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Article History

Received: 6 July 2025

Revised: 3 April 2026

Accepted: 12 April 2026

First Online: 30 April 2026

Declarations

:

: Ethical approval was granted by the Ethics Committee of the General Directorate of Health in Duhok, Kurdistan Region, Iraq (approval number: 2206202I-6–5, dated June 22, 2021), adhering to the Declaration of Helsinki. Study objectives were communicated to hospital administration to ensure institutional support. Participant confidentiality and anonymity were maintained throughout the study. Study details, including the voluntary nature of participation and the right to withdraw at any time without consequence, were explained clearly to caregivers and children to minimize potential power inequalities [ ]. Written informed consent was obtained from parents or legal guardians, and verbal assent was confirmed with each child before participation. Pseudonyms were used to protect participants’ identities in all study records and publications. Data were stored securely and will be archived 5 years according to institutional guidelines.

: The authors declare no competing interests.