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Article History

Received: 24 September 2025

Accepted: 5 December 2025

First Online: 13 December 2025

Declarations

:

: Ethical approval was obtained from the Institutional Health Research Ethics Review Committee (IHRERC) of the College of Health and Medical Sciences, Haramaya University, prior to data collection. The study was conducted in full compliance with the ethical guidelines set forth by the IHRERC. A formal permission letter was obtained from the IHRERC and submitted to HFCSH. The outpatient department director was formally notified, and the hospital reserved the right to discontinue the study in the event of any misconduct or ethical violations.Data extracted from medical records was anonymized to ensure confidentiality. Participants were informed of their right to decline or withdraw from the study at any stage without any repercussions.Voluntary, informed, written, and signed consent was also obtained from the parents or caregivers of all participating children. Confidentiality was strictly maintained by excluding names and personal identifiers from the data collection tools.This research adhered to the ethical principles outlined in the Declaration of Helsinki.

: Not applicable.

: The authors declare no competing interests.