PONE-D-21-13785The impact of the caregiver mobility on child HIV care in the Manhiça District, Southern Mozambique: a clinical based studyPLOS ONE

Dear Dr. Nhampossa,

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Oathokwa Nkomazana, MD MSC PhD

Academic Editor

PLOS ONE

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Additional Editor Comments (if provided):

Thank you for submitting the manuscript to Plos One. This is very important subject that has broad applications. Please address the comments made by Reviewer 2.

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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

Reviewer #2: Partly

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

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

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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: The manuscript was well written. The methods were clear and sound. The objectives were clear and the authors achieved the objectives. The manuscript will contribute to patient care and improve access to ART. The authors observ d ethics very well.

Reviewer #2: This is an interesting study addressing a topic with clear social and scientific value. The motivation for this study is well presented and the objectives are articulated well.

The impact of the results is limited by the relatively small sample size of the study. Although the chosen period of the study is justified by the authors assumption that hospital visits increase two to three fold during this time, it is not clear whether secular trends could affect this. Therefore a longer period than the 3 month period would have been useful to account for this. There is need to provide an estimate of the denominator figure for Children Living with HIV in the Manhica area and the number receiving care at the Manhica district hospital to give the reader perspective.

Although the results presented (both in the abstract and the main body of the manuscript) highlight non-significant association (thus negative results regarding these associations), the conclusion has ignored the implication of these. Similarly the lack of association is not discussed in the discussion section. If these were hypothesized a priori (and thus included in the conditional logistic model), they need to be fully discussed in light of the literature.

The data analysis plan (statistical methods) refers to use of parametric tests for normal continuous variables. However these tests are not specified and a review of the results show categorical variables and non-normally distributed variables. The write up in the statistical methods section limits the analysis of categorical data to the Chi-squared test (omits the appropriateness of Fisher's exact test) even though the footnote in Table 1 indicates that Fisher's exact test was used where appropriate. Details about the estimated sample size as well as assumptions used are missing.

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Reviewer #1: Yes: Goabaone Rankgoane-Pono

Reviewer #2: No

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The impact of the caregiver mobility on child HIV care in the Manhiça District, Southern Mozambique: a clinical based study

PONE-D-21-13785R1

Dear Dr. Nhampossa,

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,

Oathokwa Nkomazana, MD MSC PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: