Towards understanding the presence/absence of Human African Trypanosomosis in a focus of Côte d'Ivoire: a spatial analysis of the pathogenic system.
Towards understanding the presence/absence of Human African Trypanosomosis in a focus of Côte d'Ivoire: a spatial analysis of the pathogenic system.
复制标题
DOI：
10.1186/1476-072x-4-27
复制
发表时间：
2005-11-03
影响因子：
4.9
通讯作者：
Solano, Philippe
中科院分区：
文献类型：
--
作者：
Courtin, Fabrice;Jamonneau, Vincent;Oke, Emmanuel;Coulibaly, Bamoro;Oswald, Yohan;Dupont, Sophie;Cuny, Gerard;Doumenge, Jean-Pierre;Solano, Philippe
这项研究的目的是确定影响科特迪瓦嗜温森林Bonon地区非洲人锥虫病（HAT或昏睡病）发展的因素。之前的一项研究绘制了96名患者的主要日间活动地点，揭示了该镇以南地区（所有患者居住的地区）和该镇以北地区（显然没有疾病）之间的重要差异。为了解释这种差异，我们进行了空间分析的致病系统的关键组成部分，即人类宿主，采采蝇载体和锥虫在其环境中使用地理信息系统（GIS）。这种方法在HAT重点的规模，使我们能够确定的空间模式，与这种疾病的传播和传播。人类定居的历史（北方农村地区的开发比南方早得多）似乎是决定土地使用模式的一个主要因素，而土地使用模式本身可能是病媒密度差异的原因（南方农村地区采采蝇的数量是北方的六倍）。病媒密度，根据它被发现的人类和环境背景（这里是博农镇和农村地区之间的强烈流动性），可以解释观察到的HAT流行率的空间差异。这项工作展示了GIS分析的致病系统的关键组成部分，在提供一个更好地了解HAT的传播和传播的作用。此外，在确定了最活跃的传播区域和不利于HAT传播的区域之后，本研究更准确地划定了Bonon焦点的边界。作为后续行动，将向科特迪瓦HAT控制方案提出从Bonon以北（由于密度很低，再次入侵的机会很小）向南开展有针对性的舌蝇控制活动，并在南部进行更多的医学调查，以加强这一重点地区的疾病控制。这项工作还显示了HAT在时间和环境方面的演变，所使用的方法可能能够预测具有类似历史和空间组织的地区可能的昏睡病发展/灭绝。
This study aimed at identifying factors influencing the development of Human African Trypanosomosis (HAT, or sleeping sickness) in the focus of Bonon, located in the mesophile forest of Côte d'Ivoire. A previous study mapping the main daytime activity sites of 96 patients revealed an important disparity between the area south of the town- where all the patients lived- and the area north of the town, apparently free of disease. In order to explain this disparity, we carried out a spatial analysis of the key components of the pathogenic system, i.e. the human host, the tsetse vector and the trypanosomes in their environment using a geographic information system (GIS). This approach at the scale of a HAT focus enabled us to identify spatial patterns which linked to the transmission and the dissemination of this disease. The history of human settlement (with the rural northern area exploited much earlier than the southern one) appears to be a major factor which determines the land use pattern, which itself may account for differences found in vector densities (tsetse were found six times more abundant in the southern rural area than in the northern). Vector density, according to the human and environmental context in which it is found (here an intense mobility between the town of Bonon and the rural areas), may explain the observed spatial differences in HAT prevalence. This work demonstrates the role of GIS analyses of key components of the pathogenic system in providing a better understanding of transmission and dissemination of HAT. Moreover, following the identification of the most active transmission areas, and of an area unfavourable to HAT transmission, this study more precisely delineates the boundaries of the Bonon focus. As a follow-up, targeted tsetse control activities starting north of Bonon (with few chances of reinvasion due to very low densities) going south, and additional medical surveys in the south will be proposed to the Ivoirian HAT control program to enhance the control of the disease in this focus. This work also shows the evolution of HAT regarding time and environment, and the methodology used may be able to predict possible sleeping sickness development/extinction in areas with similar history and space organization.