Ethical Considerations
This study was approved by the ethics committee “Comité de ética e
Investigación en Seres Humanos” (CEISH)”, Guayaquil, Ecuador (IRB
number HCK-CEISH-19-0059) and by a committee for each participating
UCARE center. Each participant provided consent to completion of the
anonymous survey, and confidentiality was maintained throughout the
study.