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Conflict and human African trypanosomiasis.

Lea Berrang-Ford1, Jamie Lundine, Sebastien Breau

  • 1McGill University, Geography, 805 Sherbrooke Street Ouest, Burnside Hall Rm. 705, Montreal, QC, Canada H3A 2K6. lea.berrangford@mcgill.ca

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Conflict and political instability significantly increase Human African Trypanosomiasis (HAT) incidence in sub-Saharan Africa. HAT cases peaked approximately 10 years after conflict events, highlighting the need for socio-political factors in risk assessments.

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Area of Science:

  • Epidemiology
  • Public Health
  • Conflict Studies

Background:

  • Human African Trypanosomiasis (HAT) resurgence poses a significant public health challenge in sub-Saharan Africa.
  • Conflict is anecdotally linked to HAT incidence but lacks quantitative population-level research.
  • Controlling HAT requires understanding and mitigating factors influencing disease spread, including socio-political instability.

Purpose of the Study:

  • To quantitatively assess the association between Human African Trypanosomiasis (HAT) incidence and conflict-related processes.
  • To identify spatial and temporal patterns of HAT incidence in relation to conflict over 30 years.
  • To inform public health policy and interventions by incorporating socio-political risk factors.

Main Methods:

  • Collected HAT and conflict data for 35 sub-Saharan African countries (1976-2004).
  • Employed descriptive statistics, inferential statistics, and negative binomial regression modeling.
  • Utilized space-time scan statistics to detect significant HAT incidence clusters.

Main Results:

  • HAT incidence clusters predominantly coincided with periods of conflict and socio-political instability.
  • HAT cases were significantly higher in countries and years experiencing conflict, political terror, and internationalized civil war.
  • A lag of approximately 10 years was observed between conflict onset and peak HAT incidence.

Conclusions:

  • Socio-political factors, particularly conflict and terror, are strongly associated with HAT incidence.
  • Geographic Information Systems (GIS)-based risk assessments for HAT should explicitly include quantified socio-political measures.
  • Integrating conflict data into HAT surveillance and control strategies is crucial for effective elimination efforts.