Centering Patient Expectations of a Novel Home-Based Oral Drug Treatment among <i>T. b. rhodesiense</i> Human African Trypanosomiasis Patients in Uganda
The recent approval of fexinidazole for human African trypanosomiasis (HAT) caused by <i>T. b. gambiense</i> enables improved patient management that is pivotal to elimination. Effective in both the early and late stages of the disease, it obviates the need for invasive lumbar punctures...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-01-01
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| Series: | Tropical Medicine and Infectious Disease |
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| Online Access: | https://www.mdpi.com/2414-6366/5/1/16 |
| _version_ | 1798039544981880832 |
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| author | Shona J Lee Renah J Apio Jennifer J Palmer |
| author_facet | Shona J Lee Renah J Apio Jennifer J Palmer |
| author_sort | Shona J Lee |
| collection | DOAJ |
| description | The recent approval of fexinidazole for human African trypanosomiasis (HAT) caused by <i>T. b. gambiense</i> enables improved patient management that is pivotal to elimination. Effective in both the early and late stages of the disease, it obviates the need for invasive lumbar punctures which guide therapy, in some patients. Unlike existing injectable treatments requiring systematic hospitalisation, fexinidazole’s oral administration will allow many patients to be treated in an outpatient or home-based setting. Drawing on interviews with 25 <i>T. b. rhodesiense</i> HAT patients managed under existing protocols in Uganda where trials of fexinidazole will begin shortly, this article explores patient expectations of the new protocol to help HAT programmes anticipate patient concerns. Alongside frightening symptoms of this life-threatening illness, the pain and anxiety associated with lumbar punctures and intravenous injections of melarsoprol contributed to a perception of HAT as a serious illness requiring expert medical care. While preferring a new protocol that would avoid these uncomfortable procedures, patients’ trust in the care they received meant that nearly half were hesitant towards shifting care out of the hospital setting. Clinical observation is an important aspect of existing HAT care for patients. Programmes may need to offer extensive counselling and monitoring support before patients are comfortable accepting care outside of hospitals. |
| first_indexed | 2024-04-11T21:55:22Z |
| format | Article |
| id | doaj.art-ee5d7ac8694541a9ae52e6cd28363d58 |
| institution | Directory Open Access Journal |
| issn | 2414-6366 |
| language | English |
| last_indexed | 2024-04-11T21:55:22Z |
| publishDate | 2020-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tropical Medicine and Infectious Disease |
| spelling | doaj.art-ee5d7ac8694541a9ae52e6cd28363d582022-12-22T04:01:07ZengMDPI AGTropical Medicine and Infectious Disease2414-63662020-01-01511610.3390/tropicalmed5010016tropicalmed5010016Centering Patient Expectations of a Novel Home-Based Oral Drug Treatment among <i>T. b. rhodesiense</i> Human African Trypanosomiasis Patients in UgandaShona J Lee0Renah J Apio1Jennifer J Palmer2Department of Global Health & Development, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1H 9SH, UKDokolo Health Centre, Dokolo, UgandaDepartment of Global Health & Development, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1H 9SH, UKThe recent approval of fexinidazole for human African trypanosomiasis (HAT) caused by <i>T. b. gambiense</i> enables improved patient management that is pivotal to elimination. Effective in both the early and late stages of the disease, it obviates the need for invasive lumbar punctures which guide therapy, in some patients. Unlike existing injectable treatments requiring systematic hospitalisation, fexinidazole’s oral administration will allow many patients to be treated in an outpatient or home-based setting. Drawing on interviews with 25 <i>T. b. rhodesiense</i> HAT patients managed under existing protocols in Uganda where trials of fexinidazole will begin shortly, this article explores patient expectations of the new protocol to help HAT programmes anticipate patient concerns. Alongside frightening symptoms of this life-threatening illness, the pain and anxiety associated with lumbar punctures and intravenous injections of melarsoprol contributed to a perception of HAT as a serious illness requiring expert medical care. While preferring a new protocol that would avoid these uncomfortable procedures, patients’ trust in the care they received meant that nearly half were hesitant towards shifting care out of the hospital setting. Clinical observation is an important aspect of existing HAT care for patients. Programmes may need to offer extensive counselling and monitoring support before patients are comfortable accepting care outside of hospitals.https://www.mdpi.com/2414-6366/5/1/16human africa trypanosomiasisfexinidazolehome-based treatmentpatient-centred careugandaelimination |
| spellingShingle | Shona J Lee Renah J Apio Jennifer J Palmer Centering Patient Expectations of a Novel Home-Based Oral Drug Treatment among <i>T. b. rhodesiense</i> Human African Trypanosomiasis Patients in Uganda Tropical Medicine and Infectious Disease human africa trypanosomiasis fexinidazole home-based treatment patient-centred care uganda elimination |
| title | Centering Patient Expectations of a Novel Home-Based Oral Drug Treatment among <i>T. b. rhodesiense</i> Human African Trypanosomiasis Patients in Uganda |
| title_full | Centering Patient Expectations of a Novel Home-Based Oral Drug Treatment among <i>T. b. rhodesiense</i> Human African Trypanosomiasis Patients in Uganda |
| title_fullStr | Centering Patient Expectations of a Novel Home-Based Oral Drug Treatment among <i>T. b. rhodesiense</i> Human African Trypanosomiasis Patients in Uganda |
| title_full_unstemmed | Centering Patient Expectations of a Novel Home-Based Oral Drug Treatment among <i>T. b. rhodesiense</i> Human African Trypanosomiasis Patients in Uganda |
| title_short | Centering Patient Expectations of a Novel Home-Based Oral Drug Treatment among <i>T. b. rhodesiense</i> Human African Trypanosomiasis Patients in Uganda |
| title_sort | centering patient expectations of a novel home based oral drug treatment among i t b rhodesiense i human african trypanosomiasis patients in uganda |
| topic | human africa trypanosomiasis fexinidazole home-based treatment patient-centred care uganda elimination |
| url | https://www.mdpi.com/2414-6366/5/1/16 |
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