Ethical approval and consent

This study was carried out according to the principles of the Declaration of Helsinki, with approval from the London School of Hygiene & Tropical Medicine ethics committee and the Rwandan National Ethics Committee. All participants gave written informed consent in Kinyarwanda or provided a thumbprint. All children aged 16 or under gave verbal assent and were interviewed in the presence of a caregiver who also provided written consent. All those we identified with potential to benefit from PEC in the survey, or with other healthcare needs, were referred to the local health center.