Methods to improve zoonotic disease surveillance in poor rural settings: the example of highly pathogenic avian influenza (A) H5N1 in Southeast Asia

The Highly Pathogenic Avian Influenza virus H5N1 is still present in some of the poorest areas of the world as South-east Asia where the disease occurred on a regular basis in human and poultry. Early detection of the disease in poultry population is the most efficient method to avoid the spread of the virus to human. In poor rural communities of developing countries, such as Cambodia, this disease detection is often based on volunteer case reporting by farmers. However this surveillance method carries challenges when applied in difficult socioeconomic environments: low density of health facilities, poor communication systems, weak awareness of population, distrust on governmental authorities and lack of qualified staff. We have in this thesis conceived and applied new methods for the evaluation, the design or the improvement of passive surveillance in order to propose innovative methods to increase the involvement of rural communities in the reporting of zoonotic diseases. (Résumé d'auteur