title: Respective influence of veterinarians and local institutional stakeholders on the event-driven surveillance system for bovine brucellosis in France.
abstract: BACKGROUND
  The event-driven surveillance system for bovine brucellosis implemented in France aims to ensure the early detection of cases of bovine brucellosis, a disease of which the country has been declared free since 2005. It consists of mandatory notification of bovine abortions by farmers and veterinarians. However, as underlined by a previous qualitative study, several factors influence the decision-making process of actors in the field. This process is particularly influenced by the level of cooperation between institutional stakeholders in their département (a French département being an administrative and territorial unit), veterinarians and farmers. In this context, the objectives of this study were 1) to quantify the respective influence of veterinarians and all local institutional stakeholders on the proportion of notifying farmers and identify which actors have most influence on farmers' decisions; 2) to analyse whether the influence of veterinarians is correlated with that of local institutional stakeholders.
  
  
  RESULTS
  In addition to factors relating to the farm itself (production type and herd size), the proportion of notifying farmers was influenced by the number of veterinarians per practice and the veterinary practice's membership of a technical association. This proportion was also influenced by unknown factors relating to the veterinary practice and, to a lesser extent, the département in which the farm was located. There was no correlation between variability in the proportion of notifying farmers among veterinary practices per département and the effect of the département itself.
  
  
  CONCLUSIONS
  To our knowledge, this is the first study to quantify the influence of veterinarians and local institutional stakeholders on the notification process for a mandatory disease. In addition to carrying out regulatory interventions, veterinarians play a major role in encouraging farmers to participate in the surveillance systems. The results of this study, combined with a previous qualitative study, shed light on the need to consolidate the involvement of veterinarians and local stakeholders in the organisation of surveillance by national institutional bodies.
authors.affiliation: ANSES-Lyon, Unité Epidémiologie, 31 avenue Tony Garnier, 69364, Lyon, Cedex 07, France. anne.bronner@anses.fr.
authors.forename: Anne
authors.initials: A
authors.lastname: Bronner
authors.affiliation: ANSES-Lyon, Unité Epidémiologie, 31 avenue Tony Garnier, 69364, Lyon, Cedex 07, France. eric.morignat@anses.fr.
authors.forename: Eric
authors.initials: E
authors.lastname: Morignat
authors.affiliation: ANSES-Lyon, Unité Epidémiologie, 31 avenue Tony Garnier, 69364, Lyon, Cedex 07, France. didier.calavas@anses.fr.
authors.forename: Didier
authors.initials: D
authors.lastname: Calavas
mesh_terms: D000034:Abortion, Veterinary / Q000453:epidemiology; D000818:Animals; D002007:Brucellosis, Bovine / Q000453:epidemiology*; D002417:Cattle; D018563:Disease Notification / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D019221:Mandatory Reporting; D008962:Models, Theoretical; D011159:Population Surveillance; D018634:Veterinarians