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In agreement with the International Guidelines for Ethical Review of Epidemiological Studies by the Council for International Organizations of Medical Sciences (1991), the Office of the Associate Director for Science, CDC\/Uganda, determined that this activity was not human subjects research and its primary intent was public health practice or a disease control activity (specifically, epidemic or endemic disease control activity). Verbal informed consent was obtained from the participants before the start of each interview. Written consent could not be obtained because it was impractical as most of the participants were illiterate. However, the purpose and nature of the investigation were explained to all participants. Participants were also informed that their involvement was entirely voluntary and their refusal to answer any or all of the questions would not result in any negative consequences. 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