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Community Participation in Neglected Tropical Diseases Elimination: A case study of Human African Trypanosomiasis elimination in Democratic Republic of Congo

Human African trypanosomiasis (HAT) is a neglected tropical disease caused by trypanosomes transmitted by tsetse flies. Currently, more than 80% of all cases reported globally are from the Democratic Republic of Congo (DRC). In both DRC and globally, the number of cases of HAT is at an all-time low (<2000 reported cases/year) and hence the WHO aims to eliminate HAT as a public health problem by 2020. Epidemiological models suggest that to reach this elimination goal, it is necessary to combine mass screening and treatment of the human population with vector control. As the number of cases declines, mass screening is becoming prohibitively expensive and participation by local populations has declined. Historically, vector control has been little used in DRC because it was also too expensive and complicated to organise. Two new strategies are being introduced in the DRC to overcome these constraints. First, “Mini-mobile teams” which visit people using a door to door approach are replacing mass screening. Second, deployment of “Tiny targets”, insecticide-impregnated panels of cloth and netting, offer a simple and cost-effective method of tsetse control. The success of these two new approaches depends, in part, on their acceptability to local endemic communities. Introduction of new tools in HAT control may overcome some but others could appear or persist. The main objectives of this research is to document community perspective about Mini-mobile teams and Tiny Targets, to understand why local populations are willing to participate in HAT elimination activities in the elimination setting with low disease incidence. To achieve those objectives, three different qualitative studies will be carried out in DRC to assess the acceptability of mini-mobile screening teams, acceptability of tiny targets and community participation in vector control project. These studies aims to contribute to the implementation of the most effective HAT control strategy possible in DRC to reach HAT elimination. Furthermore it aims to bring additional insights into the overall debate about community participation in public health projects for low prevalence and neglected diseases.
Datum:3 jul 2019 →  Heden