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Article History

Received: 28 November 2025

Accepted: 11 May 2026

First Online: 21 May 2026

Declarations

Ethics approval and consent to participate: The study protocol was approved by the Institutional Review Board (IRB) of the Ethiopian Public Health Institute, following the ethical principles of the Declaration of Helsinki. Due to the minimal risk nature of the study and low literacy levels in several study areas, the IRB waived the requirement for written consent. Instead, informed verbal consent was obtained from all adult participants and informed verbal consent from parents/guardians for participants under 18 years of age, who also provided their own assent. This process followed an IRB-approved script, and all instances of informed consent were documented by data collectors on the survey forms prior to interview and sample collection.

Consent for publication: Not applicable. The manuscript does not contain any individual person’s data in any form (including individual details, images, or videos).

Competing interests: The authors declare no competing interests.