# Household-Level Vector-Borne Disease Prevention Practices and Healthcare Access Barriers in Rural Alta Verapaz, Guatemala: A Cross-Sectional Study

## TL;DR

The study explores how Indigenous Maya households in rural Guatemala prevent vector-borne diseases and face healthcare access barriers.

## Contribution

It introduces rapid household surveys in mobile clinics as a tool for local disease prevention planning.

## Key findings

- Most households covered water containers, but mosquito net use was low.
- Over half of households reported no preventive actions against vector-borne diseases.
- Distance, cost, and transportation were the top barriers to healthcare access.

## Abstract

Introduction

Vector-borne diseases (VBDs) remain endemic in Guatemala, including in Indigenous communities where access to preventive and healthcare resources may be limited. This cross-sectional study aimed to estimate the prevalence of household-level VBD prevention practices, transmission knowledge, healthcare access barriers, and self-reported syndromic illness among Indigenous Maya households in Alta Verapaz, Guatemala.

Methods

A cross-sectional household survey was conducted over five days in July 2025 across four mobile outreach clinic sites in Alta Verapaz. One adult representative per household (N = 111) completed a structured questionnaire assessing VBD prevention behaviors, transmission knowledge, healthcare access barriers, housing characteristics, and recent household febrile illness. Descriptive analyses were performed using R statistical software (R Foundation for Statistical Computing, Vienna, Austria).

Results

Preventive practices varied across clinic sites. A total of 91 (82.0%) households reported covering water containers, and mosquito net use ranged from eight (22.2%) to 19 (54.3%) households, depending on the clinic site. Additionally, 64 (57.7%) households reported taking no preventive action. Knowledge related to VBD transmission was generally low and varied across clinic sites. The most frequently reported barriers to healthcare access were distance to care for 56 (50.5%), lack of money for 41 (36.9%), and transportation barriers for 20 (18.0%) households. Recent household febrile illness with rash and joint pain was reported by 43 (38.7%) households; however, these findings were not laboratory confirmed.

Conclusions

This descriptive assessment identified variation in prevention practices and healthcare access barriers among Indigenous Maya households in Alta Verapaz. Rapid household surveys integrated into mobile outreach clinics may provide locally relevant information to support context-specific prevention planning.