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Article History

Received: 11 December 2025

Accepted: 22 January 2026

First Online: 25 February 2026

Declarations

:

: The current study is a secondary analysis of the primary study [ ] that was was reviewed and approved by the University of The Gambia Research and Publication Committee and the Joint Gambia Government/Medical Research Council Ethics Committee on human subjects research (Ref #: R022 001). All participants provided written informed consent before participating in the study, which was conducted in accordance with the Declaration of Helsinki.

: Not applicable. This study used aggregated, publicly available population-level data with no individual participant information, images, or identifiable details.

: Not applicable.

: The authors declare no competing interests.