Abstract in English


From knowledge ont he mechanisms of the major tropical endemic diseases to public health applications: a new aspect for the geography of health

Pascal Handshumacher

Géographe de la santé, IRD, UR 024, Institut de Géographie

et Jean-Pierre Hervouët

Géographe de la santé, IRD, UR02, IRSAM, UPPA

Geograpical investigations have made a substantial contribution to knowledge about the major tropical endemic diseases since the onchocerciasis (river blindness) control programme was set in place in 1975. Closely hinged on multidisciplinary work with biologists and medical practioners, theses studies showed the importance of land management by societies related to the outbreak, diffusion and propagation of such endemic diseases. This approach deploys a set of multiple-scale spatial and temporal anlyses, helping to refine a set of concepts which have become key tools for evaluating the potential epidemic-generating capacity of certain places. A multiplication of models for different environments has contributed to enhanced knowledge of situations and processes and an improved theoretical grasp of what happens. However, in spite of such advances in biogeographical knowledge of diseases -and especially those achieved in therapy and control- the public health situation has hardly seen any improvement for many pathologies for which eradication before the end of the XXth century was thought possible. The many advances achieved in cartographic and statistical tools and this relative failure on the operational front forces us to reste the priority of the issues at stake in line with the first determining factors of public heath policies and on the degree to which knowledge about transmission matches up with its application for public health purposes. The strong social demand is a factor behind a reorientation of geographical research, which, drawing on modern tools, is attaching itself resolutely to research applied to public health.

Key-words : parasitic diseases - PVD - diffusion - propagation - shared spaces - GIS - satellite imaging - public health - geography.