Ethical approval
to conduct the study was obtained from the Makerere University School of Medicine Research and Ethics Committee (#REC REF 2017 − 103) and the Uganda National Council for Science and Technology (HS217ES). Administrative clearance was obtained from the Mbale regional referral hospital research and Ethics Committee (MRRH-REC IN-COM 00/2018). Written informed consent was obtained from each of the participants before enrolment.