title: Control of highly pathogenic avian influenza in Quang Tri province, Vietnam: voices from the human-animal interface.
abstract: BACKGROUND
  Highly pathogenic avian influenza (HPAI) is caused by the haemagglutinin 5, neuraminidase 1 (H5N1) influenza A virus. Around 80% of households in rural Vietnam raise poultry, which provides food security and nutrition to their households and beyond. Of these, around 15-20% are semi-commercial producers, producing at least 28% of the country's chicken. Through learning the experiences of these semi-commercial farmers, this study aimed to explore the local understandings and sociocultural aspects of HPAI's impact, particularly the aetiology, diagnosis, and the prevention and control methods in one Vietnamese rural province.
  
  
  METHODS
  This study was conducted in Quang Tri province, Vietnam. Quang Tri province has eight districts. Five of these districts were at high risk of HPAI during the study period, of which three were selected for the present study. Within these three districts, six communes were randomly selected for the study from the list of intervention communes in Quang Tri province. Six out of the 26 intervention communes in Quang Tri were therefore selected. Participants were randomly selected and recruited from lists of semi-commercial farmers, village animal health workers, village human health workers and local authorities so that the study population (representative population) included an amount of variability similar to that of the wider population.
  
  
  RESULTS
  A key benefit of this village-level control program was the residential proximity of animal and human health professionals. Participants were well aware of the typical clinical signs for avian influenza and of the reporting process for suspect cases. However there was extensive room for improvement in Quang Tri province regarding access to the HPAI vaccine, essential medical equipment for animal use, and available financial support.
  
  
  CONCLUSIONS
  This qualitative research study provided an important insight for in-country policy makers and international stakeholders. It is vital that there are continued efforts to prevent and control highly pathogenic avian influenza through support programs that provide locally appropriate information and resources to those at the human-animal interface.
authors.affiliation: University of Sydney, Sydney, New South Wales, Australia. penny.farrell@sydney.edu.au.
authors.forename: Penny C
authors.initials: PC
authors.lastname: Farrell
authors.affiliation: University of Sydney, Sydney, New South Wales, Australia. cynthia.hunter@sydney.edu.au.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Hunter
authors.affiliation: USAID's Avian and Pandemic Influenza Initiative, Hanoi, Vietnam. bvtruong1973@gmail.com.
authors.forename: Bui
authors.initials: B
authors.lastname: Truong
authors.affiliation: Abt Associates, USAID's Avian and Pandemic Influenza Initiative, Hanoi, Vietnam. michelbunning@gmail.com.
authors.forename: Michel
authors.initials: M
authors.lastname: Bunning
mesh_terms: D000822:Animal Husbandry; D000818:Animals; D001717:Birds; D003140:Communicable Disease Control / Q000379:methods*; D003150:Community Health Workers; D004196:Disease Outbreaks / Q000517:prevention & control / Q000662:veterinary; D000067565:Farmers / Q000523:psychology* / Q000706:statistics & numerical data; D019981:Health Care Sector; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D053124:Influenza A Virus, H5N1 Subtype / Q000302:isolation & purification*; D005585:Influenza in Birds / Q000517:prevention & control* / Q000635:transmission; D007251:Influenza, Human / Q000517:prevention & control* / Q000635:transmission; D007373:Interinstitutional Relations; D011050:Policy Making; D011200:Poultry / Q000821:virology; D016730:Program Development; D015397:Program Evaluation; D036301:Qualitative Research; D019035:Rural Health Services; D014744:Vietnam; D000078329:Workforce
keywords: Asia; Environmental Health; Epidemiology; Infectious Disease; Public Health; Qualitative Research; Sociology; Traditional Healers