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Article History

Received: 11 January 2026

Accepted: 19 February 2026

First Online: 5 March 2026

Declarations

:

: This study adhered to the principles of the Declaration of Helsinki. The Institutional Review Board of Jimma University, Institute of Health, approved the research protocol and provided an ethical clearance letter (Reference No: JUIH/IRB/251/25 ). As the study was based on a retrospective review of medical records, the Institutional Review Board waived the need for consent to participate. Following protocol approval, the Department of Epidemiology issued an official letter of support and cooperation (Reference No: Epid/932/2025 ) to each of the selected study sites. Then, we obtained written permission from the facility's in-charge personnel at the selected study sites to access medical records. To ensure confidentiality of the data, medical record numbers were used instead of participant identifiers, such as names or unique ART numbers.

: Not applicable.

: The authors declare no competing interests.