Document is current

Article History

Received: 7 November 2025

Accepted: 9 February 2026

First Online: 23 February 2026

Declarations

:

: Ethical approval for this study was obtained from the University of Rwanda, College of Medicine and Health Sciences Institutional Review Board (IRB). Permission to conduct the study was granted by the Nyarugenge District Education Office and the administrations of all participating schools. The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki and relevant institutional and national research guidelines. Written informed consent was obtained from parents or legal guardians of participants below 18 years of age, and written informed assent was obtained from the adolescents. Participants aged 18 years and above provided their own written informed consent. Participant confidentiality and anonymity were strictly maintained through the use of unique study codes, secure data storage, and the reporting of findings in aggregate form without personal identifiers.

: Not applicable. No identifiable personal data or images are included in this manuscript.

: The authors declare no competing interests.