PONE-D-21-13362

Determinants of first-line antiretroviral treatment failure among adult patients on antiretroviral therapy in a Specialized Hospital, South West Ethiopia; A case control Study

PLOS ONE

Dear Dr. Siraj,

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.

Two experts in the field handled your manuscript, and we are appreciative of their time and contributions. Although interest was found in your study, several major concerns arose that require your attention. Notably, the novelty of this study needs to be stated in the rationale. Also, it was indicated that the scope of this work is a bit narrow to a region of Ethiopia and should be expanded to engage the broad audience of this Journal and how these findings could relate to international health outcomes. 

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Frank T. Spradley

Academic Editor

PLOS ONE

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3. We noted several instances in the manuscript where the P value equals zero; please correct and clarify.

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6. Thank you for submitting the above manuscript to PLOS ONE. During our internal evaluation of the manuscript, we found significant text overlap between your submission and the following previously published works, some of which you are an author.

https://www.dovepress.com/virological-treatment-failure-among-adult-hivaids-patients-from-select-peer-reviewed-fulltext-article-IDR

https://www.researchsquare.com/article/rs-2178/v2

https://www.dovepress.com/first-line-antiretroviral-treatment-failure-and-associated-factors-in--peer-reviewed-fulltext-article-HIV

We would like to make you aware that copying extracts from previous publications, especially outside the methods section, word-for-word is unacceptable. In addition, the reproduction of text from published reports has implications for the copyright that may apply to the publications.

Please revise the manuscript to rephrase the duplicated text, cite your sources, and provide details as to how the current manuscript advances on previous work. Please note that further consideration is dependent on the submission of a manuscript that addresses these concerns about the overlap in text with published work.

We will carefully review your manuscript upon resubmission, so please ensure that your revision is thorough.

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: Partly

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: No

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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

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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

Reviewer #2: Yes

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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: This is a well-written paper with a sound analysis, providing some interesting findings. The major contribution of this submission is that it is the first study in Ethiopia using viral load tests to confirm the correlates of non-adherence. Thus, while this study in Ethiopia identifies the barriers of adherence to first-line ART, there is not much new in the paper that has not been identified before. The method is sound and the study appears to have been nicely conducted. The results section is well-presented. I think this paper could be a publishable paper of some new insights within the Ethiopian context. However, I don't believe that PLOS one is the most appropriate venue as the journal includes pieces with broader focus and this paper may be a bit narrow. I would suggest that it should be published in a regional journal within Africa.

Reviewer #2: Ethical approval is not mentioned in the manuscript.

Detailed comments is as follows:

Comments to the paper: PONE-D-21-13362

General

The comments are described in the main manuscript with high-lighted texts and accessible to the author for possible amendments.

The paper is well articulated and relevant in addressing the current global health issue still imposing challenges to the globe even though showing promised changes.

Specifically to mention some,

Title

o Make it shorten if possible and to include hospital’s name

Introduction

o Abbreviated words/phrases should be explained fully at first appearance in the sentence, like ART, WHO, and the like.

o Distance of the study area from Addis Ababa, capital city of Ethiopia, not mentioned

o CD4 and viral load variables, how are they collected and analyzed, machine used never explained under data collection procedure

Methodology

o Study area is not fully described, distance/location from capital city not known.

o Sample size calculation not elaborated

o Ethical clearance and consent sub-section not included including approval board and number.

o Terms are not defined like adult, adherence (good, fair and poor), and the like

Result

o Table 1; others should be rechecked as it is greater than others; or else all mentioned variables should be listed out.

o Table2: p-value should be different from zero.

o Table 3: smoking and khat variables should be removed from that table. And also look for punctuation correction beneath the table

Discussion

o It becomes only one-sided discussion, only issue of similarity/consistency. Sometimes, disagreement is expected.

o Very recently published data/article (2021) not included in the study.

Conclusion

o It lacks recommendation

Limitation

o Not included as if the study is without limitation.

References

o Even though few, recent published data /online statistics for HIV-AIDS epidemiology not used/included.

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Reviewer #1: No

Reviewer #2: No

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Attachments

Attachment

Submitted filename: PONE-D-21-13362 commented.docx

Attachment

Submitted filename: PONE-D-21-13362 track changes.pdf

Determinants of first-line antiretroviral treatment failure among adult patients on treatment in Mettu Karl Specialized Hospital, South West Ethiopia; a case control study

PONE-D-21-13362R1

Dear Dr. Siraj,

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.

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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,

Frank T. Spradley

Academic Editor

PLOS ONE

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

Reviewer #2: All comments have been addressed

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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

Reviewer #2: Yes

**********

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

Reviewer #1: Yes

Reviewer #2: 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

Reviewer #2: Yes

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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

Reviewer #2: Yes

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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: I can see that the reporting of the paper is improved and more clarity is provided. My original concern was with regards to the paper reaching the right audience and the fit to PLOS ONE, given that the findings are new and previously unstudied in the Ethiopian context, not the international context. Should the authors and editors of PLOS ONE both be happy about the fit and intended reach, I do believe that the research is well conducted and worthy of publishing.

Reviewer #2: First of all, I thank the journal editorial team to give me the opportunity of reviewing again. I have assessed the paper in that almost all comments were addressed by the author in-charge of the research paper.

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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

Reviewer #2: No