title: The Nicaraguan pediatric influenza cohort study: design, methods, use of technology, and compliance.
abstract: BACKGROUND
  Influenza causes substantial morbidity and mortality worldwide, yet few data exist on influenza infection rates in tropical, developing countries. In 2011, we established the Nicaraguan Pediatric Influenza Cohort Study (NPICS) to study the burden and seasonality of influenza in Nicaraguan children. Here we describe the study design, methods, and participation data of the NPICS for 2011-2013.
  
  
  METHODS
  A total of 1532 children aged 0 to 12 years were enrolled into the study in 2011, and an additional 401 children were enrolled between 2012 and 2013. Children were provided with all of their medical care through the study, and data on medical visits were recorded systematically. A number of surveys were conducted together with a blood sample annually, including a height and weight measurement, a socio-economic status and risk factor survey, and a breastfeeding survey.
  
  
  CONCLUSIONS
  Unique features of our study include the customized low-cost, open-source informatics system as well as the development of methods to leverage infrastructure and resources by conducting multiple studies in the same setting while maximizing protocol adherence and quality control. These methods should be useful to others conducting large cohort studies, particularly in low-resource settings.
authors.affiliation: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA. gordonal@umich.edu.
authors.forename: Aubree
authors.initials: A
authors.lastname: Gordon
authors.affiliation: Sócrates Flores Vivas Health Center, Ministry of Health, Managua, Nicaragua. @icsnicaragua.org.
authors.forename: Guillermina
authors.initials: G
authors.lastname: Kuan
authors.affiliation: Sustainable Sciences Institute, Managua, Nicaragua. waviles@icsnicaragua.org.
authors.forename: William
authors.initials: W
authors.lastname: Aviles
authors.affiliation: Sustainable Sciences Institute, Managua, Nicaragua. @icsnicaragua.org.
authors.forename: Nery
authors.initials: N
authors.lastname: Sanchez
authors.affiliation: Sustainable Sciences Institute, Managua, Nicaragua. @icsnicaragua.org.
authors.forename: Sergio
authors.initials: S
authors.lastname: Ojeda
authors.affiliation: Sustainable Sciences Institute, Managua, Nicaragua. @icsnicaragua.org.
authors.forename: Brenda
authors.initials: B
authors.lastname: Lopez
authors.affiliation: Sustainable Sciences Institute, Managua, Nicaragua. @icsnicaragua.org.
authors.forename: Lionel
authors.initials: L
authors.lastname: Gresh
authors.affiliation: Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua. abalmaseda@minsa.gob.ni.
authors.forename: Angel
authors.initials: A
authors.lastname: Balmaseda
authors.affiliation: Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, CA, USA. eharris@berkeley.edu.
authors.forename: Eva
authors.initials: E
authors.lastname: Harris
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D019295:Computational Biology / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009980:Influenza A virus / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity; D007251:Influenza, Human / Q000453:epidemiology* / Q000821:virology; D008297:Male; D009527:Nicaragua / Q000453:epidemiology