The impact of war on the evolution of sleeping sickness in west-central Cote d'Ivoire

To evaluate the situation of sleeping sickness in west-central Cote d'Ivoire from 2000 to 2003, in view of the war which broke out in September 2002. Active surveys by medical teams and passive case detection. Between 2000 and 2003, 250 patients were diagnosed with sleeping sickness. At first it appeared that sleeping sickness prevalence had fallen since the beginning of political troubles. But this apparent drop was due to poor population coverage. Participation in medical surveys differed according to ethnic group, reflecting land use conflicts between ethnic communities. Such conflicts are common in this area, but have been exacerbated by the war. In war, assessing the importance of sleeping sickness by medical surveys only is very difficult. But detection of sleeping sickness cases by passive surveillance increased.