Over the past several years, information technologies have been increasingly used in health applications in developing countries [1–5]. Here we report our experience integrating a number of information and communication technologies (ICTs) into clinical and epidemiological studies in Nicaragua. Since 2004, our team (from the Nicaraguan Ministry of Health, the Sustainable Sciences Institute, and the University of California, Berkeley) has established a pediatric dengue cohort study (PDCS) in Managua, Nicaragua. Currently in its third year, the PDCS follows 3,800 children aged two to twelve with the aim of characterizing the natural history of dengue transmission, obtaining biological samples for vaccine safety research, and establishing appropriate infrastructure for future dengue vaccine trials. The PDCS operations are based in a Health Center where cohort children receive all primary care and are screened for dengue. Cohort children are visited in their homes for collection of annual blood samples, convalescent follow-up of suspected dengue cases, and periodic surveys. All samples are processed, catalogued, and stored at the National Virology Reference Laboratory, where serological, virological, and molecular diagnosis of dengue is performed. Finally, the Sustainable Sciences Institute, a nonprofit organization, is in charge of the project administration, coordination, data analysis, and quality control (QC) informatics and assurance. Managua, the site of the study, represented both a great challenge and an opportunity. As in many other cities in the developing world, frequent interruptions in electrical, phone, and Internet service, high temperatures and humidity, and the absence of street names and house addresses were obvious obstacles to be overcome. Additional hurdles included a time-consuming and ineffective manual process for locating patient medical records at the Health Center, the absence of a formal QC plan for clinical information and biological samples, and a rudimentary organizational system in the laboratories. To overcome these challenges, we implemented a series of low-cost yet cutting-edge ICTs. The systems were initially developed to facilitate the annual sample collection and home visits, but have now been applied in an integrated manner to other aspects of the study as well as to numerous additional routine procedures in the Health Center and Virology Laboratory (Table 1). They have not only greatly aided fieldwork but have improved QC at all levels far beyond our initial objectives and expectations. Using readily available standardized hardware and software, our Nicaraguan informatics engineer programmed, designed, and supervised the implementation of a customized ICT system that includes geographic information systems (GIS) to map and easily locate study participants' homes, personal data assistants (PDAs) for paperless data entry and wireless data upload, barcode printing and scanning for tracking participant information and specimens, fingerprint scanning for facilitating patient identification and follow-up, low-cost communication systems (Skype, two-way radios), scanners for electronic backup of all documents, and computerized information systems with integrated databases for information management and control (Figure 1). Table 1 Advantages of ICTs to Facilitate GCP, GLP, and Fieldwork Figure 1 Integration of Information Technologies in Fieldwork, the Health Center, and the Virology Laboratory During two and a half years of operation, we found that the use of these technologies greatly streamlines information flow and accessibility, improves the quality of data and QC procedures, and reduces operational costs. As a result, we have witnessed the tremendous potential for using ICTs to bolster the public health infrastructure in resource-limited developing country settings. The integration of these ICTs for different applications (fieldwork, good clinical practice [GCP], good laboratory practice [GLP], quality control, and communication) is described below.