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Article History

Received: 11 April 2025

Accepted: 8 January 2026

First Online: 19 January 2026

Declarations

:

: AFRICOS was approved by institutional review boards of the Walter Reed Army Institute of Research, Makerere University School of Public Health, Kenya Medical Research Institute, Tanzania National Institute of Medical Research, Nigerian Ministry of Defense, and all collaborating institutions. All adult participants provided written informed consent prior to any study procedures. For participants aged 15–17 years, mature and emancipated minors were consented using the same form provided to adult participants and parental or guardian consent was not required; for other participants aged 15–17 years, assent was obtained from the participant alongside parental or guardian consent. The definitions of mature and emancipated minors differ in accordance with the nations’ various regulations. For example, “mature” minors may include adolescents capable of managing financial affairs and/or consenting to medical care or research; emancipated minors may include those who are married, pregnant, and/or live apart from parents or guardians. All study procedures were conducted in compliance with the Helsinki Declaration and Army Regulation 70−25.

: Not applicable.

: Material has been reviewed by the Walter Reed Army Institute of Research. There is no objection to its publication. The opinions or assertions contained herein are the private views of the author, and are not to be construed as official, or as reflecting true views of the Department of the Army or the Department of Defense. The investigators have adhered to the policies for protection of human research participants as prescribed in Army Regulation 70−25.

: The authors declare no competing interests.