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Location of the study villages in Costa Rica: (1) Atenas (Province of Alajuela), (2) la Guácima (Province of Alajuela), (3) San Rafael (Province of Alajuela), (4) San Rafael (Province of Heredia), (5) Getsemani (Province of Heredia), (6) San Gabriel de Aserri (Province of San Jose) and (7) Vuelta de Jorco (Province of San Jose) in the Central Valley and (8) Esparza (Province of Puntarenas) on the western part of the country, 80 km from the capital, San José
