All experiments in this study were conducted in adherence to the set of ethical principles of the Declaration of Helsinki. Ethical clearance for the study was obtained from the Institutional Review Board of the Faculty of Health Sciences, University of Buea (proposal number: ID D7.1.A/MPH/SWP/PDPH/PS.CH/2340/811) while administrative authorization was sought from the South West Regional Delegation of Public Health. Authorization to conduct the surveys in primary schools was obtained from the Regional Delegation of Basic Education or the Catholic Education Secretariat. Informed consent was obtained from each participant or their caregiver following a clear explanation of the content of the information sheet for the cases and blood bank donors used as controls. Authorization to enroll participants from health facilities or schools was obtained from the Director or Head teacher and only subjects/caregivers who volunteered to participate by signing a written informed consent were enrolled.

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