Fig. 3

a: Political map showing municipalities in the Department of Quetzaltenango. Quetzaltenango, the capital and the location of the regional hospital and its nine surrounding rural municipalities of Almolonga (15), Cantel (16), Concepción Chiquirichapa (19), La Esperanza (11), Olintepeque (12), Salcajá (13), San Juán Ostuncalco (8), San Mateo (9) and Zunil (17) are the locations of the health utilization survey. Disease surveillance was conducted at the Western Regional Hospital capturing hospitalized cases from across the department of Quetzaltenango, and in four surrounding ambulatory facilities, namely the health centers in Cantel, Concepcion Chiquirichapa, La Esperanza, and Xecam. b: Health Centers in Concepcion Chiqurichapa, La Esperanza, Cantel and Xecam and Hospital Regional de Occidente where disease surveillance was conducted in Quetzaltenango Department