Response to ReviewersRevised Manuscript with Track ChangesManuscript

Shaden Kamhawi

co-Editor-in-Chief

PLOS Neglected Tropical Diseases

orcid.org/0000-0003-4304-636XX

Paul Brindley

co-Editor-in-Chief

PLOS Neglected Tropical Diseases

orcid.org/0000-0003-1765-0002

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If you did not receive any funding for this study, please simply state: u201cThe authors received no specific funding for this work.u201d

Reviewers' comments:

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: The global distribution of Taenia solium is widespread, and taeniasis caused by T. solium is a significant foodborne parasitic disease that has garnered increasing attention in recent years. Conducting epidemiological surveys on taeniasis and cysticercosis in highly endemic regions is of great importance. The author’s investigation on porcine cysticercosis in northern Uganda could provide valuable evidence for understanding the prevalence of T. solium and verify the accuracy of current epidemiological risk assessments in the region. However, the study has several limitations, outlined as follows:

The incidence of taeniasis and cysticercosis exhibits a parallel and concurrent relationship. Therefore, investigations into human infections with adult T. solium (e.g., fecal sampling for egg detection, areca nut-pumpkin seed deworming, and human serological testing) are equally critical. Additionally, the occupational status of participants (e.g., involvement in slaughtering) and dietary habits (e.g., consumption of raw pork or vegetables) are strongly correlated with cysticercosis incidence and should be included in the survey.

To enhance the representativeness of the findings, the methodology should include not only population density but also details such as the surveyed area’s size, village distribution, and household density.

Reviewer #2: The methodological approach is generally respected, with the exception of a few specific points, notably on the sampling methodology, which requires more clarification and adjustment according to the results obtained.

It is important to note that the sample size is large enough to guarantee sufficient statistical power for the study.

The writing is clear and accessible

**********

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 manuscript also contains several issues�The inappropriate presentation of these results may undermine the entire article's quality.:

舄Table 1舄: The unit for "Population density" is unspecified. What do the symbols "HH," "HH*," and "HH" denote?

舄Line 217舄: The "Data analysis" section lacks a description of statistical software used.

舄Table 2舄: Are the categorized data (sex, age, reproduction) for pigs presented as proportions or absolute numbers? If proportions, include "%." For example, 270 × 0.433 = 116.91 (non-integer pig counts are illogical). In the "Breed" category, the first group’s data (73.3 + 36.7 = 110) exceed 100%.

舄Table 3舄: Similarly, numerical values lack clarification (proportions or counts?).

舄References舄: Many citations are listed; ensure the referencing style complies with journal guidelines.

Reviewer #2: The result aligns with the analysis plan, except for a few adjustments or modifications that need to be made in the multivariate analysis.

Table 3 requires an introductory text for interpretation.

The table numbers need to be revised

**********

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: (No Response)

Reviewer #2: The subject is original and of great significance form both scientifically and operationally. A concrete example in the discussion part on the proposed One Health approach adapted to their findings would be nice.

**********

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: Minor revision.

**********

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: (No Response)

Reviewer #2: The study is grounded in a clearly defined research question and addresses a methodological gap in assessing the prevalence of porcine cysticercosis, which serves as a proxy for the evaluation and control of neurocysticercosis.

I have only a few comments, attached in this review, to help improve the manuscript prior to publication

**********

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Reviewer #1: No

Reviewer #2: No

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Attachments

Attachment

Submitted filename: Review details.docx

Dear Dr. Thomas,

We are pleased to inform you that your manuscript 'Confirmation of a hyperendemic focus of porcine cysticercosis in Northern Uganda: Prevalence and risk factor 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,

Francesca Tamarozzi

Section Editor

PLOS Neglected Tropical Diseases

Gabriel Rinaldi

Section Editor

PLOS Neglected Tropical Diseases

Shaden Kamhawi

co-Editor-in-Chief

PLOS Neglected Tropical Diseases

orcid.org/0000-0003-4304-636XX

Paul Brindley

co-Editor-in-Chief

PLOS Neglected Tropical Diseases

orcid.org/0000-0003-1765-0002

***********************************************************

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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: Yes, all the specified aspects are fully addressed in this study.

Reviewer #2: (No Response)

**********

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: Two minor points for the author to confirm�

Line 83�”Humans are the definitive hosts for the mature tapeworm as well as the aberrant hosts in cases of human cysticercosis”�I think that in this sentence, "aberrant hosts" was not very appropriate and should be changed to "intermediate hosts".

Line 303: “Other predictors were retained if P<.05 or P<0.15 for environmental variables”, 舄Change "P<.05" to "P<0.05", please confirm.

Reviewer #2: (No Response)

**********

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: Yes, all the specified aspects are fully addressed in this study.

Reviewer #2: (No Response)

**********

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: I recommend acceptance of the manuscript.

Reviewer #2: Accept

**********

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: The global distribution of Taenia solium is widespread, and taeniasis caused by T. solium is a significant foodborne parasitic disease that has garnered increasing attention in recent years. Conducting epidemiological surveys on taeniasis and cysticercosis in highly endemic regions is of great importance. The author’s investigation on porcine cysticercosis in northern Uganda could provide valuable evidence for understanding the prevalence of T. solium and verify the accuracy of current epidemiological risk assessments in the region.

Reviewer #2: Feed back OK

**********

PLOS authors have the option to publish the peer review history of their article (what does this mean? ). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy .

Reviewer #1: No

Reviewer #2: No