Responding to the Zika Epidemic: Preparation of a Neurodevelopmental Testing Protocol to Evaluate Young Children in Rural Guatemala

Amy K. Connery Children's Hospital Colorado, Aurora, Colorado;
Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, Colorado;

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Gretchen Berrios-Siervo Children's Hospital Colorado, Aurora, Colorado;
Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado;
Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado;

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Paola Arroyave Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala;

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Desiree Bauer Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala;

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Sara Hernandez Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala;

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Alejandra Paniagua-Avila Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala;

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Guillermo Antonio Bolaños Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala;

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Saskia Bunge-Montes Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala;
Center for Global Health and Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado;

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Hana M. El Sahly Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas;

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Mirella Calvimontes Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala;

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Daniel Olson Children's Hospital Colorado, Aurora, Colorado;
Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado;
Center for Global Health and Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado;

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Flor M. Munoz Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas;
Department of Pediatrics, Baylor College of Medicine, Houston, Texas

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Edwin J. Asturias Children's Hospital Colorado, Aurora, Colorado;
Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado;
Center for Global Health and Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado;

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The ongoing Zika virus (ZIKV) epidemic in Latin America presented a unique opportunity to develop a neurodevelopmental assessment protocol for children in a lower middle–income country. Although studies of neurodevelopment in young children have taken place in many diverse global settings, we are not aware of any study that has provided a high level of detail about how a measure was selected and then specifically translated and adapted in a low-resource setting. Here, we describe considerations in measurement selection and then the process of translation and adaptation to assess neurodevelopmental outcomes of infants and young children with postnatal exposure to ZIKV in rural Guatemala. We provide a framework to other research teams seeking to develop similar assessment models across the globe.

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Author Notes

Address correspondence to Amy K. Connery, Children’s Hospital Colorado, Aurora, CO 80045-7106. E-mail: amy.connery@childrenscolorado.org

Conflicts of Interest: E. A. reports grants from GlaxoSmithKline and Pfizer outside the submitted work.

Financial support: This work was supported by the National Institutes of Health (NIH), funding mechanism: VTEU Contract HHSN272201300015I, Task Order No. HHSN27200013-16-0057.C1D1.0058.

Authors’ addresses: Amy K. Connery, Children’s Hospital Colorado, Aurora, CO, and Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, E-mail: amy.connery@childrenscolorado.org. Gretchen Berrios-Siervo, Children’s Hospital Colorado, Aurora, CO, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, and Department of Neurology, University of Colorado School of Medicine, Aurora, CO, E-mail: gretchen.berrios-siervo@childrenscolorado.org. Paola Arroyave, Desiree Bauer, Sara Hernandez, Alejandra Paniagua-Avila, Guillermo Antonio Bolaños, and Mirella Calvimontes, Center for Human Development, Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala, E-mails: parroyave@ufm.edu, desibauerh@gmail.com, smhh93@gmail.com, alejandra.paniagua.fsigcu@gmail.com, guillermo.bolando.fsigcu@gmail.com, and mirellacalvimontes@yahoo.com. Saskia Bunge-Montes, Center for Human Development, Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala, Center for Global Health and Department of Epidemiology, Colorado School of Public Health, Aurora, CO, E-mail: saskia.bunge@gmail.com. Hana M. El Sahly, Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, E-mail: hana.elsahly@bcm.edu. Daniel Olson and Edwin J. Asturias, Children’s Hospital Colorado, Aurora, CO, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, Center for Global Health and Department of Epidemiology, Colorado School of Public Health, Aurora, CO, E-mails: daniel.olson@childrenscolorado.org and edwin.asturias@childrenscolorado.org. Flor M. Munoz, Department of Molecular Virology and Microbiology and Department of Pediatrics, Baylor College of Medicine, Houston, TX, E-mail: florm@bcm.edu.

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