Peer Review History

Original SubmissionApril 29, 2020
Decision Letter - Nicholas P. Day, Editor, Scott B Halstead, Editor

Dear Dr Olu,

Thank you very much for submitting your manuscript "Analysis of the performance of the Ebola virus disease alert management system in South Sudan from August 2018 to November 2019" for consideration at PLOS Neglected Tropical Diseases. As with all papers reviewed by the journal, your manuscript was reviewed by members of the editorial board and by several independent reviewers. In light of the reviews (below this email), we would like to invite the resubmission of a significantly-revised version that takes into account the reviewers' comments.

We cannot make any decision about publication until we have seen the revised manuscript and your response to the reviewers' comments. Your revised manuscript is also likely to be sent to reviewers for further evaluation.

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[2] Two versions of the revised manuscript: one with either highlights or tracked changes denoting where the text has been changed; the other a clean version (uploaded as the manuscript file).

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Please prepare and submit your revised manuscript within 60 days. If you anticipate any delay, please let us know the expected resubmission date by replying to this email. Please note that revised manuscripts received after the 60-day due date may require evaluation and peer review similar to newly submitted manuscripts.

Thank you again for your submission. We hope that our editorial process has been constructive so far, and we welcome your feedback at any time. Please don't hesitate to contact us if you have any questions or comments.

Sincerely,

Nicholas P. Day

Associate Editor

PLOS Neglected Tropical Diseases

Scott Halstead

Deputy Editor

PLOS Neglected Tropical Diseases

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Reviewer's Responses to Questions

Key Review Criteria Required for Acceptance?

As you describe the new analyses required for acceptance, please consider the following:

Methods

-Are the objectives of the study clearly articulated with a clear testable hypothesis stated?

-Is the study design appropriate to address the stated objectives?

-Is the population clearly described and appropriate for the hypothesis being tested?

-Is the sample size sufficient to ensure adequate power to address the hypothesis being tested?

-Were correct statistical analysis used to support conclusions?

-Are there concerns about ethical or regulatory requirements being met?

Reviewer #1: Line 258: Methodological aspects for qualitative data analysis is inadequate. How were these data analysed? Did you use any framework? How did you synthesize the data from the review of documents? Please explain in detail. You can check COREQ guidelines for complete qualitative data reporting. Link: https://academic.oup.com/intqhc/article/19/6/349/1791966

Reviewer #2: The objectives are clearly articulated with a stated testable hypothesis. The study design appropriately addresses the stated objectives. Yes, the population is clearly described and appropriate. There is a limitation (also identified by the authors) in relation to sample size, but given there is no control on the number of possible EVD cases, the number of cases is adequate for a descriptive study. The authors applied the correct statistical analysis to support the conclusions. I find no concerns about ethical or regulatory requirements

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Results

-Does the analysis presented match the analysis plan?

-Are the results clearly and completely presented?

-Are the figures (Tables, Images) of sufficient quality for clarity?

Reviewer #1: Page 16: since your study is focused on descriptive epidemiology of the surveillance system for Ebola. I wonder, if you could present some of these important variables in figures that would best serve the objective of your study. For e.g.

• source of identification of alert

• Place of identification of alert

• Status of alert

Table 4:

I see that you are trying to compare the timelines of alert notification in days between different parts of the year. But as you earlier said, your data had a non-normal distribution, thus you used non-parametric test: Kruskal Wallis test. For non-parametric test, it is best to present median (not mean or mode) and show only p value on the side.

Table 5: It looks like a very informative table, and I believe you have used the SWOT analysis. However, could you delineate each component, importantly, ‘opportunities’ as recommendations? That will be something interesting for other LMICs and surveillance system.

Reviewer #2: The analysis and the plan match the clearly presented results.

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Conclusions

-Are the conclusions supported by the data presented?

-Are the limitations of analysis clearly described?

-Do the authors discuss how these data can be helpful to advance our understanding of the topic under study?

-Is public health relevance addressed?

Reviewer #1: In the conclusion, you have mentioned Boma Health initiative (BHI). I think this is the first time you have talked about BHI. I recommend authors to provide a background information about BHI in the introduction section for readers to adequately anticipate and understand what it is and how does it come into the context.

Reviewer #2: The conclusions support the data presented, with the limitations of analysis well described. The in-depth discussion provide understanding on the public health relevance of the study

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Editorial and Data Presentation Modifications?

Use this section for editorial suggestions as well as relatively minor modifications of existing data that would enhance clarity. If the only modifications needed are minor and/or editorial, you may wish to recommend “Minor Revision” or “Accept”.

Reviewer #1: (No Response)

Reviewer #2: I have addressed and identified some issues that need clarification in the body of the manuscript (uploaded). Table 1 should be presented in a landscape format

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Summary and General Comments

Use this section to provide overall comments, discuss strengths/weaknesses of the study, novelty, significance, general execution and scholarship. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. If requesting major revision, please articulate the new experiments that are needed.

Reviewer #1: Thank you for the opportunity to review the paper by Olu et al. In general, the paper is well written with contextual details concentrated in discussion section. There are some sections that needs improvement. Below, I have a few specific recommendations.

Line 197: revise and mention the capital city; is it Juba? Or were you referring somewhere else?

Line 246: Mention here who are EVD stakeholders?

Line 402: IDSR and EWARN: please explain these abbreviations

Discussion is very well written and authors have explained in detail the interpretation and its practical relevance for South Sudan’s health system strengthening. I think the discussion will benefit from providing sub-headings for readers to easily pick up on the findings, challenges/recommendations.

Explain why there are highest alerts in August, October and November?

Why was there clustering of EVD alerts in Yambio?

Reviewer #2: The manuscript makes important contributions to the detection, response control of cross-border transmission of infectious diseases. While highlighting the challenges especially in a resource constrained environment, offering practical solutions for improving response activities

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Reviewer #1: Yes: Bipin Adhikari

Reviewer #2: Yes: OYEWALE TOMORI

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Attachments
Attachment
Submitted filename: PNTD-D-20-00721_reviewer (2) ebola disease alert-OT REVIEW.pdf
Revision 1

Attachments
Attachment
Submitted filename: Response to Reviewers_Rev 1.docx
Decision Letter - Nicholas P. Day, Editor, Scott B Halstead, Editor

Dear Dr Olu,

We are pleased to inform you that your manuscript 'Analyses of the performance of the Ebola virus disease alert management system in South Sudan: August 2018 to November 2019' has been provisionally accepted for publication in PLOS Neglected Tropical Diseases.

Before your manuscript can be formally accepted you will need to complete some formatting changes, which you will receive in a follow up email. A member of our team will be in touch with a set of requests.

Please note that your manuscript will not be scheduled for publication until you have made the required changes, so a swift response is appreciated.

IMPORTANT: The editorial review process is now complete. PLOS will only permit corrections to spelling, formatting or significant scientific errors from this point onwards. Requests for major changes, or any which affect the scientific understanding of your work, will cause delays to the publication date of your manuscript.

Should you, your institution's press office or the journal office choose to press release your paper, you will automatically be opted out of early publication. We ask that you notify us now if you or your institution is planning to press release the article. All press must be co-ordinated with PLOS.

Thank you again for supporting Open Access publishing; we are looking forward to publishing your work in PLOS Neglected Tropical Diseases.

Best regards,

Nicholas P. Day

Associate Editor

PLOS Neglected Tropical Diseases

Scott Halstead

Deputy Editor

PLOS Neglected Tropical Diseases

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Formally Accepted
Acceptance Letter - Nicholas P. Day, Editor, Scott B Halstead, Editor

Dear Dr Olu,

We are delighted to inform you that your manuscript, "Analyses of the performance of the Ebola virus disease alert management system in South Sudan: August 2018 to November 2019," has been formally accepted for publication in PLOS Neglected Tropical Diseases.

We have now passed your article onto the PLOS Production Department who will complete the rest of the publication process. All authors will receive a confirmation email upon publication.

The corresponding author will soon be receiving a typeset proof for review, to ensure errors have not been introduced during production. Please review the PDF proof of your manuscript carefully, as this is the last chance to correct any scientific or type-setting errors. Please note that major changes, or those which affect the scientific understanding of the work, will likely cause delays to the publication date of your manuscript. Note: Proofs for Front Matter articles (Editorial, Viewpoint, Symposium, Review, etc...) are generated on a different schedule and may not be made available as quickly.

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Thank you again for supporting open-access publishing; we are looking forward to publishing your work in PLOS Neglected Tropical Diseases.

Best regards,

Shaden Kamhawi

co-Editor-in-Chief

PLOS Neglected Tropical Diseases

Paul Brindley

co-Editor-in-Chief

PLOS Neglected Tropical Diseases

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