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Article History

Received: 5 September 2025

Accepted: 5 June 2026

First Online: 10 June 2026

Declarations

Ethics approval and consent to participate: Before data collection was initiated, ethical approval was obtained from the Ethical Review Committee of the Department of Biology, Debre Markos University, Debre Markos University (DMU/NCS/Biol/4/20/2025) A letter of permission was also sought from the Amhara Public Health Institute (APHI) to obtain support from the relevant governmental and public institutions. The study objectives, potential risks, and anticipated benefits were clearly explained to health professionals, heads of health facilities, and all study participants or their parents/guardians. Informed consent was obtained from each participant, and for children under 18 years, consent was provided by their guardians. All responses were treated with strict confidentiality and anonymity. The study was conducted in accordance with the principles of the Declaration of Helsinki [ ].

Consent for publication: All authors have approved the submission of the final copy for publication.

Competing interests: The authors declare no competing interests.