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Permission was also obtained from the Nzema East and Ahanta West District Health Directorates, Ghana.Before commencement of recruitment and sample collection, meetings were held in the study communities to explain in detail the purpose and procedures of the study. The inconveniences involved, such as blood sampling, were also explained to the participants. Verbal consent to perform the study in the villages was obtained from community leaders, i.e., chiefs and elders of the selected communities, and written informed consent was obtained from all participants. 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