{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:25:04Z","timestamp":1790810704741,"version":"4.1.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0009992","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T00:00:00Z","timestamp":1639008000000}}],"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T00:00:00Z","timestamp":1638144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1184344"],"award-info":[{"award-number":["OPP1184344"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1184344"],"award-info":[{"award-number":["OPP1184344"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1184344"],"award-info":[{"award-number":["OPP1184344"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1184344"],"award-info":[{"award-number":["OPP1184344"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1184344"],"award-info":[{"award-number":["OPP1184344"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>Gambiense human African trypanosomiasis is a deadly disease that has been declining in incidence since the start of the Century, primarily due to increased screening, diagnosis and treatment of infected people. The main treatment regimen currently in use requires a lumbar puncture as part of the diagnostic process to determine disease stage and hospital admission for drug administration. Fexinidazole is a new oral treatment for stage 1 and non-severe stage 2 human African trypanosomiasis. The World Health Organization has recently incorporated fexinidazole into its treatment guidelines for human African trypanosomiasis. The treatment does not require hospital admission or a lumbar puncture for all patients, which is likely to ease access for patients; however, it does require concomitant food intake, which is likely to reduce adherence. Here, we use a mathematical model calibrated to case and screening data from Mushie territory, in the Democratic Republic of the Congo, to explore the potential negative impact of poor compliance to an oral treatment, and potential gains to be made from increases in the rate at which patients seek treatment. We find that reductions in compliance in treatment of stage 1 cases are projected to result in the largest increase in further transmission of the disease, with failing to cure stage 2 cases also posing a smaller concern. Reductions in compliance may be offset by increases in the rate at which cases are passively detected. Efforts should therefore be made to ensure good adherence for stage 1 patients to treatment with fexinidazole and to improve access to care.<\/jats:p>","DOI":"10.1371\/journal.pntd.0009992","type":"journal-article","created":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T14:03:42Z","timestamp":1638194622000},"page":"e0009992","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Modelling the impact of fexinidazole use on human African trypanosomiasis (HAT) transmission in the Democratic Republic of the Congo"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8849-7776","authenticated-orcid":true,"given":"Aatreyee M.","family":"Das","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1103-9141","authenticated-orcid":true,"given":"Nakul","family":"Chitnis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Burri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4743-5987","authenticated-orcid":true,"given":"Daniel H.","family":"Paris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3502-6895","authenticated-orcid":true,"given":"Swati","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8375-5542","authenticated-orcid":true,"given":"Simon E. 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Available from: https:\/\/apps.who.int\/neglected_diseases\/ntddata\/hat\/hat.html."},{"key":"pntd.0009992.ref002","unstructured":"World Health Organization Global Health Observatory;. https:\/\/apps.who.int\/neglected_diseases\/ntddata\/hat\/hat.html."},{"issue":"1","key":"pntd.0009992.ref003","doi-asserted-by":"crossref","first-page":"e1008532","DOI":"10.1371\/journal.pcbi.1008532","article-title":"Quantifying epidemiological drivers of gambiense human African Trypanosomiasis across the Democratic Republic of Congo","volume":"17","author":"RE Crump","year":"2021","journal-title":"PLoS Computational Biology"},{"issue":"6","key":"pntd.0009992.ref004","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1017\/S0031182013002102","article-title":"The journey towards elimination of gambiense human African trypanosomiasis: not far, nor easy","volume":"141","author":"JR 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