[Role of patient travel in transmission of human African trypanosomiasis in a highly endemic area of the Ivory Coast].

Human African trypanosomosis (HAT) remains a major public health problem in Subsaharan Africa. The region around the town of Bonon in middle western Côte d'Ivoire is a highly endemic HAT zone. The purpose of this study was to assess the role of travelling of infected patients in transmission of HAT. The study population included a total of 96 patients in whom HAT had been diagnosed actively or passively between 1999 and 2000. Information on each patient's residence and workplaces, i.e. water site, and farm field, was used to calculate the mean distance traveled and mean number of places visited daily by each patient. Findings indicated that both parameters, i.e., distance traveled and number of places visited, were significantly higher for patients living in Bonon than those living in hamlets or homesteads. Based on analysis of patient movements the endemic zone could be divided into three subdivisions with different modes of disease transmission. This study was performed as a preliminary step for a larger investigation designed to allow specific targeting of HAT hot spots based mainly on a geographic information system.