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. 2025 Jun 20;19(6):e0013197.
doi: 10.1371/journal.pntd.0013197. eCollection 2025 Jun.

Towards elimination: Challenges in community participation to a gHAT 'screen and treat' strategy using the new oral drug acoziborole in the Democratic Republic of the Congo

Catiane Vander Kelen  1 , Alain Mpanya  2 , Ruth Nzuzi  2 , Gérard Watakembi  3 , Cathy Mbuyi  2 , Elena Nicco  1 , Epco Hasker  1
Affiliations

Towards elimination: Challenges in community participation to a gHAT 'screen and treat' strategy using the new oral drug acoziborole in the Democratic Republic of the Congo

Catiane Vander Kelen et al. PLoS Negl Trop Dis. .

Abstract

Until recently, treatment options for gambiense human African trypanosomiasis (gHAT) have been limited and toxic, negatively impacting community participation to screening and treatment. A new, non-toxic, single-dose oral drug has shown efficacy in a Phase III trial and is being tested in a trial called 'STROGHAT', which aims to demonstrate cessation of HAT transmission using a 'screen and treat' strategy. This study aims to explore community perceptions about current and future screening and treatment strategies and identify what could act as barriers to participation in order to prevent them. We conducted 8 focus group discussions and 18 semi-structured interviews with communities, community leaders and mobile unit managers in 4 selected villages out of 74 endemic villages included in the STROGHAT study. Our results highlight four main potential barriers: the rarity of cases has led to gHAT being perceived as a disease that no longer exists and participation to screening as a waste of time. Lack of awareness of new treatment and screening procedures perpetuates fears and misconceptions about treatment toxicity, lumbar puncture and mandatory hospitalisation. The introduction of a single-dose oral drug to be administered on the spot raised the issue of side effect monitoring and care. Finally, the lack of sensitivity to community cultural norms in the organisation of screening discourages people from participating. Those barriers are important to anticipate and include in elimination strategy. Also a monitor perception about acoziborole screen and treat during all the process through other social science based research is to foreseen.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Selected area in Equateur Nord, blue (Original work Elena Nicco, shapefile source: OpenStreetMap
https://www.openstreetmap.org/#map=7/2.362/20.709).
Fig 2
Fig 2. The 4 villages of the qualitative study (Original work Catiane Vander Kelen, shapefile source: OpenStreetMap
https://www.openstreetmap.org/#map=7/2.362/20.709).
See this image and copyright information in PMC

References

    1. Robays J, Bilengue MMC, Van der Stuyft P, Boelaert M. The effectiveness of active population screening and treatment for sleeping sickness control in the Democratic Republic of Congo. Trop Med Int Health. 2004;9(5):542–50. doi: 10.1111/j.1365-3156.2004.01240.x - DOI - PubMed
    1. Robays J, Lefèvre P, Lutumba P, Lubanza S, Kande Betu Ku Mesu V, Van der Stuyft P, et al. Drug toxicity and cost as barriers to community participation in HAT control in the Democratic Republic of Congo. Trop Med Int Health. 2007;12(2):290–8. doi: 10.1111/j.1365-3156.2006.01768.x - DOI - PubMed
    1. Barrett MP, Boykin DW, Brun R, Tidwell RR. Human African trypanosomiasis: pharmacological re-engagement with a neglected disease. Br J Pharmacol. 2007;152(8):1155–71. doi: 10.1038/sj.bjp.0707354 - DOI - PMC - PubMed
    1. Priotto G, Kasparian S, Mutombo W, Ngouama D, Ghorashian S, Arnold U, et al. Nifurtimox-eflornithine combination therapy for second-stage African Trypanosoma brucei gambiense trypanosomiasis: a multicentre, randomised, phase III, non-inferiority trial. Lancet. 2009;374(9683):56–64. doi: 10.1016/S0140-6736(09)61117-X - DOI - PubMed
    1. World Health Organisation. Trypanosomiase humaine africaine (maladie du sommeil). 2021. https://www.who.int/fr/news-room/fact-sheets/detail/trypanosomiasis-huma...

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