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Del Brutto, Jerome Engel Jr., and Hector H. Garc\u00eda declare that they have no conflict of interest.Dawn S. Eliashiv has received consultancy fees, honoraria payments, and payment for development of educational presentations from Cyberonics, Sunovion, and UCB.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}},{"value":"This study was partially supported by Universidad Esp\u00edritu Santo\u2014Ecuador, Guayaquil, Ecuador. H.H. Garcia is supported by a Wellcome Trust International Senior Fellowship in Public Health and Tropical Medicine.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"This article does not contain any studies with human or animal subjects performed by any of the authors.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and Animal Rights and Informed Consent"}}],"article-number":"1"}}