PONE-D-19-24012

Anemia and associated factors among type-2 diabetes mellitus patients attending public hospitals in Harari Region, Eastern Ethiopia

PLOS ONE

Dear Mr Gebremichael,

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Naeti Suksomboon

Academic Editor

PLOS ONE

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Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

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Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: No

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Bekele et al. aimed to assess the magnitude of anemia and associated factors among Type 2 Diabetic patient. They conduct a cross-sectional study to collect 374 T2D patients attending public hospitals in Harari Region, Eastern Ethiopia. This study concluded that anemia was a major health problem and routine screening of anemia for T2D patients were recommended. The manuscript was well prepared. I have only some minor comments.

1. Some exclusions have been applied in the sample recruitment. Please provide the reasoning for that.

2. In the sampling procedure section, the sample size of 410 is planned. But at the end, only 374 (line 209) were analyzed. Please clarify the discrepancy.

3. Line 260. The wording “the magnitude of anemia… was 130” reads awkward.

Reviewer #2: This study is notable for its use of in person questionnaires in a sampled population to determine the risk factors associated with anemia among hospitalized patients with T2DM. Interviews were very in depth including a seven day food frequency questionnaire. This data is interesting in the context of the nutrition programs currently underway in Ethiopia.

The authors state that that anemia is a major problem in Ethiopia. It would build the rationale for this study if they are able to reference any data supporting this in the introduction.

The methods require clarification in writing. The authors state that the study population was comprised of all T2DM patients, but they also applied a sampling scheme to select the analysis population. Overall, the data appears to be analyzed appropriately to reach the reported conclusions. For adjusted odds ratios, the authors should be sure to report what these estimates have been adjusted for (i.e. what was included in the multivariate model)

What data is available regarding the admission reason for the study participants? Are these results generalizable to individuals who have T2DM but were not hospitalized?

In the discussion, the authors report both that physical activity is linked to anemia (line 307), which does not match their results table, and that physical inactivity is linked to anemia (line 337). Please clarify.

Editing is needed particularly with respect to lines: 45 (“having faulty in the blood cells”), 73 (clarify in which cases similar signs and symptoms are observed) and in a number of places in the discussion.

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Reviewer #1: No

Reviewer #2: No

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Anemia and associated factors among type-2 diabetes mellitus patients attending public hospitals in Harari Region, Eastern Ethiopia

PONE-D-19-24012R1

Dear Dr. Gebremichael,

We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements.

Within one week, you will receive an e-mail containing information on the amendments required prior to publication. When all required modifications have been addressed, you will receive a formal acceptance letter and your manuscript will proceed to our production department and be scheduled for publication.

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With kind regards,

Naeti Suksomboon

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: (No Response)

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: (No Response)

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: (No Response)

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: (No Response)

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: (No Response)

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7. 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