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Ethical approval for the study was obtained from the Institutional Review Board (IRB) of the College of Medicine and Health Sciences, Bahir Dar University (Reference No.: 0163\/2018). The requirement for written informed consent was waived by the IRB of the College of Medicine and Health Sciences, Bahir Dar University and by TGCSH.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"444"}}