An agent-based model of sleeping sickness: simulation trials of a forest focus in southern Cameroon.

An agent-based model (AMB) used to simulate the spread of Human African Trypanosomiasis is presented together with the results of simulations of a focus of the disease. This model is a completely spatialized approach taking into account a series of often overlooked parameters such as human behaviour (activity-related movements), the density and mobility of the disease vectors--tsetse flies (Glossina spp.)--and the influence of other tsetse feeding hosts (livestock and wild animal populations). The agents that represent humans and tsetse flies move in a spatially structured environment managed by specialized location agents. Existing compartmental mathematical models governed by differential equations fail to incorporate the spatial dimension of the disease transmission. Furthermore, on a small scale, transmission is unrealistically represented by entities less than one. This ABM was tested with data from one village of the Bipindi sleeping sickness focus (southern Cameroon) and with obtained realistic simulations of stable transmission involving an animal reservoir. In varying different spatial configurations, we observe that the stability of spread is linked to the spatial complexity (number of heterogeneous locations). The prevalence is very sensitive to the human densities and to the number of tsetse flies initially infected in a given location. A relatively low and durable prevalence is obtained with shortening the phase I. In addition, we discuss some upgrading possibilities, in particular the linkage to a Geographical Information System (GIS). The agent-based approach offers new ways to understanding the spread of the disease and a tool to evaluate risk and test control strategies.