Should I get screened for sleeping sickness? A qualitative study in Kasai province, Democratic Republic of Congo - PubMed (original) (raw)

doi: 10.1371/journal.pntd.0001467. Epub 2012 Jan 17.

David Hendrickx, Mimy Vuna, Albert Kanyinda, Crispin Lumbala, Valéry Tshilombo, Patrick Mitashi, Oscar Luboya, Victor Kande, Marleen Boelaert, Pierre Lefèvre, Pascal Lutumba

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Should I get screened for sleeping sickness? A qualitative study in Kasai province, Democratic Republic of Congo

Alain Mpanya et al. PLoS Negl Trop Dis. 2012 Jan.

Abstract

Background: Control of human African trypanosomiasis (sleeping sickness) in the Democratic Republic of Congo is based on mass population active screening by mobile teams. Although generally considered a successful strategy, the community participation rates in these screening activities and ensuing treatment remain low in the Kasai-Oriental province. A better understanding of the reasons behind this observation is necessary to improve regional control activities.

Methods: Thirteen focus group discussions were held in five health zones of the Kasai-Oriental province to gain insights in the regional perceptions regarding sleeping sickness and the national control programme's activities.

Principal findings: Sleeping sickness is well known among the population and is considered a serious and life-threatening disease. The disease is acknowledged to have severe implications for the individual (e.g., persistence of manic periods and trembling hands, even after treatment), at the family level (e.g., income loss, conflicts, separations) and for communities (e.g., disruption of community life and activities). Several important barriers to screening and treatment were identified. Fear of drug toxicity, lack of confidentiality during screening procedures, financial barriers and a lack of communication between the mobile teams and local communities were described. Additionally, a number of regionally accepted prohibitions related to sleeping sickness treatment were described that were found to be a strong impediment to disease screening and treatment. These prohibitions, which do not seem to have a rational basis, have far-reaching socio-economic repercussions and severely restrict the participation in day-to-day life.

Conclusions/significance: A mobile screening calendar more adapted to the local conditions with more respect for privacy, the use of less toxic drugs, and a better understanding of the origin as well as better communication about the prohibitions related to treatment would facilitate higher participation rates among the Kasai-Oriental population in sleeping sickness screening and treatment activities organized by the national HAT control programme.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1

Figure 1. Geographic locations of the health zones included in the study.

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