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Authors
Namara, Benigna G.
Ssemanda, Innocent
Aceng, Freda Loy
Kiyimba, Anthony
Aanyu, Dorothy
Taremwa, Arnold
Lutwama, John Mary
Nawajje, Valeria Eugenia
Kwesiga, Benon
Bulage, Lilian
Migisha, Richard
Kadobera, Daniel
Ario, Alex Riolexus
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Funding
Funding for this research was provided by:
This investigation was supported by the President’s Emergency Plan for AIDS (PEPFAR) through the United States Centers for Disease Control and Prevention Cooperative Agreement (GH001353-01)
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Article History
Received: 5 October 2024
Accepted: 16 September 2025
First Online: 21 October 2025
Declarations
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: The authors declare no competing interests.
: The US Centers for Disease Control and Prevention (CDC) provided the non-research determination (NRD). In agreement with the International Guidelines for Ethical Review of Epidemiological Studies by the Council for International Organizations of Medical Sciences (1991) and the Office of the Associate Director for Science, US CDC/Uganda, it was determined that this activity was not human subject research and that its primary intent was public health practice or disease control activity (specifically, epidemic or endemic disease control activity). This activity was reviewed by the US CDC and was conducted consistent with applicable federal law and CDC policy. §§See, e.g., 45 C.F.R. part 46, 21 C.F.R. part 56; 42 U.S.C. §241(d); 5 U.S.C. §552a; 44 U.S.C. §3501 et seq. All experimental protocols were approved by the US CDC human subjects review board (The National Institute for Occupational Safety and Health Institutional Review Board) and the Uganda Ministry of Health and were performed in accordance with the Declaration of Helsinki. We obtained permission to conduct the investigation from the Mukono District health authorities and the school administration in whose custody all the students were. We obtained informed non-written consent from all the respondents aged ≥ 18 years. For those below 18, years we obtained informed non-written consent from the school administration and assent from the respondents. Non-written consent was deemed sufficient given that this investigation was in response to a public health emergency and not research, and written consent was impractical. Participants were assured that their participation was voluntary and were given all the necessary information to inform their decision to participate. They were assured that there would be no negative consequences for declining to participate in the investigation. Data collected did not contain any individual personal identifiers and information was stored in password-protected computers, which were inaccessible by anyone outside the investigation team.
