Seroepidemiology and associated risk factors of hepatitis B and C virus infections among pregnant women attending maternity wards at two hospitals in Swabi, Khyber Pakhtunkhwa, Pakistan

Muhammad Israr; Fawad Ali; Arif Nawaz; Muhammad Idrees; Aishma Khattak; Shafiq Ur Rehman; Azizullah Azizullah; Bashir Ahmad; Syeda Asma Bano; Rashid Iqbal

doi:10.1371/journal.pone.0255189

Peer Review History

Original SubmissionApril 4, 2021
29 Apr 2021 Decision Letter - Isabelle Chemin, Editor PONE-D-21-11040 Seroepidemiology and Associated Risk Factors of Hepatitis B and C Virus Infections among Pregnant Women Attending Maternity Wards at Two Hospitals in Swabi, Khyber Pakhtunkhwa, Pakistan PLOS ONE Dear Dr. Israr, 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. More details are required in the results sections (see review) , precisions in the Material and methods, discussion may be strenghtened. Please submit your revised manuscript by 2 months. 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. 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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 PLOS requires an ORCID iD for the corresponding author in Editorial Manager on papers submitted after December 6th, 2016. Please ensure that you have an ORCID iD and that it is validated in Editorial Manager. To do this, go to ‘Update my Information’ (in the upper left-hand corner of the main menu), and click on the Fetch/Validate link next to the ORCID field. This will take you to the ORCID site and allow you to create a new iD or authenticate a pre-existing iD in Editorial Manager. Please see the following video for instructions on linking an ORCID iD to your Editorial Manager account: https://www.youtube.com/watch?v=_xcclfuvtxQ 3. Thank you for including your ethics statement: "The ethical endorsement for study conduction was approved by the Institutional Research Ethical Committee (IREC) of BKMC and DHQ Hospital Swabi." a) Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified (1) whether consent was informed and (2) what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If your study included minors, state whether you obtained consent from parents or guardians. If the need for consent was waived by the ethics committee, please include this information. If you are reporting a retrospective study of medical records or archived samples, please ensure that you have discussed whether all data were fully anonymized before you accessed them and/or whether the IRB or ethics committee waived the requirement for informed consent. If patients provided informed written consent to have data from their medical records used in research, please include this information. Once you have amended this/these statement(s) in the Methods section of the manuscript, please add the same text to the “Ethics Statement” field of the submission form (via “Edit Submission”). For additional information about PLOS ONE ethical requirements for human subjects research, please refer to http://journals.plos.org/plosone/s/submission-guidelines#loc-human-subjects-research. 4. We suggest you thoroughly copyedit your manuscript for language usage, spelling, and grammar. If you do not know anyone who can help you do this, you may wish to consider employing a professional scientific editing service. Whilst you may use any professional scientific editing service of your choice, PLOS has partnered with both American Journal Experts (AJE) and Editage to provide discounted services to PLOS authors. 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Upon resubmission, please provide the following: ● The name of the colleague or the details of the professional service that edited your manuscript ● A copy of your manuscript showing your changes by either highlighting them or using track changes (uploaded as a supporting information file) ● A clean copy of the edited manuscript (uploaded as the new manuscript file) 5. Thank you for stating the following financial disclosure: The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. At this time, please address the following queries: a) Please clarify the sources of funding (financial or material support) for your study. List the grants or organizations that supported your study, including funding received from your institution. b) State what role the funders took in the study. If the funders had no role in your study, please state: “The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.” c) If any authors received a salary from any of your funders, please state which authors and which funders. d) If you did not receive any funding for this study, please state: “The authors received no specific funding for this work.” Please include your amended statements within your cover letter; we will change the online submission form on your behalf. 6. 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 7. 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. [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 ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: 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 ****** 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 ****** 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: Title: Seroepidemiology and Associated Risk Factors of Hepatitis B and C Virus Infections among Pregnant Women Attending Maternity Wards at Two Hospitals in Swabi, Khyber Pakhtunkhwa, Pakistan In the abstract: there is no result conclusion indicated! Method part � Source population is not stated under method part � Under method part: hierarchal permission process for the research was not described well and ethical principle was not stated well! (e.g. for those positive cases how the investigator manage the issue and also whether verbal or written consent was taken) � Sampling techniques and sample size were not described. � Quality assurance measures were not stated. � Hospital and health center were used interchangeably (but not the same) � Interpretation of the laboratory test for both viruses was not stated! � Data analysis steps were not clear to understand how it was performed Result � Result part was not elaborated well (e.g by describing the socio-demographic factors except in the table) � Prevalence of HBV and HCV, the socio-demographic factors and associated factors shall be stated separately under different subtitles as the objective � In addition to table, if graphs are used to show the result, it will be good to easily understand the result in %. � There must be an explanation for why “Dental extraction, Receiving blood transfusion, Educational level and Residential status associated with HBVsAg positivity and Surgical procedure, maternal age for HCV Ab positivity” Under discussion: Strength and Limitation of the study shall be specified Under Conclusion � The result was not interpreted well whether it was high or low according to WHO guidelines for HBV and HCV (whether it falls in the endemic interval or hyper endemic interval and only risk factors were stated in line with the result. ****** 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: 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: reviewer comment April 18 2021.docx https://doi.org/10.1371/journal.pone.0255189.r001
Revision 1
21 May 2021 Author Response Dear Dr. Isabelle Chemin, We are grateful to you and the reviewers for reading and constructive suggestions which improved our manuscript and for the opportunity to revise and resubmit. We are pleased to submit the revised manuscript entitled “Seroepidemiology and Associated Risk Factors of Hepatitis B and C Virus Infections among Pregnant Women Attending Maternity Wards at Two Hospitals in Swabi, Khyber Pakhtunkhwa, Pakistan” with Id PONE-D-21-11040 for consideration in PLOS ONE. On the following pages, you will find our response to the editor and reviewer comments. The editor and reviewer comments are highlighted with red color and responses to each point with bold text. On behalf of my co-authors, I thank you for your consideration of this resubmission. We appreciate your time and look forward to your response. Sincerely, Dr. Muhammad Israr, PhD, Postdoc (Corresponding Author) Associate Professor, Department of Biology The University of Haripur, KPK, Pakistan Responses to Editor Comments: 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. More details are required in the results sections (see review); precisions in the Material and methods, discussion may be strengthened. Please submit your revised manuscript by 2 months. 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. We are grateful to the editor for these constructive suggestions. The results, material and method and discussion sections were revised according to editor suggestions and highlighted with red color. 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'. A letter “Response to Reviewers” Revised Manuscript with Track Changes and Revised Manuscript without Track Changes are attached according to editor suggestions. 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 The whole manuscript is revised according to the journal PLOS ONE style requirements 2. PLOS requires an ORCID iD for the corresponding author in Editorial Manager on papers submitted after December 6th, 2016. Please ensure that you have an ORCID iD and that it is validated in Editorial Manager. To do this, go to ‘Update my Information’ (in the upper left-hand corner of the main menu), and click on the Fetch/Validate link next to the ORCID field. This will take you to the ORCID site and allow you to create a new iD or authenticate a pre-existing iD in Editorial Manager. Please see the following video for instructions on linking an ORCID iD to your Editorial Manager account: https://www.youtube.com/watch?v=_xcclfuvtxQ The registered ORCID ID of the corresponding author is validated in the Editorial Manager. 3. Thank you for including your ethics statement: "The ethical endorsement for study conduction was approved by the Institutional Research Ethical Committee (IREC) of BKMC and DHQ Hospital Swabi." a) Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified (1) whether consent was informed and (2) what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If your study included minors, state whether you obtained consent from parents or guardians. If the need for consent was waived by the ethics committee, please include this information. If you are reporting a retrospective study of medical records or archived samples, please ensure that you have discussed whether all data were fully anonymized before you accessed them and/or whether the IRB or ethics committee waived the requirement for informed consent. If patients provided informed written consent to have data from their medical records used in research, please include this information. Once you have amended this/these statement(s) in the Methods section of the manuscript, please add the same text to the “Ethics Statement” field of the submission form (via “Edit Submission”). For additional information about PLOS ONE ethical requirements for human subject’s research, please refer to http://journals.plos.org/plosone/s/submission-guidelines#loc-human-subjects-research. The ethical approval was modified according to the editor suggestions both in Method section and in the online manuscript submission system. 4. We suggest you thoroughly copyedit your manuscript for language usage, spelling, and grammar. If you do not know anyone who can help you do this, you may wish to consider employing a professional scientific editing service. Whilst you may use any professional scientific editing service of your choice, PLOS has partnered with both American Journal Experts (AJE) and Editage to provide discounted services to PLOS authors. Both organizations have experience helping authors meet PLOS guidelines and can provide language editing, translation, manuscript formatting, and figure formatting to ensure your manuscript meets our submission guidelines. To take advantage of our partnership with AJE, visit the AJE website (http://learn.aje.com/plos/) for a 15% discount off AJE services. To take advantage of our partnership with Editage, visit the Editage website (www.editage.com) and enter referral code PLOSEDIT for a 15% discount off Editage services. If the PLOS editorial team finds any language issues in text that either AJE or Editage has edited, the service provider will re-edit the text for free. Upon resubmission, please provide the following • The name of the colleague or the details of the professional service that edited your manuscript • A copy of your manuscript showing your changes by either highlighting them or using track changes (uploaded as a supporting information file) • A clean copy of the edited manuscript (uploaded as the new manuscript file) Thank you for this comment. The manuscript is copyedited for language usage, spelling, and grammar by an English speaking colleague Dr. Helen Appleton, Professor at the University of Oxford. 5. Thank you for stating the following financial disclosure: The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. At this time, please address the following queries: a) Please clarify the sources of funding (financial or material support) for your study. List the grants or organizations that supported your study, including funding received from your institution b) State what role the funders took in the study. If the funders had no role in your study, please state: “The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. c) If any authors received a salary from any of your funders, please state which authors and which funders d) If you did not receive any funding for this study, please state: “The authors received no specific funding for this work.” Please include your amended statements within your cover letter; we will change the online submission form on your behalf. The amended statements for the funders and funding source in the research work are given bellow b) “The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript”. d) “The authors received no specific funding for this work.” 6. 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 The authors are grateful to the editor for this comment. The tables and figures were included in the main manuscript and the individual files were removed according to editor suggestion. 7. 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. The references list was modified and rearranged in the revised manuscript according to journal references format as suggested by the editor. Responses to Reviewer comments 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________________________________________2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: 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________________________________________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 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: Title: Seroepidemiology and Associated Risk Factors of Hepatitis B and C Virus Infections among Pregnant Women Attending Maternity Wards at Two Hospitals in Swabi, Khyber Pakhtunkhwa, Pakistan In the abstract: there is no result conclusion indicated! We are grateful to the reviewer for this comment. The abstract of the manuscript is divided into subsections i.e. (Background & aim, Methodology, Results, Conclusion and Recommendation) and modified according to journal format. The result conclusion is also indicated according to reviewer comment and highlighted with red color. Method part � Source population is not stated under method part The authors are thankful to reviewer for this comment. Source population is added in the method section under the subheading “Source and study population” and highlighted with red color. � Under method part: hierarchal permission process for the research was not described well and ethical principle was not stated well! (e.g. for those positive cases how the investigator manage the issue and also whether verbal or written consent was taken). Thanks for this comments. The hierarchal permission process for the research and ethical principle are described well in the method part and modified according to the reviewer comment. � Sampling techniques and sample size were not described. Sample techniques and sample size are stated in the method section under the subheading “Sample size and sampling” and highlighted with red color. � Quality assurance measures were not stated. In revised manuscript, the Quality assurance measures are stated in the method section under the subheading “Quality assurance measures” � Hospital and health center were used interchangeably (but not the same) The authors are grateful to the reviewer for arising this point. The authors are agreed with reviewer that Hospital and health center are not the same and should not be used interchangeably, thus the word “Hospital” is used in the entire manuscript and highlighted with red color. � Interpretation of the laboratory test for both viruses was not stated! We are grateful to the reviewer for this comment. The laboratory tests (ICT and ELISA) were described in detail in the method section under subheadings “HBsAg and HCV-Ab detection through ICT” and “HBsAg and HCV-Ab detection through ELISA”. The interpretation of the test results are stated under the theses subheadings. � Data analysis steps were not clear to understand how it was performed The authors are thankful to the reviewer for this comment. Data analysis statement was described in detail in method section under subheading “Statistical analysis” which can clearly be understood by the readers how the data was analyzed. Result � Result part was not elaborated well (e.g by describing the socio-demographic factors except in the table) We are obliged to reviewer for this comment. The result section is sub-headed in “Socio demographic characteristics”. The socio-demographic characteristics are described in detail under result section which explains all the results stated in the tables. � Prevalence of HBV and HCV, the socio-demographic factors and associated factors shall be stated separately under different subtitles as the objective. The authors are agreed with the reviewer comment. Prevalence of HBV and HCV, Socio demographic characteristics and associated risk factors are stated separately under different subheadings and highlighted with red color. � In addition to table, if graphs are used to show the result, it will be good to easily understand the result in %. We appreciate the reviewer for this suggestion. In addition to tables, one graph was created for showing the prevalence results in percentages and uploaded as a separate file in the online Editorial Manager system according to reviewer comment. � There must be an explanation for why “Dental extraction, Receiving blood transfusion, Educational level and Residential status associated with HBsAg positivity and surgical procedure, maternal age for HCV Ab positivity” The authors are obliged to reviewer for this suggestion. Following the reviewer suggestions, the Dental extraction, Receiving blood transfusion, Educational level and Residential status associated with HBsAg positivity and surgical procedure, maternal age for HCV Ab positivity” are explained in result section under the subheadings “Socio demographic characteristics “, “Associated risk factors” and “Prevalence of HBV and HCV Infections” and highlighted with red color. Under discussion: Strength and Limitation of the study shall be specified We are grateful to the reviewer for this comment. Strength and limitations of the study are specified in the discussion section under the subheading “Study limitations” and highlighted with red color. Under Conclusion The result was not interpreted well whether it was high or low according to WHO guidelines for HBV and HCV (whether it falls in the endemic interval or hyper endemic interval and only risk factors were stated in line with the result. The authors appreciate the reviewer for this constructive suggestion. Some new sentences are added in the conclusion section which interpreted the results whether the prevalence of HBV and HCV is high or low according to WHO guideline. Attachments Attachment Submitted filename: Responses to Editor and Reviwers.docx https://doi.org/10.1371/journal.pone.0255189.r002
25 Jun 2021 Decision Letter - Isabelle Chemin, Editor PONE-D-21-11040R1 Seroepidemiology and Associated Risk Factors of Hepatitis B and C Virus Infections among Pregnant Women Attending Maternity Wards at Two Hospitals in Swabi, Khyber Pakhtunkhwa, Pakistan PLOS ONE Dear Dr. Israr, 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 few the points raised during the review process. Please submit your revised manuscript by 4 weeks. 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. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Isabelle Chemin, PhD 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. [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: (No Response) ******** 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: Please see attachment to decision letter for review comments from Reviewer #1 ****** 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 [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: Reviewer #1 Minor correction for the author (1).docx https://doi.org/10.1371/journal.pone.0255189.r003
Revision 2
26 Jun 2021 Author Response Responses to Reviewer Comments: Comments were incorporated by the authors but I do have the following minor comments to be considered! Suggestions were proposed in green colors as indicated below! Abstract part: Methodology 10 ml of blood was collected from each participated mother …rather put as “From a total of 375 pregnant women selected using systematic random sampling from both hospitals, 10ml of blood samples were collected……. Response: We are grateful to the reviewer for this suggestion. The above suggested sentence was added in the revised version and highlighted with red color in track changes Under Method parts Source and study population All pregnant women attending maternity wards for antenatal care health facilities at Bacha Khan Medical Complex (BKMC) Shahmansoor and District Head Quarter (DHQ) Hospital Swabi from surrounding urban and rural areas of district Swabi during July 2019 -January 2020 were the source and study population: Source population and study population is not the same Source populations were e all pregnant women attending hospital maternity wards for antenatal care at Bacha Khan Medical Complex (BKMC) Shahmansoor and District Head Quarter (DHQ) Hospital Swabi from surrounding urban and rural areas of district Swabi Study population were all pregnant women attending hospital maternity wards for antenatal care at Bacha Khan Medical Complex (BKMC) Shahmansoor and District Head Quarter (DHQ) Hospital Swabi from surrounding urban and rural areas of district Swabi during July 2019 -January 2020. Response: Thanks to arise this point. Yes, we are agree with reviewer that the source population and study population are not the same and can be written in separate. In order to follow the reviewer suggestion, the source population and study population were added in method section under separate headings and highlighted with red color in revised version with track changes. Sample size and sampling ……better if it will be written as “Sample size and sampling technique/procedure” The two hospitals were selected conveniently! Response: Thanks for this minor comment. The above sentence suggested by the reviewer was added in the revised version and highlighted with red color in track changes. Sample collection 10ml of blood samples were………………….better to write as “Ten milliliter of blood samples were” starting with number is not recommended Response: The authors are grateful to the reviewer for this minor comment. The above suggested sentence was added in the revised version and highlighted with red color in track changes. Ethical endorsement Management of positive tested participants not addressed? (Example: those participants with positive test were given medication free of charge OR their result was communicated with respective physician for further treatment) Response: We are obliged to the reviewer for comment. The management of HBsAg and HCV-Ab positive tested participant was incorporated with respective physician for further treatment and addressed in the revised version under the ethical endorsement and highlighted with red color in track changes. Note: The whole manuscript was read for any other minor mistakes and corrected accordingly. Attachments Attachment Submitted filename: Responses to Reviwers.docx https://doi.org/10.1371/journal.pone.0255189.r004
12 Jul 2021 Decision Letter - Isabelle Chemin, Editor Seroepidemiology and Associated Risk Factors of Hepatitis B and C Virus Infections among Pregnant Women Attending Maternity Wards at Two Hospitals in Swabi, Khyber Pakhtunkhwa, Pakistan PONE-D-21-11040R2 Dear Dr. Israr, 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, Isabelle Chemin, 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 #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: (No Response) ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: (No Response) ****** 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) ****** 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) ****** 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) ****** 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 https://doi.org/10.1371/journal.pone.0255189.r005
Formally Accepted
12 Aug 2021 Acceptance Letter - Isabelle Chemin, Editor PONE-D-21-11040R2 Seroepidemiology and Associated Risk Factors of Hepatitis B and C Virus Infections among Pregnant Women Attending Maternity Wards at Two Hospitals in Swabi, Khyber Pakhtunkhwa, Pakistan Dear Dr. Israr: 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 Mrs Isabelle Chemin Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0255189.r006

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