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Article History

Received: 20 January 2025

Accepted: 3 June 2026

First Online: 8 June 2026

Declarations

Human ethics and consent to participate: Approval of the study protocol and ethical clearance was obtained from the Dire Dawa University Institutional Review Board with a research ethics permission letter (Ref. No/ HSR /R/C/Ser/ PG/co/ 108/ 11/ 14). Additionally, both hospitals’ medical directors provided letters of permission. This study was conducted following the Declaration of Helsinki. Because this was a census-based retrospective cohort study using secondary data from medical records, the requirement for individual informed consent was waived by the Dire Dawa University Institutional Review Board.

Consent for publication: Not applicable.

Competing interests: The authors declare no competing interests.