PONE-D-20-06434

Spatial Distribution of Ascariasis, Trichuriasis and Hookworm Infections in Ogun State, Southwestern Nigeria.

PLOS ONE

Dear Dr Mogaji,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’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.

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ACADEMIC EDITOR: The study results provided some useful information, the spatial distributions of STH could be evaluated in a better/clearer way. I suggest the author modify the spatial analysis and map presentations and re-submit the revised version. Attached, 2 independent reviewers have some suggestions for your consideration.

==============================

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Additional Editor Comments (if provided):

The study results provided some useful information, the spatial distributions of STH could be evaluated in a better/clearer way. I suggest the author modify the spatial analysis and map presentations and re-submit the revised version.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

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: Yes

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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?

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

Reviewer #2: No

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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: Yes

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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: The manuscript entitled “Spatial Distribution of Ascariasis, Trichuriasis and Hookworm Infections in Ogun State, Southwestern Nigeria” investigated STH infections in Ogun State and try to mapped the spatial distribution of STH infection. Though the study results provided some useful information, the spatial distributions of STH could be evaluated in a better/clearer way. I suggest the author modify the spatial analysis and map presentations and re-submit the revised version. Below are some comments:

Major issues:

1. It seems that the georeferenced household’s information was not analyzed in the study because the figure only showed the locations of the selected communities. Since you have more than thousand georeferenced households participated in your study, why don’t you apply interpolation techniques (e.g. kriging or kernel density) to evaluate the prevalence and intensity?

2. The range of different age groups are different (e.g. 16-25, 41-70), any reason for the grouping criteria? The age distributions could be biased.

3. The investigation has been done at community level; however, the results were still presented at LGA level, and it’s hard to identify where is the most prevalent area. For instance, I have no idea where is “Yewa South” on the map (the LGA with the highest prevalence rate). Please modify the map presentation in a better way.

4. This is a cross-sectional survey which might be affected by many other factors. For example, does the infection prevalence influence by any intervention activities? Such limitation should be discussed in the manuscript.

5. Though the overall prevalence is not very high in the study area, the transmission still varied by locations. Can you explain why “Yewa South” has the highest prevalence?

Minor issue:

1. The scale bar in Figure 1 is not correct. It should not be “millimeters.” Please check whether you apply a correct projection coordination system.

2. Table 1 can be moved to the supplementary materials.

3. Figure 5. What does “Ogun State” mean in the legend? For the legend indicated the LGA with no case, please add the border.

Reviewer #2: Specific comments

Abstract

Result section

Line 2-4: The sentences “Ascariasis was the most spatially distributed found in 28 communities, with 140(13.6%) infected subjects, followed byHookworm infection in 19 communities, with 47(4.6%) infected subjects and Trichuriasis in 9 communities, with 17(1.7%) infected subjects.”

should be reconstructed to read “ Ascariasis was the most frequently observed parasite in 28 communities with a prevalence of 13.6%, followed by hookworm with a prevalence of 4.6% while Trichuris was the least encountered with a prevalence of 1.7%.

Line 6-7: The sentence is incomplete “The highest and lowest distribution of what (?) was recorded in Yewa South and Yewa North respectively.

Line 8: Delete the phrase “By WHO preventive chemotherapy thresholds”

Conclusion

This study provides information on the prevalence and spatial risk of Ascariasis, Trichuriasis

and Hookworm infection that will serve as decision-support tool to help facilitate targeting of

control interventions.

The conclusion should be re-written as “ This study provides epidemiological data on the prevalence and spatial distribution of ascariasis , trichuriasis and hookworm infection which will add to the baseline data and guide the public health officers in providing appropriate control strategies in the endemic communities.

Background

Line 7-8: Replace the phrases in parentheses (children between age 2 and 5) and (children between age 5 and 14) with (age 2-5 years) and (age 5-14 years).

Line 15: The sentence “there is an established morbidity control programme targeted at school-aged children due to their high level of contact with soils” should be re-written as “there is an established morbidity control programme targeted at school-aged children due to high worm burden as a result of their frequent contact with contaminated soils, ……………………….

Methods

Study area

Line 10: The phrase “The major occupation of the population is……………… should be re-phrased as “Major occupations of the population are………………

Study design and sampling technique

Line 1: The sentence “This study was community-based and cross-sectional in design” should be re-written as “This is a cross-sectional and community-based study”.

Selection of households for survey

Line 2: The sentence “communities were visited and sensitized about the study procedures

and were openly invited to participate in the research through community meetings and town

announcers” should be replaced with “selected communities were visited and with the permission of the community leaders, meetings were held with the members of the community to intimate them about the purpose of the study and the procedures to be adopted”.

The sub title “Collection of faecal samples and parasitological diagnosis” be replaced with “ Faecal samples collections and processing”.

Line 3-4: The sentence “All participants were asked to provide a sufficiently large stool sample (at least 5 g)” should be replaced with “Individuals who consented to take part in the study were requested to provide stool up to half (about 5gm) into the labelled plastic bottles provided.

Line 6: Delete the word “Precisely”.

Line 7-8: The sentence “The bottle was covered and agitated vigorously to suspend the stool efficiently in the solution” be replaced with “The bottle was covered and shaken vigorously to form a cloudy suspension”.

Line 9: Delete the word “further”

Line 11: The sentence “The supernatant was also discarded after centrifuging” be replaced with “The supernatant was decanted”.

Line 12-14: The sentence “7 ml of normal saline was later added to the sediment, after which 3 ml of ether was finally added to the suspension”. ( I did not agree with this procedure, it is faulty). The deposit or residue obtained after decanting the supernatant should be resuspended in distilled water or saline of a known vol and shaking vigorously. Thereafter, an equal vol of ether will then be added (i.e if 3ml of distilled water or saline was used to resuspend the residue, 3ml of ether should then be added). The authors should correct this procedure.

Results

Sex and age distribution of study participants

The sentence “A total of 1,499 respondents were subsequently enrolled after consent across the 33 communities and 20 LGAs. However, only 1,027 (68.5%) of them consented to the provision

of adequate stool samples (~5g) for laboratory analysis for parasites’ ova or larva. By

demography, 899(60.0%) were females and 600(40.0%) were males” should be rewritten as “ A total of 1499 participants comprising of 899 (60%) females and 600 (40%) males were enrolled across the 33 communities in 20LGAs out of which 1024 (68.5%) returned stool samples for laboratory analysis.

The sentence “The sex ratio of females to males was 3:2. In addition, the highest number of respondents were within the age range 41-70yrs (40.6%), followed by 26-40yrs (30.3%), 5-15yrs (10.7%), 16-25yrs (10.4%) and >70yrs (7.0%) (Table 2)” should be re-written as “The ages of the enrolled participants are provided in table 2.

Co-distribution patterns of Ascaris, Trichuris and Hookworm infections in Ogun State

Line1: Replace the words “mono infection” with single infection

Line 2: Delete the word “only”

Line 3: Replace the word “co-distribution” with the word “combination”

Line 5: Begin with combination of Ascaris and Trichuris and delete the word “co-distribution”

Line 6 & 7: Rewrite “while Trichuris and Hookworm co-distribution was recorded in 6 LGAs;” as “while combination of Trichuris and hookworm was……………………….”

Line 8-10: Rewrite “However, for triple infections, the three species (Ascaris, Trichuris and Hookworm) were co-distributed in 6 LGAs; Ado-Odo, Ipokia, Obafemi-Owode, Ogun waterside, Yewa North and Yewa South” as “ Triple infection comprising Ascaris, Trichuris and hookworm was recorded in 6 LGAs (table 3)”.

Aggregated prevalence of Ascaris, Trichuris and Hookworm infections in Ogun State

The sentences “The aggregated prevalence of 17.2% was recorded for at least one infection of Ascaris lumbricoides, Trichuris trichiura or hookworm. The prevalence range was between 5.3 –

49.2% across the LGAs (Figure 4). Infections were highest in Yewa south, lowest in Yewa

north and no infection was recorded in Ijebu-Ode. Of the 19 endemic LGAs, 9 had prevalence

status ranging between 20.0%-49.2% (Abeokuta north, Abeokuta south, Ifo, Ikenne, Ipokia,

Obafemi owode, Ogun waterside, Remo north and Yewa south” should be reduced to “ The highest prevalence of 49.2% was recorded in Yewa South while the lowest of 5.3% was recorded in Yewa North, however, no infection was recorded in Ijebu-Ode.

Delete this sentence “However, 10 LGAs haprevalence status ranging between 5.3%-15.8% which is below the WHO recommended thresholds for preventive chemotherapy (Ado-odo ota, Ewekoro, Ijebu east, Ijebu north, Ijebu north east, Imeko afon, Odeda, Odogbolu, Sagamu and Yewa north).

Specific prevalence estimates for Ascaris, Trichuris and Hookworm infections in Ogun

State.

The contents under this section is too wordy. The authors should highlight significant findings in terms of the most frequently encountered parasite in each LGA, the range of other parasites and if there is significant differences in prevalence of infection across the communities.

Aggregated and specific mean intensity estimates for Ascaris, Trichuris and Hookworm

infections in Ogun State.

The authors should express the intensity as eggs per gram (epg) of faeces i.e epg should be put in front of the mean intensity values in all cases.

The authors stated under this section about the single, doubleand triple infections, however there was no dat presented to show the prevalences of this infection. The table should be provided.

Discussion.

The authors should use simple grammar to discuss their findings.

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Reviewer #1: No

Reviewer #2: No

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files to be viewed.]

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Attachments

Attachment

Submitted filename: Comments on the reviewed MS.docx

PONE-D-20-06434R1

Distribution of Ascariasis, Trichuriasis and Hookworm Infections in Ogun State, Southwestern Nigeria.

PLOS ONE

Dear Dr Mogaji,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’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.

ACADEMIC EDITOR: Please revise the ms according the reviewer's suggestions to polish your ms.

We would appreciate receiving your revised manuscript by Jun 11 2020 11:59PM. When you are ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter.

To enhance the reproducibility of your results, we recommend that if applicable you deposit your laboratory protocols in protocols.io, where a protocol can be assigned its own identifier (DOI) such that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). This letter should be uploaded as separate file and labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. This file should be uploaded as separate file and labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. This file should be uploaded as separate file and labeled 'Manuscript'.

Please note while forming your response, if your article is accepted, you may have the opportunity to make the peer review history publicly available. The record will include editor decision letters (with reviews) and your responses to reviewer comments. If eligible, we will contact you to opt in or out.

We look forward to receiving your revised manuscript.

Kind regards,

Chia Kwung Fan, LL.M, PhD

Academic Editor

PLOS ONE

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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

Reviewer #2: 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: Yes

Reviewer #2: Yes

**********

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

Reviewer #1: Yes

Reviewer #2: Yes

**********

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: Yes

Reviewer #2: Yes

**********

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: Yes

Reviewer #2: Yes

**********

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)

Reviewer #2: Comments on the revised version of the MS

General comments: The authors revised the MS in line with the suggestions provided, however, there are still some minor corrections that needs to be effected in the discussion section.

Specific comments

Discussion

Line 283-284: The prevalence estimates also corroborates ………………………………….due to chemotherapy programmes in SSA countries (The statement is not clear). However, I would suggest that the sentence should be re-written to read “The prevalence values for the 3STHs recorded in this study is comparable ………………………………. (The values obtained should be compared with the findings of previous studies and may then give reason for the similarities or differences.).

Line 287: Replace the words “Sub-state level” with LGAs and communities

Line 292: Replace the following words “reported” with “recorded”; “corroborates” with “comparable”; “recent” with “previous”.

Line 293-295: The sentence “Ascaris lumbricoides infections were observed in …………………………………..by Oluwole et al. (12) should be recast to read “The increase in prevalence of A. lumbricoides infection as observed in 19 of the 20 LGAs studied is similar to the findings of Oluwole et al (12) with respect to spatial pattern of A. lumbricoides. This may be due to similar ecological factors (mention the factors) which favours the transmission of STHs in the areas of study”.

Line 296-299: Please delete the sentences “where moderate……………………………………… of STH parasites in the state”.

Line 300-302: The sentences “However, none of the LGAs studied has……………………. Population in the report of Oluwole et al. (12)” should be recast to read “The moderate prevalence of less than 20% recorded in various communities in contrast with prevalence of more than 50% reported by Oluwole et al. (12) may be due to the difference in the composition of population studied.

Line 313: Please delete the word “aggregate”

Line 316: Your assertion that hookworms egg can withstand extreme temp (I guess you meant extreme heat). Remember hookworm eggs have thin shells compared with thick shell of Ascaris eggs. It is only Ascaris eggs which can withstand adverse environmental conditions.

Line 317: Please replace the word ‘commonalities” with the word “similarities”

Line 326: replace the word “observed” with “reported”

Line 332: Replace the word “study” with “studied”

Table 3: The title should be rephrased to read “Intensity (Mean ± SEM) of Ascaris, hookworm and Trichuris infection in selected population in Ogun State”.

In table 3: Re-write the abbreviation “SE” as “SEM”. Define SEM as Standard Error of Mean

Table 4: The title should be rephrased to read "Prevalence of STH infections in relation to sex and age in selected population

Still in Table 4: Under Age group insert the word "Years" and delete the word "Years" from each age group.

**********

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

Reviewer #2: No

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files to be viewed.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email us at figures@plos.org. Please note that Supporting Information files do not need this step.

Distribution of Ascariasis, Trichuriasis and Hookworm Infections in Ogun State, Southwestern Nigeria.

PONE-D-20-06434R2

Dear Dr. Mogaji,

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,

Chia Kwung Fan, LL.M, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: