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Authors
Bogler, Lisa https://orcid.org/0000-0002-5679-9777
Vollmer, Sebastian https://orcid.org/0000-0002-7863-0462
Rampanjato, Zavaniarivo https://orcid.org/0009-0006-4581-9943
Andriamasy, Harizaka Emmanuel https://orcid.org/0009-0000-9067-353X
Vieira, Bítia https://orcid.org/0009-0006-8253-7291
Schäfer, Louis Noël https://orcid.org/0009-0004-0039-1037
Rajemison, Elsa https://orcid.org/0000-0001-6766-9065
Ravololohanitra, Onja Gabrielle https://orcid.org/0009-0002-1944-7526
Ralisimalala, Andriamampianina https://orcid.org/0009-0008-4661-1276
Bärnighausen, Till https://orcid.org/0000-0002-4182-4212
Knauss, Samuel https://orcid.org/0000-0002-3046-9075
Emmrich, Julius Valentin https://orcid.org/0000-0002-3393-0840
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Funding
Funding for this research was provided by:
Charité - Universitätsmedizin Berlin
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Article History
Received: 23 September 2025
Accepted: 20 July 2026
First Online: 11 August 2026
Declarations
Ethics approval and consent to participate: This study received ethical approval from University of Heidelberg, Germany (S-428/2019) and the National Institute for Public and Community Health (INSPC), Madagascar (012/2019-CEER/INSPC). Written informed consent was secured from all respondents.
Consent for publication: Not applicable.
Competing interests: JVE and SK are shareholders of the non-profit company mTomady and Co-PIs on the BMBF-funded 4MOTHERS trial. ZR was the project manager of mTomady during the implementation of the trial. ER is CEO of mTomady. All other authors declare no conflicts of interest.
