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Article History

Received: 29 May 2024

Accepted: 2 August 2025

First Online: 26 September 2025

Declarations

:

: A permission letter was secured from the South Gondar Zone health department. The study was submitted and approved by the South Gondar Zone Health Department ethical review committee with an issue number and date as SGZ/14/435/15, 12/04/2015. A support letter was written by the zone health department to the respected study area. The purposes and the importance of the study were explained to participants. Written informed consent was obtained from all the participants and from the parent or guardian for those under 16 years old and for illiterate participants. Confidentiality was assured at all levels of the study using a password-protected computer. The identification of each participant was deleted, and numerical coding was used. Furthermore, all information obtained from the respondents was kept confidential. The data was not provided to a third party without the participant’s permission. This study does not harm and injured all study participants. Participants were fully autonomous for their participation. Conflicts of interest were disclosed. Force or pressure for participation was avoided. Independent health professionals were assigned to protect the life, privacy, and dignity of the participants. All vulnerable groups and individuals specifically received protection.

: Written informed consent for publication of identifying images or other personal or clinical details was obtained from all the participants and from parents or legal guardians of any participant under the age of 18.

: The authors declare no competing interests.