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Article History

Received: 10 December 2025

Accepted: 3 June 2026

First Online: 13 July 2026

Declarations

:

: This study was conducted in strict accordance with the ethical principles outlined in the Declaration of Helsinki. Formal ethical approval was granted by the University of Calabar Department of Public Health Ethics Committee (Ref: UC/PUH/MPH/18/056) and the National Health Research Ethics Committee of Nigeria (NHREC) (Ref: NHREC/20/02/2023). Prior to participation, all individuals were fully briefed on the study’s objectives, risks, and benefits. Informed consent was freely provided by all participants, who were assured of their right to withdraw from the study at any time without penalty. All data were anonymized to ensure the confidentiality and privacy of the participants throughout the research process.

: Informed written and verbal consent was obtained from all adult participants before they took part in this study. For participants under the age of 18, informed written and verbal consent was obtained from their parents and/or legal guardians, alongside assent from the participants themselves. Participation was completely voluntary, and respondents were at liberty to withdraw from the study at any time without facing any consequences. Strict measures were put in place to ensure the confidentiality and anonymity of all responses.

: All participants provided explicit informed consent for the results of this research, including anonymized data and summarized findings, to be published in a peer-reviewed journal. No identifying information, such as names or specific personal identifiers, is included in the manuscript to ensure participant anonymity and privacy.

: This study was conducted in strict accordance with the Declaration of Helsinki and the ethical guidelines and regulations established by the University of Calabar Ethics Committee and the National Health Research Ethics Committee of Nigeria (NHREC).

: The authors declare no competing interests.