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Article History

Received: 26 December 2019

Accepted: 29 October 2020

First Online: 2 December 2020

Ethics approval and consent to participate

: Ethics approval was obtained through the Moi University School of Medicine Institutional Research Ethics Committee and the University of Toronto Health Sciences Research Ethics Board, as part of an overall approval for retrospective analysis of the AMPATH Medical Records System (AMRS) aimed at improving clinical care. Included in this ethics approval is a waiver of informed consent, due to the retrospective nature of the analysis.

: Consent for publication was not required as the manuscript does not contain any individual person’s data in any form.

: Much of AMPATH’s work is supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through USAID under the terms of the Cooperative Agreement No. AID-623-A-12-0001; however, this funder did not have a role in the study design; collection, analysis, and interpretation of data; writing of the report; or the decision to submit the manuscript for publication. The contents of this manuscript are the sole responsibility of the authors and do not necessarily reflect the views of USAID or the United States Government.AMPATH’s program and several co-authors receive support from public-sector research funding, including the NIH and CIHR, as well as private foundations; however none of these funders played a role in the design, writing, or funding of this manuscript.The first draft of the manuscript was written by the first author, Millar HC. No honorarium, grant or other form of payment was given to anyone to produce the manuscript. The authors do not have any conflicts of interest to declare.