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Article History

Received: 30 July 2024

Accepted: 23 December 2024

First Online: 2 January 2025

Declarations

:

: This study strictly adhered to the ethical and legal standards outlined in CNS Resolution No. 466/2012 (ethical guidelines for research involving human beings), CNS Resolution No. 510/2016 (guidelines for research in social and human sciences), CNS Resolution No. 580/2018 (protection of personal data in research), Law No. 12.527/2011 (LAI, regulating public information access), Law No. 13.709/2018 (LGPD, governing personal data processing), and the Declaration of Helsinki (international ethical principles for medical research involving human subjects). Ethical approval was granted by the Ethics Committee of the Universidade Federal de Alfenas (UNIFAL-MG), protocol number 5.812.620. The Ethics Committee at UNIFAL-MG waived the requirement for informed consent, in accordance with CNS Resolution No. 580/2018 and LGPD (Law No. 13.709/2018), due to the study’s exclusive use of anonymized secondary data provided by the Brazilian Ministry of Health and the São Paulo State Government, with institutional authorization. Informed consent is deemed unnecessary under national regulations for research involving anonymized secondary data, as long as the study fully complies with applicable ethical and legal standards.

: Since the study was conducted using anonymized secondary data, it was not necessary to obtain informed consent from the participants.

: The authors declare no competing interests.