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All participants were given an informed consent form in Kiswahili, which included information on potential risks and benefits of participation, for their review and signature. Ethical approval was obtained from institutional review boards at the University of South Carolina (#Pro00072005), the George Washington University (#NCR213554), as well as the National Institute of Medical Research of Tanzania (NIMR\/HQ\/R.8aNol. IX\/2529). All procedures were followed in accordance with the Declaration of Helsinki guidelines for human subject research.","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":"1166"}}