This PhD thesis aimed at evaluating the contribution of participatory epidemiology (PE) to improve the foot-and-mouth disease (FMD) surveillance and control activities, especially the involvement of farmers at local level. The first objective aimed at assessing the effectiveness of the FMD surveillance and vaccination strategy at local level by using PE approach. The second objective aimed at assessing the feasibility of applying PE tools to improve the involvement of farmers in the FMD surveillance in Vietnam. PE methods performed in our study included informal interviews (focus group and individual), scoring tools (pairwise ranking, proportional pilling, disease impact matrix scoring and disease signs matrix scoring), visualization tools (mapping, timeline, flow chart) and sociological tools called Q methodology. 122 focus groups, 467 individual interviews, 339 questionnaire surveys were performed during two field studies in 2014 and 2015. 409 sera and 152 probang samples were taken. Conventional questionnaire surveys, Bayesian modelling and laboratory test (ELISA and rtRT-PCR) was used to validate the performance of PE in FMD surveillance. Disease was considered as the most important issues in animal production. FMD was the most important disease for dairy cattle production, followed by haemorrhagic septicaemia. For beef cattle production, it was recorded in reverse order. The most important disease for pig production was porcine reproductive and respiratory syndrome while FMD was ranked fourth. Farmers showed their abilities in differential diagnostic of important diseases based on its clinical symptoms. Sero-prevalence of FMD were estimated at 23% for population 1 (bordering with Cambodia) and 31% for population 2 (locating far from the border), respectively. Sensitivity and Specificity of PE were found to be 59% and 81%, respectively. The positive and negative predictive value were found to be 48% and 86% for population 1 and 58% and 81% for population 2, respectively. The presence of serotype A, lineage A/Asia/Sea-97 and serotype O with two separate lineages, O/ME-SA/PanAsia and O/SEA/Mya-98 supported virus circulation through trans-boundary animal movement activities. Dairy farms frequently applied quarantine, disinfection and vaccination as prevention methods. Beef farms preferred cleanliness and good husbandry management practices. Pig farms considered that all prevention methods had the same importance. Three distinct discourses “Believe”, “Confidence”, “Challenge”, representing common perceptions among farmers and accounting for 57.3 % of the variance, were identified based on Q methodology. Farmers take vaccination decisions themselves without being influenced by other stakeholders and feel more secure after FMD vaccination campaigns. However, part of the studied population did not consider vaccination to be the first choice of prevention strategy. The benefitcost ratio of FMD vaccination for dairy cow production in large-scale and in small-scale and meat cattle production were 37.2, 30.0 and 7.3, respectively. The sensibility analysis showed that FMD vaccination was profitable for all of production types even through the increase of vaccine cost and decrease of market price of milk and slaughter cattle. From the focus groups organized at sentinel villages, 18 new villages were identified as potentially infected by FMD. 77 suspected animals were confirmed positive for FMD, with viral serotypes O and A. Sensitivity and specificity of participatory surveillance were recorded at 0.75 and 0.65, respectively. The effectiveness of PE in FMD surveillance system to detect outbreak in Vietnam was demonstrated. It was demonstrated that vaccination was the most effective and economic method to prevent FMD. Through the application of simple, adaptive tools which facilitate direct and active participation of farmers, PE allowed to reach a better acceptability of surveillance and to obtain qualified information.

Cette thèse porte sur l’analyse des apports des approches participatives épidémiologiques (PE) dans l’amélioration de la surveillance de la fièvre aphteuse (FA), en particulier dans l’implication des éleveurs à l’échelle locale. Le premier objectif était d’évaluer l’efficacité de la surveillance et de la vaccination contre la FA à l’échelle locale en utilisant PE. Le deuxième objectif était d’évaluer la faisabilité d’application des outils de PE pour améliorer l’implication des éleveurs dans la surveillance de la FA au Vietnam. Les méthodes de PE ont compris des entretiens informelles (en groupes ou individuels), des outils de notation (classement par paires, empilement proportionnel, matrice de notation), des outils de visualisation (cartographie, lignes de temps, diagramme d’écoulement) et d’outil sociologique appelée méthode Q. 122 entretiens en groupe, 467 entretiens individuels, 339 questionnaires ont été effectuées en 2014 et 2015. 409 sérums et 152 fluides d’oesophagiens ont été prélevées. Les enquêtes par questionnaire, les tests d’ELISA et de rtRT-PCR et la modélisation de Bayésienne ont été utilisées pour valider la performance de PE dans la surveillance de la FA. La maladie a été considérée comme la problème la plus importante dans la production animale. La FA était la maladie la plus importante pour la production laitière, suivie par la septicémie hémorragique. Pour la production de bovin de viande, elle a été enregistrée dans l'ordre inverse. La maladie la plus importante pour la production porcine était le syndrome reproducteur et respiratoire porcin tandis que la FA était classé en quatrième. Les agriculteurs ont des capacités de diagnostic différentiel des maladies en fonction des symptômes cliniques. La prévalence sérique de la FA a été estimée à 23% pour la population 1 (proche la frontière du Cambodge) et 31% pour la population 2 (loin de la frontière du Cambodge), respectivement. La sensibilité et la spécificité de PE a été estimée à 59% et 81%, respectivement. La valeur prédictive positive et négative a été estimée à 48% et 86% pour la population 1 et 58% et 81% pour la population 2, respectivement. La présence du sérotype A, de la lignée A/Asia/Sea-97 et du sérotype O, lignées O/ME-SA/PanAsia et O/SEA/Mya-98 a soutenu la circulation du virus par des mouvements transfrontalières des animaux. Les fermes laitières ont appliquées la quarantaine, la désinfection et la vaccination comme méthodes de prévention. Les fermes de bovin de viande ont préférées la propreté et les bonnes pratiques de gestion de l'élevage. Les fermes porcines ont considérées que toutes les méthodes de prévention avaient la même importance. Trois discours «Croire», «Confiance», «Défi», représentés les perceptions communes des éleveurs et représentés 57,3% de la variance, ont été identifiés en utilisant méthode Q. Les éleveurs ont pris eux-mêmes les décisions de vaccination et se sont sentis plus en sécurité après la vaccination contre la FA. Cependant, une partie de la population étudiée n'a pas considérée la vaccination comme le premier choix de prévention. L'analyse de sensibilité de rapport de bénéfice-coût de la vaccination de la FA a montré que la vaccination était rentable pour tous les types de production, même si l'augmentation du coût de la vaccination et la diminution du prix de lait et de viande. 18 nouveaux villages sentinelles ont été identifiés comme potentiellement infectés par la FA. 77 animaux soupçonnés ont été confirmés positives avec la FA. La sensibilité et la spécificité de PE a été estimée à 0,75 et 0,65 respectivement. L'efficacité de PE pour détecter une épidémie de FA au Vietnam ont été démontrée. La vaccination a était montré la méthode la plus économique et la plus efficace pour prévenir la FA. Grâce à l'application des outils simples et adaptables qui facilitent la participation directe et active des éleveurs, PE permet d'obtenir une meilleure acceptabilité de la surveillance et des informations qualifiées. / This PhD thesis aimed at evaluating the contribution of participatory epidemiology (PE) to improve the foot-and-mouth disease (FMD) surveillance and control activities, especially the involvement of farmers at local level. The first objective aimed at assessing the effectiveness of the FMD surveillance and vaccination strategy at local level by using PE approach. The second objective aimed at assessing the feasibility of applying PE tools to improve the involvement of farmers in the FMD surveillance in Vietnam. PE methods performed in our study included informal interviews (focus group and individual), scoring tools (pairwise ranking, proportional pilling, disease impact matrix scoring and disease signs matrix scoring), visualization tools (mapping, timeline, flow chart) and sociological tools called Q methodology. 122 focus groups, 467 individual interviews, 339 questionnaire surveys were performed during two field studies in 2014 and 2015. 409 sera and 152 probang samples were taken. Conventional questionnaire surveys, Bayesian modelling and laboratory test (ELISA and rtRT-PCR) was used to validate the performance of PE in FMD surveillance. Disease was considered as the most important issues in animal production. FMD was the most important disease for dairy cattle production, followed by haemorrhagic septicaemia. For beef cattle production, it was recorded in reverse order. The most important disease for pig production was porcine reproductive and respiratory syndrome while FMD was ranked fourth. Farmers showed their abilities in differential diagnostic of important diseases based on its clinical symptoms. Sero-prevalence of FMD were estimated at 23% for population 1 (bordering with Cambodia) and 31% for population 2 (locating far from the border), respectively. Sensitivity and Specificity of PE were found to be 59% and 81%, respectively. The positive and negative predictive value were found to be 48% and 86% for population 1 and 58% and 81% for population 2, respectively. The presence of serotype A, lineage A/Asia/Sea-97 and serotype O with two separate lineages, O/ME-SA/PanAsia and O/SEA/Mya-98 supported virus circulation through trans-boundary animal movement activities. Dairy farms frequently applied quarantine, disinfection and vaccination as prevention methods. Beef farms preferred cleanliness and good husbandry management practices. Pig farms considered that all prevention methods had the same importance. Three distinct discourses “Believe”, “Confidence”, “Challenge”, representing common perceptions among farmers and accounting for 57.3 % of the variance, were identified based on Q methodology. Farmers take vaccination decisions themselves without being influenced by other stakeholders and feel more secure after FMD vaccination campaigns. However, part of the studied population did not consider vaccination to be the first choice of prevention strategy. The benefitcost ratio of FMD vaccination for dairy cow production in large-scale and in small-scale and meat cattle production were 37.2, 30.0 and 7.3, respectively. The sensibility analysis showed that FMD vaccination was profitable for all of production types even through the increase of vaccine cost and decrease of market price of milk and slaughter cattle. From the focus groups organized at sentinel villages, 18 new villages were identified as potentially infected by FMD. 77 suspected animals were confirmed positive for FMD, with viral serotypes O and A. Sensitivity and specificity of participatory surveillance were recorded at 0.75 and 0.65, respectively. The effectiveness of PE in FMD surveillance system to detect outbreak in Vietnam was demonstrated. It was demonstrated that vaccination was the most effective and economic method to prevent FMD. Through the application of simple, adaptive tools which facilitate direct and active participation of farmers, PE allowed to reach a better acceptability of surveillance and to obtain qualified information.