers' Diseases / Q000453:epidemiology / Q000517:prevention & control; D032407:Avicennia; D016022:Case-Control Studies; D002648:Child; D017753:Ecosystem; D005260:Female; D040362:Geographic Information Systems; D016701:Guinea / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects; D012275:Oryza; D043982:Rhizophoraceae; D012307:Risk Factors; D014353:Trypanosomiasis, African / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D014881:Water Supply; D055815:Young Adult