PONE-D-21-19925Prevalence and Factors Associated with Acute Respiratory Infection among Under-five Children in Selected Tertiary Hospitals of Kathmandu ValleyPLOS ONE

Dear Dr. Pratima Ghimire,

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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 and need Major Revision. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process by the reviewers.

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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: No

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

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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: No

Reviewer #2: No

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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: No

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 is not presented in an intelligible fashion and is written in standard English. Authors need to read this paper carefully and make all the necessary changes, as there are several errors while reporting this paper.

Reviewer #2: Abstract

A few clarifications needed. Please reword:

Acute respiratory infection (ARI) is responsible for 30-50 percent of visits to health facilty and 20-30 percent of admissions to hospital in Nepal. – is this for both adults and children or for children under 5 years old?

What does it mean, ‘incidence of ARI/1000 children < 5 years of age is 344 in Nepal’? Does this mean 344/1000? Please reword: The incidence of ARI in children < 5 years old is 344/1000.

The sentences are not clear. Please reword to make it clear.

Non-probability is not equivalent to purposive. Purposive is to target those with ARI. In this study, I believe it is convenient sampling – please stick to convenient sampling.

When you say out of the 286 children, half had ARI. What did the other children have?

Also, do not include conclusion that male children are not susceptible to ARI, because the results were insignificant.

Introduction

Line 60: ARI is responsible for about 30-50% of visits…. Question: is this in children under 5 years old? Please specify.

Line 64: The deaths due to ARI at health facility is 127. What does this mean? Any health facility or hospitals or primary care? Can remove this information as it is not clear.

Methodology

Line 91: Please specify the time and duration of the data collection period e.g. from month, year until month, year.

Line 106: Please add the Cronbach alpha for the pretesting that you have done, to show whether the questionnaire was reliable.

From paragraph 66-73 in the introduction, please add in the methodology the factors that was studied in your study.

Chi-squared test was done to show relationship between the categorical variables. My personal opinion is it is better to do simple logistic regression, and then move on to multiple logistic regression for the significant factors. Any reason why you use Chi-squared test rather than simple logistic?

Results – okay

Discussion

You are right to discuss in line 204 regarding the prevalence of ARI.

218: In the discussion, you do not need to mention twice but to just discuss about the three factors that were associated with increase risk of ARI in children, which are religion, presence of child in the kitchen while cooking and presence of respiratory tract infection in family member.

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Reviewer #1: No

Reviewer #2: Yes: Associate Professor Dr. Farnaza Ariffin

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Prevalence and Factors Associated with Acute Respiratory Infection among Under-five Children in Selected Tertiary Hospitals of Kathmandu Valley

PONE-D-21-19925R1

Dear Dr. Pratima Ghimire,

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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Kind regards,

Sajid Bashir Soofi

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Congratulations, your paper is accepted for publication

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 #2: All comments have been addressed

Reviewer #3: 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 #2: Yes

Reviewer #3: Yes

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

Reviewer #2: Yes

Reviewer #3: Yes

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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 #2: Yes

Reviewer #3: 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 #2: Yes

Reviewer #3: 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 #2: Thank you for addressing all of the comments. The manuscript could improve in its linguistic delivery. Otherwise, no other comments.

Reviewer #3: all the comments have been adequately addressed.

the paper is of significant public health importance and also opens the discussion on environmental health and impact .

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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 #2: No

Reviewer #3: Yes: Shabina Ariff Associate Professor ,Aga khan university Pakistan