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Article History

Received: 25 June 2024

Accepted: 21 May 2025

First Online: 1 July 2025

Declarations

:

: The Muhimbili University of Health and Allied Sciences (MUHAS) Institutional Review Board (IRB) granted ethical approval for this study, with the reference number DA.282/298/01. The Management and Development for Health (MDH) provided permission to access the necessary data. Given the retrospective observational nature of the study and the anonymization of medical records, the MUHAS-IRB waived the requirement for individual patient informed consent. This decision was based on two factors: firstly, the study utilized anonymized, routinely collected secondary data from CTCs, eliminating the need for direct interaction with participants. Secondly, all data were extracted from the CTC database, ensuring that the authors involved in this study had no physical contact with participants or access to identifiable information during or after the data analysis process. The study was conducted in accordance with the ethical principles of the Declaration of Helsinki, and all procedures involving human data adhered to these guidelines [].

: Not applicable.

: I have read the journal's policy, and the author of this manuscript has the following competing interests. Prof. Emmanuel Balandya, a coauthor of this publication, held the position of Director of Research and Publication on the Institutional Review Board (IRB) at Muhimbili University of Health and Allied Sciences. Although Prof. Emmanuel Balandya did not take part in the review or approval process for the study mentioned in this manuscript and abstained from any discussions or decisions regarding it, his role as the acting director of research and publication at the university required him to sign the ultimate ethical approval document. This potential conflict of interest is disclosed to guarantee transparency in the study process. All other remaining authors declare no conflicts of interest.