{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T10:25:21Z","timestamp":1767176721528,"version":"build-2238731810"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013197","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000}}],"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>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 \u2018STROGHAT\u2019, which aims to demonstrate cessation of HAT transmission using a \u2018screen and treat\u2019 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.<\/jats:p>","DOI":"10.1371\/journal.pntd.0013197","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T13:39:40Z","timestamp":1750426780000},"page":"e0013197","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Towards elimination: Challenges in community participation to a gHAT \u2018screen and treat\u2019 strategy using the new oral drug acoziborole in the Democratic Republic of the Congo"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6862-8986","authenticated-orcid":true,"given":"Catiane Vander","family":"Kelen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alain","family":"Mpanya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Nzuzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00e9rard","family":"Watakembi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cathy","family":"Mbuyi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Nicco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Epco","family":"Hasker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"issue":"5","key":"pntd.0013197.ref001","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1111\/j.1365-3156.2004.01240.x","article-title":"The effectiveness of active population screening and treatment for sleeping sickness control in the Democratic Republic of Congo","volume":"9","author":"J Robays","year":"2004","journal-title":"Trop Med Int Health"},{"issue":"2","key":"pntd.0013197.ref002","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1111\/j.1365-3156.2006.01768.x","article-title":"Drug toxicity and cost as barriers to community participation in HAT control in the Democratic Republic of Congo","volume":"12","author":"J Robays","year":"2007","journal-title":"Trop Med Int Health"},{"issue":"8","key":"pntd.0013197.ref003","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1038\/sj.bjp.0707354","article-title":"Human African trypanosomiasis: pharmacological re-engagement with a neglected disease","volume":"152","author":"MP Barrett","year":"2007","journal-title":"Br J Pharmacol"},{"issue":"9683","key":"pntd.0013197.ref004","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/S0140-6736(09)61117-X","article-title":"Nifurtimox-eflornithine combination therapy for second-stage African Trypanosoma brucei gambiense trypanosomiasis: a multicentre, randomised, phase III, non-inferiority trial","volume":"374","author":"G Priotto","year":"2009","journal-title":"Lancet"},{"key":"pntd.0013197.ref005","author":"World Health Organisation","year":"2021"},{"issue":"4","key":"pntd.0013197.ref006","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/S1473-3099(22)00660-0","article-title":"Efficacy and safety of acoziborole in patients with human African trypanosomiasis caused by Trypanosoma brucei gambiense: a multicentre, open-label, single-arm, phase 2\/3 trial","volume":"23","author":"VK Betu Kumeso","year":"2023","journal-title":"Lancet Infect Dis"},{"issue":"1","key":"pntd.0013197.ref007","doi-asserted-by":"crossref","first-page":"29","DOI":"10.3390\/tropicalmed5010029","article-title":"New Drugs for Human African Trypanosomiasis: A Twenty First Century Success Story","volume":"5","author":"EA Dickie","year":"2020","journal-title":"Trop Med Infect Dis"},{"key":"pntd.0013197.ref008","doi-asserted-by":"crossref","first-page":"23","DOI":"10.12688\/openreseurope.19077.1","article-title":"The STROGHAT study protocol: An intervention study to evaluate safety, effectiveness and feasibility of treating gambiense HAT seropositive subjects with acoziborole","volume":"5","author":"E Nicco","year":"2025","journal-title":"Open Res Eur"},{"issue":"984","key":"pntd.0013197.ref009","first-page":"1","article-title":"Control and surveillance of human African trypanosomiasis","author":"World Health Organization","year":"2013","journal-title":"World Health Organ Tech Rep Ser"},{"issue":"1","key":"pntd.0013197.ref010","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0001467","article-title":"Should I get screened for sleeping sickness? 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