Dear Dr. Li,

Thank you very much for submitting your manuscript "Infection and biogeographical characteristics of Paragonimus westermani and P. skrjabini in humans and animal hosts in China: a systematic review and meta-analysis" 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. The reviewers appreciated the attention to an important topic. Based on the reviews, we are likely to accept this manuscript for publication, providing that you modify the manuscript according to the review recommendations.

All reviewers concur on the study's value and quality, offering only minor comments. Kindly be aware that Reviewer 3's comments have been included as annotations in the PDF file.

Please prepare and submit your revised manuscript within 30 days. If you anticipate any delay, please let us know the expected resubmission date by replying to this email.

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[1] A letter containing a detailed list of your responses to all review comments, and a description of the changes you have made in the manuscript.

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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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Thank you again for your submission to our journal. 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,

Qu Cheng, Ph.D.

Academic Editor

PLOS Neglected Tropical Diseases

jong-Yil Chai

Section Editor

PLOS Neglected Tropical Diseases

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All reviewers concur on the study's value and quality, offering only minor comments. Kindly be aware that Reviewer 3's comments have been included as annotations in the PDF file.

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: Methodology and study design week articulated and appropriate.

Reviewer #2: The work complies with the aspects mentioned above. The period covered by the study, although the end date is stated (it is understood from 2010 to the present), the beginning could be better specified (it is a very broad period to say before 1990)

Reviewer #3: All in the MS

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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: The analysis presented do match the analysis plan and are well presented.

Reviewer #2: The work complies with the itms indicated above

Suggested details:

Line 202-203: The total number of publications is not clear (876 - 10642?)

Line 222-224: Table 1 does not show human cases in Hong Kong and Macau either.

Line 227: 71.12% or 71.21%

Fig 2: the reference system with parentheses is difficult to interpret

Line 219-222: it could be indicated that the cases by gender, source and age are obviously above those documented, explicitly consider that there is a significant number that is not specified

Fig 1: the value 261 is not clear? (38+107+174+58=377)

Linea 297: 94 estudios and line 307: 81 estudios = 175. En la linea 206 menciona 172 en second intermediate host

Reviewer #3: All in the MS

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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: Conclusions well justified and limitations well noted.

Reviewer #2: The items indicated above are fully contemplated in the work.

Reviewer #3: All in the MS

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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 editorial suggestions other than what has been suggested to the authors below.

Reviewer #2: (No Response)

Reviewer #3: All in the MS

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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: This study provides a comprehensive meta-analysis for studies on the epidemiology paragonimiasis in China. I would suggest that the authors add in the Introduction some information about the possible socio-economic impacts of the disease in endemic areas. In the discussion: is there any explanation for the marked gender difference in the prevalence of the infection? Based on this extensive review I think it would be helpful to add any suggestions to standardize future surveys

Reviewer #2: The work is a valuable contribution by summarizing the situation of infection by P. westermani and P. skrjabini in their main hosts, as well as the geographical distribution. The figures that allow a visual-spatial representation of the infection situation in China stand out, being a fundamental pillar when establishing prevention-control measures.

Otros puntos:

When only Paragonimus is mentioned without specifying the species, it could be indicated as Paragonimus spp.

Line 87: P. westerman would be P. westermani

Line 87 - 91: would include some bibliographical reference

Line 446: ...prevalence of 52.02 % (95% CI 42.65 - 75.79%). The CI differs from Table 4

Line 458: P. iloktsuensis or P. iloktsuenensis?.

T. chiui: is it previously defined?

Reviewer #3: All in the MS

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Reviewer #1: Yes: Ahmed Awad Adeel

Reviewer #2: Yes: Zully Hernández

Reviewer #3: Yes: José Alberto Iannacone Oliver

Figure Files:

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References

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article's retracted status in the References list and also include a citation and full reference for the retraction notice.

Attachments

Attachment

Submitted filename: Revision Paragonimus.pdf

Attachment

Submitted filename: PNTD-D-24-00165.pdf

Dear Dr. Li,

We are pleased to inform you that your manuscript 'Infection and biogeographical characteristics of Paragonimus westermani and P. skrjabini in humans and animal hosts in China: a systematic review and meta-analysis' 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,

Qu Cheng, Ph.D.

Academic Editor

PLOS Neglected Tropical Diseases

Jong-Yil Chai

Section Editor

PLOS Neglected Tropical Diseases

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