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Article History

Received: 28 November 2025

Accepted: 7 April 2026

First Online: 20 April 2026

Declarations

:

: This study was approved by the University of Sussex Research Ethics Committee (approval no. ER/JP411/1) on August 1, 2014, and the University of Dar es Salaam (approval no. AB/3/(B) on 11 August 2014. All research procedures were conducted in accordance with the ethical guidelines and regulations of both committees, and all methods were performed in compliance with institutional requirements and recognised standards for research involving human participants, including protocols appropriate for Indigenous and community-based research. Informed consent to participate was obtained from all adult participants through culturally appropriate verbal procedures. For participants under 16, verbal consent was obtained from a parent or legal guardian in accordance with ethical guidelines and community protocols.

: Consent to publish, including the use of anonymised data and direct quotations, was obtained verbally from all adult participants. For participants under 18, verbal consent to publish was provided by a parent and/or legal guardian in accordance with ethical guidelines and community protocols.

: All participants were fully informed about the study’s purpose, procedures, potential risks, and benefits before taking part. Consent for participation, publication, and the use of anonymised data and direct quotations was obtained through culturally appropriate verbal procedures, with parental or guardian consent provided for minors in line with approved ethical guidelines for Indigenous research.

: The authors declare no competing interests.