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Article History

Received: 8 August 2018

Accepted: 26 February 2019

First Online: 7 March 2019

Ethics approval and consent to participate

: Ethical approval was given by the London School of Hygiene and Tropical Medicine [Ref: 10225] and from the Gambia Government/MRC Joint ethics committee [SCC1426 and SCC1509]. Approval letter was obtained from the Ministry of Basic and Secondary Education, The Gambia. The investigators and trained, supervised research assistants kept all research records confidential in lockable cabinets and cupboards.Prior to the study, community sensitisation was done to inform the community of the aims of the project and get approval from the village elders and members of the community to carry out the project in their village. After this first contact, the study team visited the houses of the selected participants and explained and distributed information sheets to the parents/guardians about the study. To participate in the study, written consent was required from students aged 11–17 years along with their parents/guardian’s written consent, and written consent was required from those aged 18 years or older. We used thumb print and signature of an independent witness, in the case of consenting eligible parents/guardians with literacy challenges.

: All the participants gave consent for direct quotes from their interviews to be used in this manuscript.

: The authors declare that they have no competing interests.

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