Sub-Regional Variations in Sexually Transmitted Infections Manifesting as Vaginitis among Reproductive-Aged Women in Sub-Saharan Countries

Round 1

Reviewer 1 Report

congratulations for the idea of the study, but I think that the design presents too many bias.

Author Response

Please see the attachment.

 

Response to Reviewers’ Reports

Reviewer 1

Congratulations for the idea of the study, but I think that the design presents too many bias.

Response: Thank you very for reviewing our paper and congratulating us for the idea of the paper. As with all population-based studies, we have presented the limitations of the study in section 4.2 for readers to be aware. We hope the study will not be rejected only for this reason, provided it is technically sound. 

“4.2. Strengths and limitations

Estimates of STI, genital sore or ulcer, abnormal genital discharge and prevalence of STI in African countries were presented in this study. For plausible comparisons, large national datasets were analyzed. The ability to combine many countries is a significant advantage. This study can be used as a scorecard for various countries to indicate the performance of their healthcare systems, in terms of the female reproductive health issues. This can spark coordinated efforts and new policies and programs, as well as a call to strengthen existing programs related to proper reproductive and sexual health care and practices. This study would highlight a call for other low- and middle-income countries (LMICs) to investigate genital sore or ulcer, abnormal genital discharge and prevalence. We used a cross-sectional study, however, to collect data from different countries at different points in time. It may have potential factors influencing the socioeconomic condition of each country that are linked to the study's variables. These factors include the political situation, the development of health care facilities, and the government's health policy, which may result in a different capture of socioeconomic conditions in each country over time. This could lead to sampling bias. Further to that, the DHS does not gather information on household spending, which are traditional wealth indicators. The assets-based wealth index used here is merely a proxy for household economic status, and its results are not always consistent with the results obtained from measurements made of revenue and expenditure where such statistics are available or can be collected reliably. Furthermore, we do not know the fraction of women, whether due to genetics or purely, because other factors could have contributed.”

 

Reviewer 2

Sexually transmitted infection is a public health problem with significant implications for medical practice.

The topic is relevant and exciting to the field of the journal.  The article makes a significant contribution to the field.  The text is clear and easy to read.  The manuscript has an excellent methodical description.  The overall paper is organized and well written.  The methods, the overall study design, and statistical analysis are clearly described.  Discussions Section presents other research findings.  The literature reviews are insightful and informative.

The tables are well presented and easy to read and understand.  The presented aspects sufficiently support the conclusions.

 

Response: Thank you very much for the insightful comments.

 

I have only a few remarks to make:

-         sub-Saharan is written with small and with capitalizing letters also – recommended to write uniform

 

Response: Thank you very much. We have now corrected “sub-Saharan” throughout the paper.

-         please verify that the abbreviations should be defined the first time they appear in every three sections.  Some abbreviations are defined for more time in the same section, and others are not defined.

 

Response: We have revised the abbreviations as recommended. Thank you.

-         at 2.2.1.  c) quotation marks are missing

 

Response: The missing quotation mark has been included. Thank you very much.

 

-         at 2.4.  HREC is better be written after National Health Research Ethics Committee

 

Response: This has been corrected. Thank you very much for the insightful comment.

-         at reference 26 after Zungu -Dirwayi N., delete the point

Response: The point has been deleted. Thank you very much for your recommendations.

 

 

Author Response File: Author Response.docx

Reviewer 2 Report

Sexually transmitted infection is a public health problem with significant implications for medical practice.

The topic is relevant and exciting to the field of the journal.  The article makes a significant contribution to the field.  The text is clear and easy to read.  The manuscript has an excellent methodical description.  The overall paper is organized and well written.  The methods, the overall study design, and statistical analysis are clearly described.  Discussions Section presents other research findings.  The literature reviews are insightful and informative.

The tables are well presented and easy to read and understand.  The presented aspects sufficiently support the conclusions.

I have only a few remarks to make:

-         sub-Saharan is written with small and with capitalizing letters also – recommended to write uniform

-         please verify that the abbreviations should be defined the first time they appear in every three sections.  Some abbreviations are defined for more time in the same section, and others are not defined.

-         at 2.2.1.  c) quotation marks are missing

-         at 2.4.  HREC is better be written  after National Health Research Ethics Committee

-         at reference 26 after Zungu -Dirwayi N., delete the point

Author Response

Reviewer 2

Sexually transmitted infection is a public health problem with significant implications for medical practice.

The topic is relevant and exciting to the field of the journal.  The article makes a significant contribution to the field.  The text is clear and easy to read.  The manuscript has an excellent methodical description.  The overall paper is organized and well written.  The methods, the overall study design, and statistical analysis are clearly described.  Discussions Section presents other research findings.  The literature reviews are insightful and informative.

The tables are well presented and easy to read and understand.  The presented aspects sufficiently support the conclusions.

 

Response: Thank you very much for the insightful comments.

 

I have only a few remarks to make:

-         sub-Saharan is written with small and with capitalizing letters also – recommended to write uniform

 

Response: Thank you very much. We have now corrected “sub-Saharan” throughout the paper.

-         please verify that the abbreviations should be defined the first time they appear in every three sections.  Some abbreviations are defined for more time in the same section, and others are not defined.

 

Response: We have revised the abbreviations as recommended. Thank you.

-         at 2.2.1.  c) quotation marks are missing

 

Response: The missing quotation mark has been included. Thank you very much.

 

-         at 2.4.  HREC is better be written after National Health Research Ethics Committee

 

Response: This has been corrected. Thank you very much for the insightful comment.

-         at reference 26 after Zungu -Dirwayi N., delete the point

Response: The point has been deleted. Thank you very much for your recommendations.

 

 

 

 

Author Response File: Author Response.docx