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Article History

Received: 31 July 2025

Accepted: 17 September 2025

First Online: 17 October 2025

Declarations

:

: The authors declare no competing interests.

: Permission was sought from the State Universal Basic Education Board. Ethical Approval for the study was obtained from the Health Research and Ethics committee of the University of Port Harcourt Teaching Hospital, before commencement of the study. The study protocol, including the consent procedure, was reviewed and approved by the Health Research and Ethics Committee (Approval No: UPTH/ADM/90/S.II/VOL.XI/1948). Considering the minimal-risk and non-interventional nature of the study, and logistical challenges of obtaining written parental consent, parents were informed through the school head, who obtained verbal consent on their behalf. In addition, all children were provided with age-appropriate explanations of the study and gave verbal assent before participation.To ensure confidentiality, all collected data were securely stored in anonymized systems, adhering to the ethical standards outlined in the Declaration of Helsinki for human subject research.

: Not applicable since the analyzed data contained only de-identified data.

: The authors declare that they have no competing interests.