PONE-D-20-35931

The epidemiology of autoimmune bullous diseases in Sudan between 2000 and 2016

PLOS ONE

Dear Dr. Siddig,

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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Amit Sapra

Academic Editor

PLOS ONE

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Reviewers' comments:

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Comments to the Author

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Reviewer #1: Yes

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

Reviewer #1: Yes

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Reviewer #1: Yes

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Reviewer #1: Yes

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Reviewer #1: 1) the study design should be- Retrospective Cross Sectional Study. 2) Lack of consent - can present as an ethical consideration 3) Grammatical errors which need correction 4) Better to mention the percentages of males and females being affected for each AIBD group should be mentioned rather than Male: Female ratio. 5) Bar graph representation of the age of patients being affected for each AIBD group can be included for a better visual representation. 6) Authors have included a Fig 3 ( bar graph) showing various comorbidities that the patients had. I think it would be better if the authors elaborate on the same. For an example if they found a higher prevalence of an AIBD's with a particular underlying comorbidity, that would be very informative.

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Reviewer #1: No

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PONE-D-20-35931R1

The epidemiology of autoimmune bullous diseases in Sudan between 2000 and 2016

PLOS ONE

Dear Dr. Siddig,

Thank you for submitting your revised 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 May 06 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,

Feroze Kaliyadan, M.D.

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

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Reviewers' comments:

Reviewer #2: I appreciate the authors attempt to evaluate ‘The epidemiology of autoimmune bullous diseases in Sudan between 2000 and 2016’. Some minor comments

1. “However, in some Arab Gulf countries, namely Kuwait [9] and Saudi Arabia [23], the disease was reported in males more than females suggesting an element of gender inequality in those countries [32]….” (Lines 151-153). Strongly recommend to delete the wording ‘gender inequality in those countries’. How will a difference in male:female ratio in a country denote an element of gender inequality? The reference 32 as cited by the authors was commenting on concluded that “his study highlighted important differences in access to and utilisation of PHCS between urban and rural populations in Riyadh province in the KSA. These findings have implications for policy and planning of PHCCs and reducing inequalities in health care between rural and urban populations…” Hence the authors claim is neither supported by the cited literature. There are AI conditions where there may be male:female incidence differences. In the same paragraph, authors were commenting “In contrast, more males were affected by PF than females in France [26], Turkey [16], Singapore [19], and Israel [22]…” Whether authors inference that there is ‘an element of gender inequality’ in these countries too! Moreover, in Line 184, authors were stating there is higher female preponderance for BP in Kuwait.

2. The authors rightly mentioned in the manuscript regarding retrospective study design and possibility of missing the information (as could be extracted from a leading question). Please highlight specifically the lack of information on neurological disease a/w AIBD in this study.

[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.

The epidemiology of autoimmune bullous diseases in Sudan between 2000 and 2016

PONE-D-20-35931R2

Dear Dr. Siddig,

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.

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Kind regards,

Feroze Kaliyadan, M.D.

Academic Editor

PLOS ONE