PONE-D-21-18903Hepatitis B screening and vaccination status of young psychoactive substance users in informal settlements in Kampala, UgandaPLOS ONE

Dear Dr. Ssekamatte,

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. See the peer-review comments attached. 

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We look forward to receiving your revised manuscript.

Kind regards,

Hamidreza Karimi-Sari, MD

Academic Editor

PLOS ONE

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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: 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?

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Reviewer #1: Yes

Reviewer #2: No

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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 present manuscript is a well-written cross-sectional study on predictors of hepatitis B vaccination and screening among young adults with a history of psychoactive substance use. Authors have found some significant associations for socioeconomic indicators and lack of knowledge. In general, the manuscript can be considered for publication after minor revisions.

Background: This section can be shortened to 3-4 structured paragraphs in order to improve the flow of the background. There is some unnecessary information that can be removed, especially in paragraph 3, and the 4th and 5th paragraphs can be summarized and combined into one paragraph. Also, the first sentence of background should be grammatically revised.

Methods: There is no need to name all divisions and hospitals in Kampala here. The last sentence of scope and design and the second sentence of study population belongs to the background. What is Khat? Please define.

Results: Some figures and tables are located incorrectly in the manuscript. Please check.

For example, the section “predictors of hepatitis B screening” does not represent the data of figure 2, while the section “Hepatitis B vaccination status” is describing figure 2. Also, table 2, 3, and 4 has been wrongly named in the text. This sentence should be revised: “only 2.7% (21/768) had received two vaccine doses while only 2.7% (21/768) had completed the hepatitis B vaccination schedule of 3 doses.”

In addition to the above, there are some minor grammatical and linguistic errors that needs proofreading.

Reviewer #2: Unable to locate where the data is available without restriction.

Please explain what is meant by the term “settlement”. Is it permanent housing? Temporary? How long do people stay and why? Do they live in groups? Families? Give a rationale for excluding those who have lived there <6 months.

Revision should address vaccine related policies. If vaccines are required/recommended in childhood, recall bias is a major concern and should be described in the limitations. Be certain to reference other studies related to vaccine recall.

No reference is provided in the introduction for the statement “they are more likely to be unaware of their Hepatitis B status, and unvaccinated”. If there is no evidence to support it, delete the statement.

Are use of marijuana and alcohol associated with risk of hepatitis B? Please spend some time explaining the theoretical framework to help readers understand why you included all substance users and not just injection drug users. Explain how multiple risk factors tend to co-occur, etc.

The theoretical framework should also address how covariates were chosen. It’s not appropriate to let the model decide which variables to include- please explain the rationale and revise your models appropriately. Consider causal pathways and do not adjust for factors that lie in the pathway.

How many were excluded due to intoxication? Clarify how this is accounted for in the response rate.

What time of day was data collection performed?

Please spell out what you mean by RDS and fully explain how potential respondents were approached. Tone down the use of the word “always” unless you have evidence to back up such a strong claim.

Remove any language related to unweighted analyses from your description of the methods. This makes it sound like you have weighted data and chose not to use the weights. This is misleading for readers. Given the study population, it would not be possible/practical to weight the data, and this is the only rationale- do not site a statistical rationale.

Are females more likely to be screened because of pregnancy-related practices? Are pregnant women routinely screened for hepatitis B?

Remove the word “variable” from figure 2.

What is meant by “sensitization”?

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Reviewer #1: Yes: Sanam Hariri

Reviewer #2: No

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PONE-D-21-18903R1Hepatitis B screening and vaccination status of young psychoactive substance users in informal settlements in Kampala, UgandaPLOS ONE

Dear Dr. Ssekamatte,

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 Apr 28 2022 11:59PM. 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: https://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,

Hamidreza Karimi-Sari, MD

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.

Review Comments to the Author

Reviewer #2: 

No further comments, thank you for diligently addressing concerns. This is important research and you should be proud to see it in print.

Reviewer #3: 

Authors have tried to answer all comments from the reviewers and the manuscript is much improved, particularly the methods and results sections. Here are some additional minor comments:

The abstract contains many repetitive words and needs to be rewritten to sound good. There is no need to repeat the title in the abstract.

As I mentioned before, the introduction is long and contain some unnecessary or unrelated information. Authors may try to be concise and focused on the main problem that the current study is going to address. Also, this section can be shortened into 4-5 paragraphs.

In general, discussion is well-written but can also be more summarized and some sentences can be combined. There are terms like young psychoactive substance users or informal settlements in Kampala that repeats many times throughout the manuscript. Avoid repetitions like this: …vaccination status of young psychoactive substance users in informal settlements in Kampala. Among young psychoactive substance users living in urban informal settlements, we found... (Discussion-1st paragraph)

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Predictors of Hepatitis B screening and vaccination status of young psychoactive substance users in informal settlements in Kampala, Uganda

PONE-D-21-18903R2

Dear Dr. Ssekamatte,

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,

Hamidreza Karimi-Sari, MD

Academic Editor

PLOS ONE