PONE-D-20-27939

Seroepidemiology of Toxoplasma gondii infection in people with alcohol consumption

PLOS ONE

Dear Dr. Cosme Alvarado-Esquivel

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. I have reviewed both reviewer comments, one of them was "reject" and the other one was Minor revision. Thus, I will give you another chance to address the comments carefully. 

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Gheyath K. Nasrallah, PhD

Academic Editor

PLOS ONE

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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: No

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?

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: 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 authors evaluated the " Seroepidemiology of Toxoplasma gondii infection in people with alcohol consumption". After close review I have recommended that the manuscript cannot be accepted for publication. Please see some major concerns as below:

Add the location of study in the title

Keywords must be different from title words.

The rational of the study is not clearly understood.

About the inclusion criteria, what about other criteria such as immune deficiency diseases, chronic diseases, etc?????

What about the exclusion criteria?

The main disadvantage of this study is the lack of a control group.

Considering serological tests, what about the range of equivocal results and index values for IgG and IgM?

Considering low specificity of IgM and IgG in the ELISA test, it is better that the authors perform the high level tests such as Elecsys Toxo IgM assay, PCR assay, …..

Add ethical statement number

Reviewer #2: Summary:

The authors studied the seroprevalence of toxoplasma in people with alcohol consumption in Durango in Mexico. They also reported the associated factors with being seropositive. The study included 1544 participants during the period 2014 to 2018 and found 11.2 % prevalence. The authors used bivariate analysis to compare the Prevalence Ratio among participants with different sociodemographic and clinical characteristics where they identified the characteristics associated with higher (or lower) prevalence ratio. The authors then included variables with statistical significance in a logistic regression model where they compared the Odd Ratio and identified consumption of armadillo meat, the use of latrine for elimination of excretes, and crowding at home as associated factors with being positive.

The authors addressed an interesting topic in a presentable fashion. They studied a wide range of characteristics which were quite compressive. The statistical methods were appropriately used to present the results.

The authors didn’t give clear description of the study setting, the sampling frame and the sampling technique.

Issues:

1- Authors might need to give a bit of context for the study settings including if it was conducted in Durango state or Durango city. It was not clear to the reviewer what area does this study cover. It was not clear as well where the recruitment of participant in the study was conducted (community, health facilities, ….???).

2- Would you explain the number mentioned in line 134 (336,606) as the size of population from which the sample was selected?

3- What was the sampling technique employed in this study? How the participants in the study were selected and enrolled?

4- Would you please highlight if the study duration of 4 years (2014 – 2018) would impact the interpretation of the results?

5- In table 5, the authors presented the logistic regression results of high IgG and some characteristics. The bivariate analysis of this characteristics was not reported in the manuscript.

6- The authors didn’t consider a P value of exactly 0.05 as significant, which is debatable.

7- In line 172, the authors stated that (crowding was not associated with seropositivity). However, it was mentioned that crowding was associated with (high) antibodies. The authors need to define the term (seropositivity) and make clear distinction between IgG, IgM and both IgG/IgM positive cases. Moreover, the clinical and statistical significance of the levels of IgG need to be explained.

8- It was mentioned in line 111 and 112 that “traveling, frequency of eating away from home (in restaurants or fast food outlets)” were studied as an associated factors. In the results section in lines 184 to 188, authors reported that these factors were not found to be associated with seropositivity. However, the reviewer failed to find these factors among the results tables.

9- In lines 173, 174 and 175, the authors mentioned that visual impairment, history of surgery, and hepatitis were associated with IgG seropositivity. This should be corrected to (negatively associated) as mentioned in line 36.

10- In line 33, the sentence starting (fitty-five …..) is confusing. Please consider mention first that 167 of the IgG positives were also tested for IgM and 55 of them were positive.

11- In line 29, please replace the word (detected) by another word (e.g. studies, measured) to avoid confusion.

12- Please consider how this study will inform the prevention and control measures.

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Reviewer #1: No

Reviewer #2: Yes: Sayed Himatt

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Seroepidemiology of Toxoplasma gondii infection in people with alcohol consumption in Durango, Mexico

PONE-D-20-27939R1

Dear Dr. Cosme Alvarado-Esquivel,

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

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Gheyath K. Nasrallah, PhD

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 #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 #2: Yes

**********

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

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 #2: Yes

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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 #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 #2: (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 #2: Yes: Sayed Himatt