Rodgers, Kathryn M.
Fimbres, Jocelyn
Velázquez, Juan José Amador
Jarquin, Emmanuel
García-Trabanino, Ramón
Lopez-Pilarte, Damaris
Keogh, Sinead
Petropoulos, Zoe
Reynolds, Morgan
Kannan, Kurunthachalam
Friedman, David J.
Brooks, Daniel R.
Leibler, Jessica H.
Scammell, Madeleine K.
Article History
Received: 24 October 2025
Revised: 21 April 2026
Accepted: 23 April 2026
First Online: 2 June 2026
Competing interests
: The authors declare no competing interests.
: The MANOS study protocol was approved by the Boston University Medical Campus Institutional Review Board, the Salvadoran National Ethics Committee for Health Research (Comité Nacional de Ética de las Investigaciones en Salud), and the Nicaraguan Ministry of Health National Ethics Committee (Comité Institutional de Revisión Etica) and Office of Teaching and Research (Dirección General de Docencia e Investigaciones). All methods were performed in accordance with the relevant guidelines and regulations. Informed consent was obtained from all participants.