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Additionally, an Administrative Research Authorization was granted by the Cameroon Ministry of Public Health (no. 631\u20131315). We also met the Permanent Secretary of the National Onchocerciasis Control Programme, the Regional Delegates of Public Health for the West, Centre and Littoral Regions, and the District Medical Officers of the selected Health Districts, to obtain their verbal or written approvals. All participants were informed about the study objectives and the audio taping of interviews\/FGD before the beginning and agreed with the procedure. 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