Document is current

Article History

Received: 23 February 2026

Accepted: 31 August 2026

First Online: 5 September 2026

Declarations

Ethics approval and consent to participate: Ethical approval for this study was obtained from the Institutional Review Board of Mekelle University, College of Health Sciences/Ayder Comprehensive Specialized Hospital (Ref. No. 2467/2025). The study was conducted in accordance with institutional ethical guidelines and regulations, as well as the principles of the Declaration of Helsinki. Oral informed consent was obtained from all participants prior to data collection. Because many participants had limited literacy and some older adults were unable to read or write, written consent was not feasible. Participants were informed about the purpose of the study, voluntary nature of participation, confidentiality protections, and their right to decline participation or withdraw at any time without consequence. For participants under the age of 16 years, oral informed consent was obtained from a surviving parent or legal guardian before participation. Confidentiality and anonymity were maintained throughout the study.

Consent for publication: Not applicable. The manuscript contains anonymized data and does not include any identifiable individual information.

Competing interests: The authors declare no competing interests.