PONE-D-21-12148

Immunosurveillance and molecular detection of hepatitis B virus infection amongst vaccinated children in the West Gonja District in Savanna Region of Ghana

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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Reviewer #1: Yes

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Reviewer #1: Yes

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Reviewer #1: Yes

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5. Review Comments to the Author

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Reviewer #1: This is a cross-sectional study conducted by investigators at three universities of Ghana to decide the seroprotection rate and the prevalence of hepatitis B virus (HBV) infection among 350 fully vaccinated children in the West of Gonja, Ghana, Africa, in 2019. Ghana is a low-income country where HBV vaccination was implemented in 2002. The study supplies data like international publications.

Although hepatitis B is an immuno-preventable disease, there is still a substantial proportion of people suffering from chronic infection and of these, more than 80% are in sub-Saharan Africa. Although in Ghana the prevalence of chronic HBV infection is less than 10%, it is particularly important to know the vaccination status.

The authors presented an interesting manuscript, whose implemented method that supports the obtained findings and their conclusions. The results of this study show the importance of monitoring seroprotection after vaccination for HBV to assess the ability of the vaccine.

This study is also important because in West Gonja, Damongo no studies have been carried out to evaluate seroprotection and therefore its findings supply new knowledge. Although electricity problems are known to affect the quality of the vaccine, it is important that these findings are considered when implementing post-vaccination surveillance programs.

Specific comments

1. The introduction has the overall context and approach of importance of vaccination HBV.

2. In the study design and study site section, the authors should include a further description of the geographical area where the study was carried out. Consider aspects of temperature, organization, size of the city, population or another information that authors considers important.

3. In the study population and eligibility criteria to include how much is the n of the population from 9 months to 17 years and of these how many are fully vaccinated. What was the sample size calculation? Indicate the prevalence for hepatitis B infection and the power considered to calculate the sample size. Additionally, describe in detail the inclusion criteria for the study.

4. In the laboratory analysis section to include the number of replicates of the experiment and how the authors confirmed the results.

5. In the DNA detection section, which controls were used. Mention the sensitivity and specificity of the molecular test.

6. In the results section, explain in detail how many children were initially screened and how many didn't have the inclusion criteria.

7.It is suggested to the authors for the presentation of the results of Table 3, to make a flow chart that writes down in better detail the results obtained in the serological and molecular study. This table does not have an adequate presentation.

8. The conclusion describes that 86% of the participants seroconverted after primary vaccination. Could the authors explain how was obtained this result?

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Reviewer #1: No

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Immunosurveillance and molecular detection of hepatitis B virus infection amongst vaccinated children in the West Gonja District in Savanna Region of Ghana

PONE-D-21-12148R1

Dear Dr. Narkwa,

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,

Isabelle Chemin, PhD

Academic Editor

PLOS ONE

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