Community-based surveillance models for avian influenza

PURPOSE: CARE Vietnam's CBS model trains community leaders and mobilizes volunteer networks to detect and respond to suspected cases of AI. The redesigned model builds on past success while addressing concerns identified in the evaluation of the initial model by targeting more appropriate venues and incorporating new techniques. METHODS: A joint evaluation of CARE's model and the Food and Agriculture Organization (FAO) model, which uses informants and rumor surveillance to improve passive surveillance, assesses the strengths and weaknesses of each to propose a more sustainable and scalable joint design. Two CARE intervention villages paired with two FAO sites and two non-intervention villages are examined to assess the impact of active surveillance, drills, community outreach and strengthened infrastructure on preventing, reporting, and detecting AI. The evaluation will inform model redesign incorporating technical and policy expertise from the Vietnam Ministry of Health and Ministry of Agriculture and Rural Development (MARD), civil society organizations, US government donors, and FAO. RESULTS: In a CARE intervention area, community members successfully identified, reported, and contained three outbreaks of confirmed H5N1in poultry. Preliminary findings indicate the intervention may improve timeliness of reports and local response. Volunteer networks for regular household visits may be difficult to sustain. Communities use the volunteer networks for other prevention activities, including collecting information on poultry populations and organizing vaccinations. POLICY RECOMMENDATIONS: Collaborative evaluation and redesign of AI and pandemic influenza detection and response models may yield more efficient, sustainable, and effective national and international AI programs. PARTNERS:CDC, FAO, CIRAD, Vietnam Ministry of Health, Vietnam MARD.