Document Type


Publication Date



Epidemiologic surveillance, Community participation, Influenza, Guatemala



Early detection of emergent influenza strains is a global health priority. However, maintaining active surveillance is economically and logistically challenging. While community-based surveillance is an attractive alternative, design and operation of an effective epidemiological surveillance program requires community engagement that can be linked to public health reporting and response. We report the results of a study in rural Guatemalan communities aimed at identifying opportunities for and barriers to community engagement in disease surveillance.


Using an ethnographic approach followed by a descriptive cross-sectional survey, we documented local terms and ideas about animal illnesses, including the possibility of animal-human transmission.


The community perceived disease causation principally in terms of changes in the physical environment and weather and categorized illnesses using local terminology based on observable clinical signs. Knowledge about prevention and treatment was derived predominantly from local networks of family and friends without evidence of professionally-based knowledge being regularly introduced into the community.


Bridging the divide between professional and community-based descriptive disease terminology, incorporating animal and human health responsiveness to common illnesses, and providing professional knowledge into the community-based networks were identified as addressable challenges to effective implementation of community-based surveillance.


Original publication available at

Publication Statement

Copyright held by the author. User is responsible for all copyright compliance.

Copyright Statement / License for Reuse

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.