Knowledge and attitude on blackflies and onchocerciasis and participation in Mass Drug Administration in frontline communities near Erin-Ijesha and Arinta waterfalls, Southwest Nigeria.

PLOS Neglected Tropical Diseases

Dear Dr. Dauda,

Thank you for submitting your manuscript to PLOS Neglected Tropical Diseases. After careful consideration, we feel that it has merit but does not fully meet PLOS Neglected Tropical Diseases's publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. The editor agrees with one reviewer that the study as it is written now, is mostly of local interest. Therefore it is important to point out in a substantially revised version why the results are important for the national onchocerciasis elimination program in Nigeria and elsewhere in Africa.

Please submit your revised manuscript within 60 days May 05 2025 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosntds@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pntd/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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Kind regards,

Peter U Fischer

Academic Editor

PLOS Neglected Tropical Diseases

Nigel Beebe

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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Reviewers' Comments:

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: (No Response)

Reviewer #2: -The broader methodology used in the study to achieve the objective are adequate. However, authors need to provide additional information around the population used for sample size calculation as well as information on the endemicity status of the LGA of the study communities.

Reviewer #3: -Are the objectives of the study clearly articulated with a clear testable hypothesis stated? Yes

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

-Is the population clearly described and appropriate for the hypothesis being tested? not clear how the study participants were selected. Not representative of the general population

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

-Were correct statistical analysis used to support conclusions? limited statistical analysis done

-Are there concerns about ethical or regulatory requirements being met? No

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: (No Response)

Reviewer #2: The analysis and data presentation in the current study are adequate.

Reviewer #3: -Does the analysis presented match the analysis plan? No analysis plan

-Are the results clearly and completely presented? Yes

-Are the figures (Tables, Images) of sufficient quality for clarity? Not very good

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: While the conclusions is largely supported by data presented, authors need to clarify, modify and delete some conclusion presented in the study as data presented in the study are inadequate to infer such conclusion. Conclusion should be within the limit of data presented and limitations of study should be included.

Reviewer #3: -Are the conclusions supported by the data presented? ok

-Are the limitations of analysis clearly described? Not described

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

-Is public health relevance addressed? Yes

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: (No Response)

Reviewer #3: "Comunities not previously mapped." What does this mean?

The study population was not representative of the general pululation. > 70% women, and young people underrepresented

Limited number of farmers generally most exposed to blackfly biting

No study limitations are mentioned

No recommendations are proposed to further investigate the onchocerciasis endemicity in the area?

Improving health education seems to be the only recommendation

No qualitative research done

No CDTI coverage data reported by CDDs?

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: This is generally a well done study. However, authors should address all the critical comments in the manuscript to ensure the interpretation of data and information generated from the study is not over-extended beyond what is necessary.

Reviewer #3: Results of the study are mainly of local importance

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Reviewer #1: No

Reviewer #2: No

Reviewer #3: Yes:  Robert Colebunders

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Reproducibility:

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Attachments

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Submitted filename: Reviewer comment - PLOS NTD - 01.28.2025.docx

Attachment

Submitted filename: PNTD-D-24-01867_reviewer.pdf

Knowledge and attitude of populations on blackflies and onchocerciasis and participation in Mass Drug Administration in first-line communities near Erin-Ijesha and Arinta waterfalls, Southwest Nigeria.

PLOS Neglected Tropical Diseases

Dear Dr. Dauda,

Thank you for submitting your manuscript to PLOS Neglected Tropical Diseases. After careful consideration, we feel that it has merit but does not fully meet PLOS Neglected Tropical Diseases's publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript within 60 days Jul 12 2025 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosntds@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pntd/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

* A rebuttal letter that responds to each point raised by the editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. This file does not need to include responses to any formatting updates and technical items listed in the 'Journal Requirements' section below.

* A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.

* An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, competing interests statement, or data availability statement, please make these updates within the submission form at the time of resubmission. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

We look forward to receiving your revised manuscript.

Kind regards,

Peter U Fischer

Academic Editor

PLOS Neglected Tropical Diseases

Nigel Beebe

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

Additional Editor Comments (if provided):

The authors addressed most of the reviewers’ comments. However, the editor has still some concerns about this ms.

Line 82/83 Reference 10 clearly states that the reported population treated in Nigeria in 2023 was 34.9 million. What do the authors mean with ‘Currently, ivermectin has been administered to over 45 million Nigerians…’? [10]

Table 1. What do the authors mean with ‘Numbers’? Number of study participants?

Table 3: Onchodermatitis and itching are the most common signs of onchocerciasis. Why was this not included? How is ‘ocular dermatitis’ defined? Do the authors mean periorbital dermatitis? Ocular disease caused by O. volvulus that can be easily seen is sclerosing ceratitis. How would this be included in the table. How is blindness defined?

Line 199. Why did the authors introduce the phrase mass administration of medicine (MAM)? What is the difference to the commonly used term mass drug administration (MDA)?

Table 4. CDTi is a special form of MDA. What is the difference between CDTi and MAM?

Line 331. Why is knowledge of blackfly bioecology important to increase compliance to MDA? Many studies have shown that trust to community drug distributors is more important than disease specific knowledge. The authors may want to address this point more in detail in their discussion.

In addition, the ms still contains typos (for example Table 2 blackflies vs black flies).

Journal Requirements:

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* U.S. Geological Survey (USGS) - All maps are in the public domain. (http://www.usgs.gov)

* PlaniGlobe - All maps are published under a Creative Commons license so please cite u201cPlaniGlobe, http://www.planiglobe.com, CC BY 2.0u201d in the image credit after the caption. (http://www.planiglobe.com/?lang=enl)

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Dear Mr Dauda,

We are pleased to inform you that your manuscript 'Knowledge and attitude of populations on blackflies and onchocerciasis and participation in Mass Drug Administration in first-line communities near Erin-Ijesha and Arinta waterfalls, Southwest Nigeria.' 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,

Nigel Beebe, PhD

Section Editor

PLOS Neglected Tropical Diseases

Nigel Beebe

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

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

Thanks for attending to the reviewer's comments.

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