PONE-D-20-38405

The Magnitude of Hypertension and Associated Factors among Clients Receiving Highly Active Antiretroviral Treatment in Southern Ethiopia, 2020 (Hospital-Based Cross-Sectional Study)

PLOS ONE

Dear Dr. Habte,

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Claudia Marotta

Academic Editor

PLOS ONE

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Additional Editor Comments:

dear Authors follow reviewer suggestions to improve your paper

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Reviewers' comments:

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Comments to the Author

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Reviewer #1: Partly

Reviewer #2: Yes

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

Reviewer #1: I Don't Know

Reviewer #2: No

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: No

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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: Major

1) the objectives of the study are not clear and should be stated in the initial study design section

2) the sample size calculation section is confusing. It should be clear what the primary objective is and the assumptions used to calculate a sample size to meet that primary objective.

3) The sampling strategy is also unclear. Were the clients listed randomly and then every third chosen? Were they stratified in any way? Or just every third chosen from the existing client register? This needs to be clarified in the manuscript.

4) Please address why no participants appear to be on second line PI-based regimens.

5) The frequency of hyperlipidemia is listed at 12 percent but it is not clear how this is defined or measured. Medical history or self report is unlikely to be accurate unless there is comprehensive screening for hyperlipidemia as standard of care in this setting.

6) It is not clear how the alternate measurement tool could account for the alcohol use finding. This should be addressed more specifically

7) The authors should discuss potential explanations for TDF based regimens being a risk factor and the implications of the TLD transition

8) I don't think use of contraceptives or receipt of corticosteroids are appropriate exclusion criteria. it would be important to know how common these exclusions were.

Minor

1) probably more appropriate to use the term "frequency" of hypertension rather than "magnitude"

2) Prefer "renal failure" to "kidney failure"

3) prefer "people living with HIV" to "HIV-positive people"

4) recommend consistently use ART instead of HAART

5) It would be helpful to describe the usual practice of blood pressure screening for HIV clinic visits at the hospital where participants were recruited and the usual standard of care for hypertension management in this setting.

6) It would be acceptable to just cite the methods for hypertension definition as opposed to detailing in the manuscript

7) Could consider using a separate table to list out the many definitions

8) describe what a recent viral load is considered to be in the paper (within the past year?)

9) What is the "reference" CD4? The nadir or baseline? Recommend clarification.

Reviewer #2: See attachment.

The paper needs language edit.

Issue related with sample size should be cleared

Current BMI should be in the model and see the AOD for other variables, the findings may change.

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Reviewer #1: No

Reviewer #2: Yes: Saro Abdella Abrahim

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Attachments

Attachment

Submitted filename: Reviewer comment_Saro.docx

Attachment

Submitted filename: Manuscript to be reviewed.docx

PONE-D-20-38405R1

The Magnitude of Hypertension and Associated Factors among Clients on Highly Active Antiretroviral Treatment in Southern Ethiopia, 2020: A Hospital-Based Cross-sectional Study

PLOS ONE

Dear Aklilu Habte,

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 15th Sept 2021. 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,

Professor Kwasi Torpey, MD PhD MPH

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.

Additional Editor Comments (if provided):

Thank you for the revision of the manuscripts to address the reviewers' comments. It has significantly improved however there are still a number of areas requiring attention.

1. There is a difference between the manuscript with tracked changes and the clean version. The tracked changes version captures most of the proposed changes. I suggest the authors to use the tracked changes version to generate the clean version paying attention to version control. Given the differences, the tracked changes version was used in this review

2. Abstract/Results: Correct typo hypertensiion to hypertension

3. Introduction page 3 last but one paragraph: Should be ART not ARRT

Page 3 last but one paragraph: Should be people living with HIV not people livening with HIV

4. Intro page 3 last but one paragraph : Sentence should read treatment is not risk free or free of side effects

and not risk free or side effects

5. Into last paragraph AIDS unrelated mortality should be non-AIDS related mortality

6. Materials and methods: need to be consistent on use of capitalization. For examples naming the departments ie Some are capitalized others are not

7. Population of the study line 172: remove comma and start capitalize w in women

8. Data quality management Line 236/7: . Revise sentence. Data collected was verified for completeness. PI and supervisor oversaw overall data collection. Remove every day from sentence

9. Conclusion: Revise opening statement . Seems out of place

10. Manuscript needs another round of copyediting. Lipodystrophy instead of lypodystrophy. Keep spelling consistent

11. Revise all references to meet journal requirements

[Note: HTML markup is below. Please do not edit.]

[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.]

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The Magnitude of Hypertension and Associated Factors among Clients on Highly Active Antiretroviral Treatment in Southern Ethiopia, 2020: A Hospital-Based Cross-sectional Study

PONE-D-20-38405R2

Dear Aklilu Habte,

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,

Professor Kwasi Torpey, MD PhD MPH

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: