Challenges and lessons learned in a multicenter emerging neuroinfections study in Colombia: A pathfinder study

Background Multicenter research studies in low-and middle-income countries face complex operational, methodological, and logistical challenges that are rarely documented systematically. The Emerging Neuroinfections in the Americas Study (NEAS) is a 10-year multicenter research project in Colombia. The Pathfinder methodology was applied to map research processes, identify challenges, and generate transferable lessons from NEAS. Methods A multi-method design combining in parallel a systematic document analysis and key informant interviews was used. A process map was constructed to organize findings across the planning and execution phases of NEAS, covering data collection, biological sample management, and clinical follow-up. Qualitative evidence was analyzed thematically around three operational axes: clinical data management, handling and storage of biological samples, and participants follow-up. Results NEAS originated as a public health emergency response to the 2015–2016 Zika epidemic, subsequently transitioning into a fully structured study. The protocol underwent continuous adaptation, including incorporation of COVID19 pandemic procedures. Annual turnover of study physicians required structured boarding protocols. There were gaps in a formal data management plan. Sample loss risks were minimized by implementing standardized procedures (SOPs), physician verification and project manager-led quality control. International alliances were critical for sustainability. A stakeholder map was developed identifying stakeholders across a power–interest matrix. Conclusions Long-term multicenter research in Colombia is feasible but requires robust governance structures, flexible yet standardized protocols, sustained international partnerships, and systematic documentation practices. The lessons generated are transferable to other studies in Latin America and the Caribbean, contributing to the growing capacity to conduct research in response to global health emergencies.