The proposal was approved by the joint University of Ibadan/University College Hospital, Ibadan Institutional Review Board (IRB) of the University College Hospital (UCH), University of Ibadan, Nigeria (reference number UI/EC/18/0463). It was also approved by IRB at Debre Markos University (reference number HSC/30/02/2011). We obtained permission from Amhara Public Health Institute. Moreover, we obtained written informed consent from each study subject.

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