Participatory Epidemiology: Principles, Practice, Utility, and Lessons Learnt

Abstract

Participatory epidemiology (PE) evolved as a branch of veterinary epidemiology and has been largely employed for the control and early warning of infectious diseases within resource-limited settings. It was originally based on combining practitioner communication skills with participatory methods to facilitate the involvement of animal caretakers and owners (embracing their knowledge, experience, and motivations) in the identification and assessment of animal disease problems, including in the design, implementation, monitoring and evaluation of disease control programs, policies, and strategies. With the importance of understanding social perceptions and drivers receiving increasing recognition by epidemiologists, PE tools are being adapted for an increasingly wide range of settings and endeavors. More recently, PE tools have been adapted for use in food and nutrition security programs, One Health activities, wildlife disease surveillance and as part of mixed-methods research across a range of socio-economic settings. This review describes the evolution of PE (in relation to veterinary epidemiology and briefly in relation to public health epidemiology), the underpinning philosophy and principles essential to its effective application and the importance of gender-sensitive approaches and data triangulation, including conventional confirmatory testing. The article also provides illustrative examples highlighting the diversity of approaches and applications of PE, hallmarks of successful PE initiatives and the lessons we can learn when these are missing. Finally, we look forward, describing the particular utility of PE for dealing with emerging infectious diseases, gaining attention of field-level cross-sector officials who can escalate concerns to a higher level and for continuing to raise the voices of those less-heard (such as women, minority groups, and remote communities with limited exposure to formal education) in defining the problems and planning activities that will likely impact directly on their well-being and livelihoods.

Antimicrobial Use in Animals in Timor-Leste Based on Veterinary Antimicrobial Imports between 2016 and 2019

“…The use of veterinary antimicrobials in Timor-Leste was even lower than countries such as New Zealand, Norway, and Iceland which are known to have some of the lowest use levels in the world [ 45 , 46 ]. The low level of use is likely due to the subsistence agriculture system in Timor-Leste [ 33 , 47 ] where there is poor access to veterinary services and medicines. The low level of use is also consistent with another study in Timor-Leste which showed that only 1% of backyard chicken farmers used commercial medicines in their animals [ 48 ].…”

Beyond Numbers: Determining the Socioeconomic and Livelihood Impacts of African Swine Fever and Its Control in the Philippines

“…Participatory activities included community timelines, seasonal calendars, and collection of epidemiological information through proportional piling, ranking, tabulation and open discussion. Participatory epidemiological methods policies ( 17 , 18 ) are more sensitive than surveys for capturing local, contextual information and hold great utility for rapid assessments of disease impact in the field. To understand the vulnerability context of the community, seasonal calendars were developed to study disease and risk factors, population structures, disease features, biosecurity, disease timeline—historical data, disease impacts, strategies employed, plans for the future, indicative farm budget information, and responses to disease at community level.…”

Biosecurity in Village and Other Free-Range Poultry—Trying to Square the Circle?

“…It should also not be assumed, that disease is the most pressing problem and a more holistic, participatory and gender-sensitive approach to poultry production appears warranted. To appropriately tailor biosecurity and husbandry interventions to local conditions, it is essential that the various members (i.e., men, women and those of differing socio-economic and language groupings) of communities and households knowledgeable about poultry production be involved from the outset ( 26 ).…”