PONE-D-22-16696Knowledge, attitudes and practices towards COVID-19 at two points of entry in South-Eastern BotswanaPLOS ONE

Dear Dr. SIAMISANG,

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.

===========================================

ACADEMIC EDITOR:1. Please revise the manuscript per the reviewers' comments.

2. Please follow the journal guideline to prepare the manuscript.

==========================================

Please submit your revised manuscript by Sep 05 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,

Farzad Taghizadeh-Hesary

Academic Editor

PLOS ONE

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When submitting your revision, we need you to address these additional requirements.

1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at 

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In your revised cover letter, please address the following prompts:

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We will update your Data Availability statement on your behalf to reflect the information you provide.

Additional Editor Comments:

Reviewer 1: he short form KAP should be used throughout the article in place of Knowledge, attitude, and practice. The analysis should not include incomplete data (data not documented). The name of the statistical test to test the difference in KAP between two POE needs to be mentioned. The data collection and study periods are missing, which are essential to interpret the results. Overall the language and presentation is not standard and needs proofreading.

Reviewer 2: ummary of the research and overall impression

The manuscript presents an interesting and useful study relatively novel, of KAP towards COVID-19 among staff at ports of entry in Botswana. Addressing COVID -19 or indeed any pandemic at ports of entry is important in controlling its spread. The manuscript is technically sound, written in an intelligible fashion and in standard English. The statistical analysis has been performed appropriately and the data supports the conclusions. However, the following issues raised below should be addressed to enhance the quality.

Reviewer 3: The manuscript stands to contribute to the exist body of knowledge regarding COVID 19. However, the following revision will be required.

Title:

The author may need to rephrase the title to put in to context the subjects.

Introduction:

Land borders crossing may be more appropriate as against border cross on line 67 etc

The statement on line 85 should be revised, it should be "in" as against "In".

The objective of the study as stated on lines 121 -122 is ambiguous as subject of the study was not mentioned. Additionally, the introduction section is a bit lengthy, it may be revised down in word count to contextually focus on the subject matter.

Methods:

The authors should provide information how the sample size for this study was estimated including the assumptions used in its estimation.

Though the authors have stated the source of that data collection being adapted from a previous study. It is unsure how the reliability of the tool was assessed ( Cronbach alpha) as well as the other measures used for standardizing the tool. Furthermore, since self administration method was used, it will be good if the authors can provide the details of the filled questionnaire retrieval mechanism used and how they were able to mitigate against missing data.

Results

The authors have used median and IOR as the summary indices for age but it is not clear how the normality of this variable was assessed. If age of the participants is skewed there is need for it to be mentioned in methods section.

Footnote should be provided to denote what "others" stand for in table 1 for religion and work cadre.

The author had stated that this was a descriptive study and but a test of comparison of level of knowledge, as well as for practice was done while a composite bar chart was used, it is unclear which statistical test was used and its rationale. If this is desired to be included, then it should be done properly in a contingency tabular format and it should be be captured in the objective and appropriate details included in the

method under data analysis section.

Discussion

The discussion can be revised such that results are not recited while the implications of the findings to the practice of public health are emphasized.

Major areas of improvement.

Title

1. The authors should include ‘staff’ or any phrase that conveys the study population in the title and also the type of study (cross-sectional). They should consider replacing ‘practices’ with ‘preventive practices’ or ‘preventive measures’ for a better conveyance of intended meaning.

Introduction

2. The authors should consider citing the following article for some COVID-19 response measures undertaken in Botswana: link provided

https://doi.org/10.12688/wellcomeopenres.16070.3

Methods

3. More detail is needed in the ‘study population and selection of subjects’ section. For example, the total number of eligible staff at each site, any inclusion and exclusion criteria, how the participants recruited.

Discussion

4. In the section under knowledge and attitude, it would be preferable to include comparisons with other African countries and discuss. Some of these studies were mentioned in the practice section only

Minor Areas of Improvement

1. The manuscript would benefit from minor grammar and spelling editing. For instance line 101 spelling should be referred, line 103 should be patients not patient.

Reviewer 4:

1. The manuscript requires English copy-editing.

2. The main conclusions-stating "The knowledge, attitudes, and practices were generally good" doesn't adhere to the results. The study found that 47% of the participants had GOOD knowledge of COVID-19, which is not satisfactory.

3. Introduction: Please correct the full term of Covid-19. Its correct full term is coronavirus disease 2019. Besides, please use same acronym of Covid-19 along the manuscript. Now, some are "Covid-19" and some others are "Covid 19".

4. Introduction, Line 80-81: Please cite the following relevant article for the sentence "This is undesirable due to the disruption of normal life,

which has multiple social, economic, and mental health effects".

- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8184167/

5. Introduction-Lines 102-103: The following sentence is hard to understand. Please revise it.

"Batswana who tested positive were refereed for facility isolation and foreigners were repatriated back to their respective countries."

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

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

Reviewer #3: Partly

Reviewer #4: Yes

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

Reviewer #1: No

Reviewer #2: Yes

Reviewer #3: Yes

Reviewer #4: 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: Yes

Reviewer #3: Yes

Reviewer #4: 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: No

Reviewer #2: Yes

Reviewer #3: Yes

Reviewer #4: No

**********

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 short form KAP should be used throughout the article in place of Knowledge, attitude, and practice. The analysis should not include incomplete data (data not documented). The name of the statistical test to test the difference in KAP between two POE needs to be mentioned. The data collection and study periods are missing, which are essential to interpret the results. Overall the language and presentation is not standard and needs proofreading.

Reviewer #2: Summary of the research and overall impression

The manuscript presents an interesting and useful study relatively novel, of KAP towards COVID-19 among staff at ports of entry in Botswana. Addressing COVID -19 or indeed any pandemic at ports of entry is important in controlling its spread. The manuscript is technically sound, written in an intelligible fashion and in standard English. The statistical analysis has been performed appropriately and the data supports the conclusions. However, the following issues raised below should be addressed to enhance the quality.

Major areas of improvement.

Title

1. The authors should include ‘staff’ or any phrase that conveys the study population in the title and also the type of study (cross-sectional). They should consider replacing ‘practices’ with ‘preventive practices’ or ‘preventive measures’ for a better conveyance of intended meaning.

Introduction

2. The authors should consider citing the following article for some COVID-19 response measures undertaken in Botswana: link provided

https://doi.org/10.12688/wellcomeopenres.16070.3

Methods

3. More detail is needed in the ‘study population and selection of subjects’ section. For example, the total number of eligible staff at each site, any inclusion and exclusion criteria, how the participants recruited.

Discussion

4. In the section under knowledge and attitude, it would be preferable to include comparisons with other African countries and discuss. Some of these studies were mentioned in the practice section only

Minor Areas of Improvement

1. The manuscript would benefit from minor grammar and spelling editing. For instance line 101 spelling should be referred, line 103 should be patients not patient.

Reviewer #3: The manuscript stands to contribute to the exist body of knowledge regarding COVID 19. However, the following revision will be required.

Title:

The author may need to rephrase the title to put in to context the subjects.

Introduction:

Land borders crossing may be more appropriate as against border cross on line 67 etc

The statement on line 85 should be revised, it should be "in" as against "In".

The objective of the study as stated on lines 121 -122 is ambiguous as subject of the study was not mentioned. Additionally, the introduction section is a bit lengthy, it may be revised down in word count to contextually focus on the subject matter.

Methods:

The authors should provide information how the sample size for this study was estimated including the assumptions used in its estimation.

Though the authors have stated the source of that data collection being adapted from a previous study. It is unsure how the reliability of the tool was assessed ( Cronbach alpha) as well as the other measures used for standardizing the tool. Furthermore, since self administration method was used, it will be good if the authors can provide the details of the filled questionnaire retrieval mechanism used and how they were able to mitigate against missing data.

Results

The authors have used median and IOR as the summary indices for age but it is not clear how the normality of this variable was assessed. If age of the participants is skewed there is need for it to be mentioned in methods section.

Footnote should be provided to denote what "others" stand for in table 1 for religion and work cadre.

The author had stated that this was a descriptive study and but a test of comparison of level of knowledge, as well as for practice was done while a composite bar chart was used, it is unclear which statistical test was used and its rationale. If this is desired to be included, then it should be done properly in a contingency tabular format and it should be be captured in the objective and appropriate details included in the

method under data analysis section.

Discussion

The discussion can be revised such that results are not recited while the implications of the findings to the practice of public health are emphasized.

Reviewer #4: Comments:

1. The manuscript requires English copy-editing.

2. The main conclusions-stating "The knowledge, attitudes, and practices were generally good" doesn't adhere to the results. The study found that 47% of the participants had GOOD knowledge of COVID-19, which is not satisfactory.

3. Introduction: Please correct the full term of Covid-19. Its correct full term is coronavirus disease 2019. Besides, please use same acronym of Covid-19 along the manuscript. Now, some are "Covid-19" and some others are "Covid 19".

4. Introduction, Line 80-81: Please cite the following relevant article for the sentence "This is undesirable due to the disruption of normal life,

which has multiple social, economic, and mental health effects".

- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8184167/

5. Introduction-Lines 102-103: The following sentence is hard to understand. Please revise it.

"Batswana who tested positive were refereed for facility isolation and foreigners were repatriated back to their respective countries."

**********

6. 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: Yes: Dr. Adaoha Pearl Agu

Reviewer #3: Yes: Tolulope Olumide Afolaranmi

Reviewer #4: No

**********

[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.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

PONE-D-22-16696R1Knowledge, attitudes and preventive practices towards COVID-19 among workers at two points of entry in South-Eastern Botswana: a cross-sectional studyPLOS ONE

Dear Dr. SIAMISANG,

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 Nov 18 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,

Farzad Taghizadeh-Hesary

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:

Please find the reviewer no. 3's comments and revise the manuscript.

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

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: (No Response)

Reviewer #4: All comments have been addressed

**********

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

Reviewer #4: (No Response)

**********

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

Reviewer #2: Yes

Reviewer #3: (No Response)

Reviewer #4: (No Response)

**********

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: (No Response)

Reviewer #4: (No Response)

**********

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

Reviewer #4: (No Response)

**********

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: All the comments in the various sections- Title, Introduction, Methods, Discussion- have been addressed. The concerns on language editing have also been addressed.

Reviewer #3: The rationale for using 50% or 0.5 as P in the sample size estimation is not very clear. The authors may need to consider using P from a previous study. The assumption that the proportion of individuals with good KAPs would fall between 10% and 90% seems not well substantiated in the light of the fact that knowledge, attitudes and practice were assessed separately.

Reviewer #4: My comments are convincingly addressed and the manuscript quality is substantially improved. I have no more comments.

**********

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: Yes: Dr. Adaoha Pearl AGU

Reviewer #3: Yes: Tolulope Olumide Afolaranmi

Reviewer #4: No

**********

[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.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Knowledge, attitudes and preventive practices towards COVID-19 among workers at two points of entry in South-Eastern Botswana: a cross-sectional study

PONE-D-22-16696R2

Dear Dr. SIAMISANG,

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.

An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org.

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,

Farzad Taghizadeh-Hesary

Academic Editor

PLOS ONE​