Acknowledgments
The authors thank the staff of the Regiones Sanitarias III and IX of the Ministry of Health of Paraguay.
Financial & competing interests disclosure
This study was supported by the United Nations Development Program/World Bank/World Health Organization Special Program for Research and Training in Tropical Diseases and the Universidad Nacional de Asunción. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.