Trends of proximate low birth weight and associations among children under-five years of age: Evidence from the 2016 Ethiopian demographic and health survey data

Mesfin Wudu Kassaw; Ayele Mamo Abebe; Ayelign Mengesha Kassie; Biruk Beletew Abate; Seteamlak Adane Masresha

doi:10.1371/journal.pone.0246587

Peer Review History

Original SubmissionSeptember 4, 2020
20 Nov 2020 Decision Letter - William Joe, Editor PONE-D-20-27909 Trends of proximate low birth weight and associations among children under-five years of age : Evidence from the 2016 Ethiopian demographic and health survey data PLOS ONE Dear Dr. Kassaw, 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. Please submit your revised manuscript by Dec 26 2020 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 plosone@plos.org. When you're 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. 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). You should upload this letter as a separate file labeled 'Response to Reviewers'. 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, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols We look forward to receiving your revised manuscript. Kind regards, William Joe Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. Please include your tables as part of your main manuscript and remove the individual files. Please note that supplementary tables (should remain/ be uploaded) as separate "supporting information" files 3. Please list the name and version of any software package used for statistical analysis, alongside any relevant references. For more information on PLOS ONE's expectations for statistical reporting, please see https://journals.plos.org/plosone/s/submission-guidelines.#loc-statistical-reporting. [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 ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: No Reviewer #2: Yes ****** 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: Yes ****** 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: No Reviewer #2: Yes ****** 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: 1)In abstract result is not presented properly instead only statistics are given. please write the major findings in sentence. 2)In method section you have listed a set of of characteristics but you have not given any justification why you refer to these characteristics, are they from your literature study, if so mention clearly. please highlight the specific research gap you have tried to address in your work. 3) The result section is presented in a casual manner and table statistics were presented only. please write in words what they imply. 4) If information on birth weight is available in the data set then can you use this variable as birth size may be subjective as it is based on perception of the mother may be or that of respondent. 5) The set of of explaining variables in the table 2 does not give justification why you choose them, instead you can run a factor analysis and find out the most important ones. some of these explaining variables might have association between them. 6) I suggest authors should use factor analysis to identify which explaining variables are related to the individual characteristics (maternal education, khat chewing, child sex, sex of the child, child birth type etc), household characteristic (wealth, residence religion etc) and policy variable (place of delivery, delivery attended by whom??). 7) a justification for using binomial logit can be provided. 8) the language in the text needs to be refined. please take help of professional to refine the text. for example what do you mean by 'child sex', instead sex of the child would be better. 9) In conclusion section there is no reference to how this research contributes to policy for child health. please include some policy implication. 10)Your region variable is very important and you have not shown how different regions in Ethopia vary in socioeconomic profile. It will help to build context for regional variation in your analysis. 11) Please give the model statistics to show the robustness of your model fit. 12) please write a section on policies adopted in Ethopia on child health and what can be done to improve them for better child health outcome in terms of birth weight and size of the child at birth. Reviewer #2: I really appreciate the efforts by the author(s) on this manuscript but I feel the paper is not yet ready for publication in current shape and needs some major revisions. My comments are as follows: 1. The introduction should aim to contextualize the topic for the empirical analysis from the evidence with focus on similar studies from Ethiopia that were conducted in recent years. 2. The authors should present bivariate analysis to see the relationship and outcome of independent and dependent variables rather than directly attempting the regression analysis. This analysis will help understand the correlations across determinants and its association with low birth weight. 3. I also found the author(s) is missing many of the maternal health factors which are affecting the birth weight. For example, maternal BMI, anemia status, maternal nutrition and indicators such as antenatal care etc. 4. The policy implications of the findings should be discussed in the context of the literature and policy focus in Ethiopia. 5. The trend analysis should be highlighted in the introduction or in the discussion section. Author should incorporate the comments and revise the manuscript and submit again as I think the topic has potential to be published but not in current form. ****** 6. 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: Yes:** RUDRA NARAYAN MISHRA 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.] 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 PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. Attachments Attachment Submitted filename: Review_31-10-20.docx https://doi.org/10.1371/journal.pone.0246587.r001
Revision 1
27 Nov 2020 Author Response Responses for reviewer comments First of all, we would like to say thank you for your constructive and very important comments. General comments We accept the comments and take appropriate changes. We have also edited the language Reviewer #1: 1. In abstract, result is not presented properly instead only statistics are given. Please write the major findings in sentence. We write the prevalence, and the variation in child size. In addition we have also listed the associated variables. But we may not able to show the findings clearly. The major findings are presented with major statistics. 2. In method section you have listed a set of characteristics but you have not given any justification why you refer to these characteristics, are they from your literature study, if so mention clearly. Please highlight the specific research gap you have tried to address in your work. We select the characteristics based on literature but if the variables we select are not available at the EDHS data, we forced to omit it. We tried to add the gaps regarding this research in last paragraph of the introduction part. 3. The result section is presented in a casual manner and table statistics were presented only. Please write in words what they imply. We write some of the contents of the table in narration as per the comment. But we are unable to write all the contents from the table to text. 4. If information on birth weight is available in the data set then can you use this variable as birth size may be subjective as it is based on perception of the mother may be or that of respondent. The birth weight in the data set is not complete. There are many missing variables even mothers cannot remember the exact birth weight but they can remember the size easily. And almost many of mothers gave a date regarding the average size. But, if there is a data of birth weight, we did not use it because our operational definition does not consider it. We take the data reported from mothers or care givers as per the EDHS inclusion criteria 5. The set of explaining variables in the table 2 does not give justification why you choose them, instead you can run a factor analysis and find out the most important ones. Some of these explaining variables might have association between them. Sorry for missing the clarification of variable selection to multivariate analysis but we included in this version at the first paragraph, first line of factors associated with proximate LBW section. We select variables that have a p-value of 0.25 or below, and we run mlticollinearity test between close variables based on literature and authors knowledge. In this scenario, Khat chewing and cigarette smoking were had collinearity. Thus, we select Khat chewing to the multivariate analysis. However, none of the other variables have no collinearity and we tried some of the variables randomly. 6. I suggest authors should use factor analysis to identify which explaining variables are related to the individual characteristics (maternal education, khat chewing, child sex, sex of the child, child birth type etc), household characteristic (wealth, residence, religion etc) and policy variable (place of delivery, delivery attended by whom?). We accept the comment and we tried a multicollinearity test for the association in between them. In the entire variables, there was no association as the Tolerance (VIF) indicates except Khat chewing and cigarette smoking. 7. A justification for using binomial logit can be provided. The outcome variables are binary, and fulfill the assumption of logistic regression like normality test, and large sample size, and model fitness test. We included this justification in the data analysis section. 8. The language in the text needs to be refined. Please take help of professional to refine the text. For example what do you mean by 'child sex', instead sex of the child would be better. Accepted and get an English language professional for final edition. 9. In conclusion section there is no reference to how this research contributes to policy for child health. Please include some policy implication. Accepted and try to include a policy implication using data from Minister of Health, Ethiopia and other find. We have also cited as per the comment. 10. Your region variable is very important and you have not shown how different regions in Ethiopia vary in socioeconomic profile. It will help to build context for regional variation in your analysis Thank you, most of the regions have association with PLBW as our multivariate analysis indicates but we did not describe it as per the socio-economic perspective. However, we include a justification with citation in the discussion part. 11. Please give the model statistics to show the robustness of your model fit. We include it in data analysis section that the model is fitted as per the Hosmer-lemeshow-goodness of fit test. 12. Please write a section on policies adopted in Ethiopia on child health and what can be done to improve them for better child health outcome in terms of birth weight and size of the child at birth. We have added such section in the background Reviewer #2: 1. The introduction should aim to contextualize the topic for the empirical analysis from the evidence with focus on similar studies from Ethiopia that were conducted in recent years. We accept the comment and we cited some studies that conducted in Ethiopia. 2. The authors should present bivariate analysis to see the relationship and outcome of independent and dependent variables rather than directly attempting the regression analysis. This analysis will help understand the correlations across determinants and its association with low birth weight. In table two, we include the cross-tab result, the binary result (COR), and the multilevel regression (AOR) result. We did not directly run multilevel analysis, but to include the details of the binary result, the table cannot be managed. However, we include the most important components even for authors who want to done meta-analysis we include the cross-tab (A, B, C & D) variables. For selecting variables for multivariate analysis based on COR, we indicate in (). Thus, we cannot manage all the binary and multivariate results in one table rather we prefer to present the most important contents based on some other researches. 3. I also found the author(s) is missing many of the maternal health factors which are affecting the birth weight. For example, maternal BMI, anemia status, maternal nutrition and indicators such as antenatal care etc. I really sorry for not answering this question by adding the variables, but these variables were excluded at the beginning of the study when we refine the data. The major limitation of DHS analysis is losing such important variables. When we select the outcome variables, we forced to lose some variables simultaneously. In addition, some of variables like BMI excluded because of missing data on the variable. 4. The policy implications of the findings should be discussed in the context of the literature and policy focus in Ethiopia. We accepted it and include a policy indication in the conclusion section with citation 5. The trend analysis should be highlighted in the introduction or in the discussion section. We tried to indicate the trend as follow The aim of this study was to assess the trends of proximate LBW and associations from 2011 to 2016 in Ethiopia using the 2016 EDHS data. Since the survey had 5 years compressive data, it can indicate the trends better than the other primary and area specific studies. Attachments Attachment Submitted filename: Point by point feedback-to reviewers.docx* https://doi.org/10.1371/journal.pone.0246587.r002
4 Jan 2021 Decision Letter - William Joe, Editor PONE-D-20-27909R1 Trends of proximate low birth weight and associations among children under-five years of age: Evidence from the 2016 Ethiopian demographic and health survey data PLOS ONE Dear Dr. Kassaw, 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. Please submit your revised manuscript by Feb 18 2021 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 plosone@plos.org. When you're 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. 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). You should upload this letter as a separate file labeled 'Response to Reviewers'. 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, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols We look forward to receiving your revised manuscript. Kind regards, William Joe Academic Editor PLOS ONE [Note: HTML markup is below. Please do not edit.] 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 ******** 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 ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: 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 ****** 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 ****** 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: you can give the equation for your logistic model in the final version of the paper. Also write bit more about policy implication of your paper. In the introduction write few sentence about how this research is bridging any existing gap in the available research on the topic. ****** 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: Yes:** RUDRA NARAYAN MISHRA [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.] 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 PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0246587.r003
Revision 2
11 Jan 2021 Author Response Responses for reviewer comments First of all, we would like to say thank you for your constructive and very important comments. I included the following sentences as per the reviewer comments You can give the equation for your logistic model in the final version of the paper. 1. In the introduction write few sentences about how this research is bridging any existing gap in the available research on the topic. 2. Because of that most previous conducted studies are limited geographically, by population, and sample size. In addition, those studies are single shot and did not show the trends of low birth weight which might be susceptible to bias because of drought or other seasonal factors like political instability and natural disaster. However, this study considered a 5 consecutive year’s data to assess the trends and potential determinants of proximate low birth weight. Also write bit more about policy implication of your paper 3. Thus, this paper will be used by ministry, health facilities, and volunteer organizations to develop and amend policies to treat or prevent low birth weight in the country. Thank you!! Attachments Attachment Submitted filename: Responses for reviewer comments.docx https://doi.org/10.1371/journal.pone.0246587.r004
22 Jan 2021 Decision Letter - William Joe, Editor Trends of proximate low birth weight and associations among children under-five years of age: Evidence from the 2016 Ethiopian demographic and health survey data PONE-D-20-27909R2 Dear Dr. Kassaw, 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. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, William Joe Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0246587.r005
Formally Accepted
29 Jan 2021 Acceptance Letter - William Joe, Editor PONE-D-20-27909R2 Trends of proximate low birth weight and associations among children under-five years of age: Evidence from the 2016 Ethiopian demographic and health survey data Dear Dr. Kassaw: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. William Joe Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0246587.r006

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