Table 3 Key sign/symptom categories with example participant quotes

Feverish (n = 48)

“Participant (adult): And after a while of…of having the chills, I got hit with a…a fever, a really high fever.” (chills/fever; 31 years old female from Iquitos, Peru)

“Participant (caregiver): I would feel him and he would be really hot, with a fever.” (feeling warmer/hotter/fever; caregiver of a 4 year old male from Iquitos, Peru)

Gastrointestinal (n = 46)

“Participant (adolescent): I was disgusted, I didn´t want to eat, even just seeing it I felt disgusted.” (loss of appetite; 13 year old male from Iquitos, Peru)

“Participant (caregiver): My son told me that his stomach hurt.” (tummy pain; caregiver of a 4 year old male from Iquitos, Peru)

Pain (n = 45)

“Participant (child): I felt like my head was going to explode right then.” (headache; 12 year old female from Machala, Ecuador)

“Participant (caregiver): The pain—the body aches, yes, there were moments. There were a few moments he’d lay down, feel better, that is. He could move, walk. Then it would flare up again.” (body pain; caregiver of a 4 year old male from Iquitos, Peru)

Fatigue (n = 45)

“Participant (adult): I could do things, but very slowly, it was difficult for me, because I was very tired” (feeling tired; 21 year old male from Machala, Ecuador)

“Participant (adolescent): I felt weak- I didn’t have any strength.” (weak body; 16 year old female from Iquitos, Peru)

Skin (n = 38)

“Participant (adult): I had a rash over my whole body, my whole body was completely red, red and swollen.” (rash; 27 year old female from Iquitos, Peru)

“Participant (adolescent): When I wanted to sleep, that’s when I started to feel itchy. Then I moved my leg and the itchiness started to get worse and worse…” (itch; 13 year old male from Iquitos, Peru)

Eye/vision (n = 37)

“Participant (adult): I would feel the pressure here in this area of the eyebrows. I would bend over and I would feel a pressure coming down.” (eye pain; 23 year old female from Iquitos, Peru)

“Participant (adolescent): They were turning red like vampire.” (red eyes; 15 year old male from Iquitos, Peru)

Mouth/nose/throat (n = 37)

“Participant (adolescent): I couldn’t eat. I had a sour taste in my mouth.” (bad taste; 15 year old female from Iquitos, Peru)

“Participant (caregiver): Her throat was sore. She could eat, she would eat, and she would put her hand on where she was sore.” (sore throat; caregiver of a 5 year old female from Iquitos, Peru)

Neurological (n = 26)

“Participant (adult): Dizzy, yes … you feel like you´re drunk, like I was about to fall over.” (dizziness; 38 year old female from Iquitos, Peru)

“Participant (child): I ju… just felt dizzy when I walked.” (dizziness; 9 year old male from Machala, Ecuador)

Bleeding (n = 10)

“Participant (caregiver): [he] did start bleeding and started spitting blood.” (bleeding; caregiver of a 9 year old male from Iquitos, Peru)

“Interviewer: Did you have bruises at any point?

Participant (adolescent): I had some spots on my arms … Brown.” (bruising; 16 year old female from Iquitos, Peru)