Ethics approval and consent to participate
Ethical approval 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) approved the protocol. The Mbale Hospital Research and Ethics Committee (MRRH-REC IN-COM 00/2018) gave us administrative clearance. Confidentiality of information was maintained through avoiding use of any personal identifiers and restricting access to study documents during data collection. All study procedures were carried out in accordance with the principles of declaration of Helsinki. Written informed consent was obtained from each of the participants before enrollment into the primary study, and those below the legal age of consent were treated as emancipated minors able to give a valid consent.