[The role of environmental factors in the current recrudescence of human African trypanosomiasis].

The authors highlight the major target for the prevention of human african trypanosomiasis (HAT) i.e. decrease of parasites reservoir. For this purpose, they state that it is necessary to detect HAT patients, to treat them, and to break down the contact between human and vectors. Then, they review the environmental factors that could be involved in the HAT outbreak. A political direction would strengthen the HAT prevention by the increase of resources attributable to the disease. But, choice of priorities is based on technical criteria which are not in favour of HAT. Many difficult situations, occurring at the borders of concerned states, are restricting factors for a global and co-ordinated prevention. Moreover, internal political disturbances and local conflicts lead to a mismanagement of health care departments. These conflicts lead also to a migratory flow of populations; thereafter, the individuals have no access to medical structure. Beside the economical and political factors, some others have a great importance: human behavior, estimation of risk by the authorities, psychological perception of the disease by the population. The part of these different factors must be perfectly identified to avoid any disturbance in the actions of HAT prevention. The least failure leads to a quick increase of parasites transmission, and the HAT control has to start all over again.