Community Surveillance for Avian Influenza in Vietnam

This briefing note from CARE International describes the potential role of community detection of avian influenza (AI) or bird flu, as well as other infectious diseases. It states that community detection can help build a more complete picture of the spread of disease, giving public health personnel and health facilities information to respond appropriately and trigger community preventative measures to help control the spread of disease to family and community.



The document cites the problem of early detection of contagious disease caused by the fact that health surveillance systems generally depend on the patient's arrival at a health facility. Existing barriers to health care prevent the reporting of "epidemic-prone infectious diseases such as polio, HIV, tuberculosis and avian influenza." The author suggests applying lessons learned from polio community surveillance to challenges such as AI. He recommends the community
surveillance kit developed by the Academy for Educational Development (AED) (click here for access to
this kit) as a potential tool for developing a community surveillance network.
It a methodology for developing a network of community volunteers who are trained and
supervised by a community surveillance coordinator serving as a connection between the community and the nearest health facility. The role of the community surveillance coordinator "is to orient communities to
the importance of surveillance, work with them to select volunteers,
support those volunteers, and bring volunteer-completed surveillance reports of targeted
diseases to the immediate attention of the closest health facility."



A possible pilot project for applying this model to AI is the Center for Disease Control (CDC)-funded CARE TRAIN Project, which is designed to enhance AI surveillance
capacity and behaviour change at the village, commune, and district level, and link to the national early warning and response system. In the context of Vietnam, the project is described as:
"A cadre of village
group leaders will serve as community AI surveillance volunteers. They will receive focused training
sessions on how to conduct ongoing house-to-house AI surveillance and reporting from
CARE-trained community representatives, village health workers (VHWs), and animal
health workers (AHWs). This village-based group of AI volunteers will then have the
capacity to extend the role of VHWs and AHWs, who cannot themselves conduct house-to-house AI surveillance for the 100-300 households they oversee. The VHWs and
AHWs, in turn, will serve as the primary community surveillance supervisors for the
village group leader."


CARE has created training materials for community supervisors and reporting tools for the monitoring effort. Plans exist for a village level simulation to test and assess the materials and training.


The author suggests that this strategy could be extended by including different community groups from outside of the health sector, including schools, women’s organisations, youth groups, farmers’ clubs, and church groups. The health education work of schools coupled with surveillance training, as stated here, could add sustainability to the surveillance network. The surveillance system might aid in detection of other infectious diseases, might have potential for rapid mobilisation in the event of an epidemic, and might provide monitoring of good health practices at a local level, as well as providing a base for health promotion in immunisation campaigns, family planning, and malnutrition detection.