title: Should I get screened for sleeping sickness? A qualitative study in Kasai province, Democratic Republic of Congo.
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.
  
  
  RESULTS
  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
  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.
authors.affiliation: Programme National de Lutte contre la Trypanosomiase Humaine Africain, Kinshasa, Democratic Republic of Congo.
authors.forename: Alain
authors.initials: A
authors.lastname: Mpanya
authors.forename: David
authors.initials: D
authors.lastname: Hendrickx
authors.forename: Mimy
authors.initials: M
authors.lastname: Vuna
authors.forename: Albert
authors.initials: A
authors.lastname: Kanyinda
authors.forename: Crispin
authors.initials: C
authors.lastname: Lumbala
authors.forename: Valéry
authors.initials: V
authors.lastname: Tshilombo
authors.forename: Patrick
authors.initials: P
authors.lastname: Mitashi
authors.forename: Oscar
authors.initials: O
authors.lastname: Luboya
authors.forename: Victor
authors.initials: V
authors.lastname: Kande
authors.forename: Marleen
authors.initials: M
authors.lastname: Boelaert
authors.forename: Pierre
authors.initials: P
authors.lastname: Lefèvre
authors.forename: Pascal
authors.initials: P
authors.lastname: Lutumba
mesh_terms: D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D014344:Trypanocidal Agents / Q000627:therapeutic use; D014353:Trypanosomiasis, African / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D014344:Trypanocidal Agents