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Authors
Fawkes, Leanne S.
Adamu, Yau
Gimeno Ruiz de Porras, David
Pearce, Neil
Caplin, Ben
González-Quiroz, Marvin https://orcid.org/0000-0002-0093-6357
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Funding
Funding for this research was provided by:
UK Colt Foundation (CF/02/18)
UK Medical Research Council (MR/V033743/1)
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Article History
Received: 30 April 2026
Accepted: 17 July 2026
First Online: 28 July 2026
Declarations
Competing interests: The authors declare no competing interests.
Ethical approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics committee of Universidad Nacional Autónoma de Nicaragua, León (Acta No.116, Año 2014; Acta No.71, Año 2018), the London School of Hygiene and Tropical Medicine (Ref: 8643) and University College London (Ref: 14,175) approved the study protocol. For this study, de-identified samples were used, and the University of Texas Health Science Center at San Antonio Institutional Review Board approved the study.
Consent to participate: All cohort participants provided written informed consent for their participation in the study.
