A cross-sectional study of the psychological impact of the COVID-19 pandemic on camped refugees in Ghana

Barbara Sakyi; Fiifi Amoako Johnson

doi:10.1371/journal.pone.0277515

Peer Review History

Original SubmissionJuly 18, 2022
7 Sep 2022 Decision Letter - Guillermo Salinas-Escudero, Editor Transfer Alert This paper was transferred from another journal. As a result, its full editorial history (including decision letters, peer reviews and author responses) may not be present. PONE-D-22-20247The psychological impact of the COVID-19 pandemic on camped refugees in GhanPLOS ONE Dear Dr. Amoako Johnson, 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 Oct 22 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. 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(Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Dear authors, Thank you for your valuable work and efforts. I have few comments. Please, Add study design in obvious title and illustrate it. Also, Add sample type Add ethical considerations Warm regards Reviewer #2: This is an interesting workThis is exciting and novel work. Studying the impact of the COVID-19 pandemic on a particularly vulnerable population becomes highly relevant. The manuscript is generally well written and methodologically meets sufficient quality criteria to be published. However, I suggest reinforcing some points to improve its quality. 1. It is recommended to analyze the statistical differences between refugee camps. 2. Although the aim of the study focuses on refugee camps, the findings indicate that the characteristics related to the camps do not have the expected statistical relevance. Thus, the results may reflect vulnerable populations, regardless of their area of location. It is therefore suggested to discuss in depth whether the reported characteristics may represent other disadvantaged groups or present more evidence about why these data only represent individuals in refugee camps. 3. Explain in greater detail the findings presented in Table 5, models 1 and 2, regarding the categories that are not significant for the variables (age of the head of the household 40 and over, three or more sources of information on COVID, and marital status. Discuss these findings in the corresponding section. ****** 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? 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Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0277515.r001
Revision 1
5 Oct 2022 Author Response Response to Reviewer’s comments PONE-D-22-20247R1 A cross-sectional study of the psychological impact of the COVID-19 pandemic on camped refugees in Ghana PLOS ONE We are grateful to the Editor and Reviewers for providing us with positive feedback and useful suggestions for ‎the revision. The following notes explain how we addressed each comment in the revised ‎manuscript. Please note C1, C2… refer to comments from the Editor and Reviewers and R1, R2… refer to ‎authors response. The corrections are highlighted in yellow shade. ‎ Journal Requirements When submitting your revision, we need you to address these additional requirements. C1. 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 https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf. R1. Thank you for the comment. The style has been revised to meet PLOS ONE’s style requirements. C2. Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified (1) whether consent was informed and (2) what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If your study included minors, state whether you obtained consent from parents or guardians. If the need for consent was waived by the ethics committee, please include this information. If you are reporting a retrospective study of medical records or archived samples, please ensure that you have discussed whether all data were fully anonymized before you accessed them and/or whether the IRB or ethics committee waived the requirement for informed consent. If patients provided informed written consent to have data from their medical records used in research, please include this information. R2. Informed consent, explaining the objectives of study and its relevance and assuring respondents of anonymity and confidentiality, was sort before interviews were conducted. Respondents who could read were made to read the informed consent themselves before signing them. For those who could not read, the informed consent was read to them and where necessary interpreted before signing or thumbprinting. Where respondents were below 18 years of age, informed consent was sort from parents/guardians. This has been indicated in the revised manuscript. Please, see page 5, line 20-23 and page 6, line 1 and 2. We have also added the ethical considerations. Please, see page 6, lines 3-13. C3. We note that you have indicated that data from this study are available upon request. PLOS only allows data to be available upon request if there are legal or ethical restrictions on sharing data publicly. For information on unacceptable data access restrictions, please see http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. In your revised cover letter, please address the following prompts: a) If there are ethical or legal restrictions on sharing a de-identified data set, please explain them in detail (e.g., data contain potentially identifying or sensitive patient information) and who has imposed them (e.g., an ethics committee). Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. b) If there are no restrictions, please upload the minimal anonymized data set necessary to replicate your study findings as either Supporting Information files or to a stable, public repository and provide us with the relevant URLs, DOIs, or accession numbers. Please see http://www.bmj.com/content/340/bmj.c181.long for guidelines on how to de-identify and prepare clinical data for publication. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. We will update your Data Availability statement on your behalf to reflect the information you provide. R3. Thank you. The data availability statement has been revised based on your suggestions. Please see 20, lines 17-21. C4. We note that Figure 1 in your submission contain map/satellite images which may be copyrighted. All PLOS content is published under the Creative Commons Attribution License (CC BY 4.0), which means that the manuscript, images, and Supporting Information files will be freely available online, and any third party is permitted to access, download, copy, distribute, and use these materials in any way, even commercially, with proper attribution. For these reasons, we cannot publish previously copyrighted maps or satellite images created using proprietary data, such as Google software (Google Maps, Street View, and Earth). For more information, see our copyright guidelines: http://journals.plos.org/plosone/s/licenses-and-copyright. We require you to either (1) present written permission from the copyright holder to publish these figures specifically under the CC BY 4.0 license, or (2) remove the figures from your submission: a) You may seek permission from the original copyright holder of Figure 1 to publish the content specifically under the CC BY 4.0 license. We recommend that you contact the original copyright holder with the Content Permission Form (http://journals.plos.org/plosone/s/file?id=7c09/content-permission-form.pdf) and the following text: “I request permission for the open-access journal PLOS ONE to publish XXX under the Creative Commons Attribution License (CCAL) CC BY 4.0 (http://creativecommons.org/licenses/by/4.0/). Please be aware that this license allows unrestricted use and distribution, even commercially, by third parties. Please reply and provide explicit written permission to publish XXX under a CC BY license and complete the attached form.” Please upload the completed Content Permission Form or other proof of granted permissions as an "Other" file with your submission. In the figure caption of the copyrighted figure, please include the following text: “Reprinted from [ref] under a CC BY license, with permission from [name of publisher], original copyright [original copyright year].” b) If you are unable to obtain permission from the original copyright holder to publish these figures under the CC BY 4.0 license or if the copyright holder’s requirements are incompatible with the CC BY 4.0 license, please either i) remove the figure or ii) supply a replacement figure that complies with the CC BY 4.0 license. Please check copyright information on all replacement figures and update the figure caption with source information. If applicable, please specify in the figure caption text when a figure is similar but not identical to the original image and is therefore for illustrative purposes only. The following resources for replacing copyrighted map figures may be helpful: USGS National Map Viewer (public domain): http://viewer.nationalmap.gov/viewer/ The Gateway to Astronaut Photography of Earth (public domain): http://eol.jsc.nasa.gov/sseop/clickmap/ Maps at the CIA (public domain): https://www.cia.gov/library/publications/the-world-factbook/index.html and https://www.cia.gov/library/publications/cia-maps-publications/index.html NASA Earth Observatory (public domain): http://earthobservatory.nasa.gov/ Landsat: http://landsat.visibleearth.nasa.gov/ USGS EROS (Earth Resources Observatory and Science (EROS) Center) (public domain): http://eros.usgs.gov/# Natural Earth (public domain): http://www.naturalearthdata.com/ R4. Thank you for the clarification. We have removed the figure from the revised manuscript. C5. 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. R5. We have checked all the references to ensure that they are cited in the manuscript. Additional references included at the revision stage are indicated in this document. Please, see pages 5 and 6 of this document. Comments from Reviewer 1 Reviewer #1: Dear authors, Thank you for your valuable work and efforts. I have few comments. C6. Please, Add study design in obvious title and illustrate it. R6. Thank you for the comment. The study design was cross-sectional. This has been included in the revised title. Please, see page 1, line 1. C7. Also, Add sample type R7. A two-stage sampling approach was used to select respondents. At the first stage, a systematic sampling approach was used to select housing units. At the second stage, where more than one eligible respondent was identified in a housing unit, simple random sampling approach was used to select one respondent. This has been clarified in the revised manuscript. Please, see page 6, line 21, 24-25 and page 7, lines 6-7. C8. Add ethical considerations R8. Thank you. We have included the ethical considerations in the revised manuscript. Please, see page 5, lines 20-23 and page 6, line 1-13. Comments from Reviewer 2 Reviewer #2: This is an interesting work. This is exciting and novel work. Studying the impact of the COVID-19 pandemic on a particularly vulnerable population becomes highly relevant. The manuscript is generally well written and methodologically meets sufficient quality criteria to be published. However, I suggest reinforcing some points to improve its quality. C8. It is recommended to analyze the statistical differences between refugee camps. R8. Thank you for the comment. We have analysed the differences between the camps and included it in the revised manuscript. The results showed that the camp effects were not statistically significantly different for both the bivariate (Please, see highlighted section of Table 4 and page 11, line 3) and multivariate analysis (since they were not significant, they were not included in Table 5). The camp of residence is also included as a covariate. See page 8, line 22. These are also included among the non-significant covariates in the Discussions. See page 15, line 20. C9. Although the aim of the study focuses on refugee camps, the findings indicate that the characteristics related to the camps do not have the expected statistical relevance. Thus, the results may reflect vulnerable populations, regardless of their area of location. It is therefore suggested to discuss in depth whether the reported characteristics may represent other disadvantaged groups or present more evidence about why these data only represent individuals in refugee camps. R9. Thank you for the comment. We noticed that the statement was not clear enough. Since most of the background characteristics were not statistically significant, we intended to imply that the psychological distress of the COVID-19 is not limited to camped refugees of particular background characteristics, for example, by educational attainment, country of origin, sex, etc…but it is a problem in the general population of camped refugees. It is also important to note that, since the data focused on camped refugees we cannot infer to reflect all vulnerable populations. The statement has been modified in the revised manuscript. Please, see page 19, lines 3-7. C10. Explain in greater detail the findings presented in Table 5, models 1 and 2, regarding the categories that are not significant for the variables (age of the head of the household 40 and over, three or more sources of information on COVID, and marital status. Discuss these findings in the corresponding section. R10. Thank you. We have provided detailed discussions of the categories that were not significant for the variables age of the household head, number of sources of information and marital status. Please, see page 16, lines 2 – 17 and page 17, lines 3 – 14. The references below have been included in the revised manuscript to support the discussions. 58. Baird, S., et al., Intersecting disadvantages for married adolescents: Life after marriage pre-and post-Covid-19 in contexts of displacement. Journal of Adolescent Health, 2022. 70(3): p. S86-S96. 59. Jace, C.E. and C.A. Makridis, Does marriage protect mental health? Evidence from the COVID‐19 pandemic. Social Science Quarterly, 2021. 102(6): p. 2499-2515. 60. Ahituv, A. and R.I. Lerman, How do marital status, work effort, and wage rates interact? Demography, 2007. 44(3): p. 623-647. 61. Glenn, N.D. and C.N. Weaver, The contribution of marital happiness to global happiness. Journal of Marriage and the Family, 1981: p. 161-168. 62. Gove, W.R., M. Hughes, and C.B. Style, Does marriage have positive effects on the psychological well-being of the individual? Journal of health and social behavior, 1983: p. 122-131. 63. Kiecolt-Glaser, J.K. and T.L. Newton, Marriage and health: his and hers. Psychological bulletin, 2001. 127(4): p. 472. 64. Lillard, L.A. and L.J. Waite, 'Til death do us part: Marital disruption and mortality. American journal of sociology, 1995. 100(5): p. 1131-1156. 65. Islam, M.M. and M. Alharthi, Impact of COVID-19 on the Quality of Life of Households in Saudi Arabia. International Journal of Environmental Research and Public Health, 2022. 19(3): p. 1538. 71. Alrasheed, M., S. Alrasheed, and A.S. Alqahtani, Impact of Social Media Exposure on Risk Perceptions, Mental Health Outcomes, and Preventive Behaviors during the COVID-19 Pandemic in Saudi Arabia. Saudi Journal of Health Systems Research: p. 1-7. 72. Garfin, D.R., R.C. Silver, and E.A. Holman, The novel coronavirus (COVID-2019) outbreak: Amplification of public health consequences by media exposure. Health psychology, 2020. 39(5): p. 355. 73. Han, R., J. Xu, and D. Pan, How Media Exposure, Media Trust, and Media Bias Perception Influence Public Evaluation of COVID-19 Pandemic in International Metropolises. International Journal of Environmental Research and Public Health, 2022. 19(7): p. 3942. 74. Purvis, R.S., et al., Perceptions of adult Arkansans regarding trusted sources of information about the COVID-19 pandemic. BMC Public Health, 2021. 21(1): p. 1-9. Attachments Attachment Submitted filename: Response to Editor and Reviewers Comments.docx https://doi.org/10.1371/journal.pone.0277515.r002
18 Oct 2022 Decision Letter - Guillermo Salinas-Escudero, Editor PONE-D-22-20247R1A cross-sectional study of the psychological impact of the COVID-19 pandemic on camped refugees in GhanaPLOS ONE Dear Dr. Amoako Johnson, 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 Dec 02 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, Guillermo Salinas-Escudero, PhD. MsC. 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: Add the comparison between both groups for each variable presented in table four. Ensure to add a column with the correspondent significance level. [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 #1: (No Response) Reviewer #2: 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 #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: No Reviewer #2: Yes ****** 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: Yes Reviewer #2: Yes ****** 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: (No Response) Reviewer #2: Please note that the statistical differences between refugee camps need to be done for each variable. ****** 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 ******** [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. https://doi.org/10.1371/journal.pone.0277515.r003
Revision 2
20 Oct 2022 Author Response Response to Reviewer’s comments PONE-D-22-20247R1 A cross-sectional study of the psychological impact of the COVID-19 pandemic on camped refugees in Ghana PLOS ONE We are once again grateful to the Editor and Reviewers for their comments and suggestions. The following notes explain how we addressed the comments in the revised ‎manuscript. Please note C1, C2… refer to comments from the Editor and Reviewers and R1, R2… refer to ‎authors response. The corrections are highlighted in yellow shade. ‎ Journal Requirements C1. 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 R1. Thank you, We have checked the reference list and confirm that they are complete and correct. To address C2, the reference below was added to support the discussion. Please, see page 9, lines 16 – 17 and page 26, lines 4 – 5. 46. Kim, H.-Y., Statistical notes for clinical researchers: Sample size calculation 2. Comparison of two independent proportions. Restorative Dentistry & Endodontics, 2016. 41(2): p. 154-156. Additional Editor Comments C2. Add the comparison between both groups for each variable presented in table four. Ensure to add a column with the correspondent significance level. Thank you for the suggestion. The suggested analysis has been included in the revised manuscript. Please see pages 35 and 36, highlighted section of Table 4. Please, note that Fisher's Exact Test was used to test for significant differences where cell sample size were small (less than five). The reference below has been included to support the decision. Please, see page 9, lines 16 – 17. The results are discussed in the highlighted sections of pages 11 – 13. 46. Kim, H.-Y., Statistical notes for clinical researchers: Sample size calculation 2. Comparison of two independent proportions. Restorative Dentistry & Endodontics, 2016. 41(2): p. 154-156. Attachments Attachment Submitted filename: Response to Editor and Reviewers Comments.docx https://doi.org/10.1371/journal.pone.0277515.r004
25 Oct 2022 Decision Letter - Guillermo Salinas-Escudero, Editor PONE-D-22-20247R2A cross-sectional study of the psychological impact of the COVID-19 pandemic on camped refugees in GhanaPLOS ONE Dear Dr. Amoako Johnson, 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 Dec 09 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, Guillermo Salinas-Escudero, PhD. MsC. 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 (if provided): Reviewer 2 was requesting the comparison of each variable of table 4 between the 2 refugees camps, to evaluate whether the values between camps are different or not (significance level), unfortunately, an analysis of the differences between the different categories of the variable for all the fields, which does not correspond to the reviewer's request. Therefore, it is forwarded for correction, [Note: HTML markup is below. Please do not edit.] Reviewers' comments: [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. https://doi.org/10.1371/journal.pone.0277515.r005
Revision 3
27 Oct 2022 Author Response Response to Reviewer’s comments PONE-D-22-20247R3 A cross-sectional study of the psychological impact of the COVID-19 pandemic on camped refugees in Ghana PLOS ONE We are grateful to the Editor and Reviewers for their comments and suggestions. The following notes explain how we addressed the comments in the revised ‎manuscript. Please note C1, C2… refer to comments from the Editor and Reviewers and R1, R2… refer to ‎authors response. The corrections are highlighted in yellow shade. ‎ Journal Requirements C1. 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. R1. Thank you, we have checked the reference list and confirm that they are complete and correct. Additional Editor Comments C2. Reviewer 2 was requesting the comparison of each variable of table 4 between the 2 refugees camps, to evaluate whether the values between camps are different or not (significance level), unfortunately, an analysis of the differences between the different categories of the variable for all the fields, which does not correspond to the reviewer's request. Therefore, it is forwarded for correction. R2. Thank you for the clarity. We have conducted both within and between camp analysis for the two refugees camps. We have included the p-values which examines the significance of the different categories of each variable for within and between the two camps in the revised manuscript. Please, see highlighted section of Table 4 and highlighted sections of page 11 – 15 . This is also clarified in the statistical analysis section. Please, see page 9, line 16 – 20. https://doi.org/10.1371/journal.pone.0277515.r006
31 Oct 2022 Decision Letter - Guillermo Salinas-Escudero, Editor A cross-sectional study of the psychological impact of the COVID-19 pandemic on camped refugees in Ghana PONE-D-22-20247R3 Dear Dr. Amoako Johnson, 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, Guillermo Salinas-Escudero, PhD. MsC. Academic Editor PLOS ONE Additional Editor Comments (optional): The work was reviewed and approved by both reviewers. However, it is recommended to include reviewer two's recommendations to improve the quality of the manuscript. 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 ******** 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 ****** 3. Has the statistical analysis been performed appropriately and rigorously? 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 #2: Yes ****** 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 ****** 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: Thanks for responding to my comment. It seems, however, that I did not express my request very well. It does not make sense to present a test of differences between each variable category. What is relevant is to know if there are significant differences for each variable between groups. Thus, I suggest analyzing differences for each variable between groups. Also, please make it clear in the table's foot which test of difference of means or proportions was performed. ****** 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 ******** https://doi.org/10.1371/journal.pone.0277515.r007
Formally Accepted
4 Nov 2022 Acceptance Letter - Guillermo Salinas-Escudero, Editor PONE-D-22-20247R3 A cross-sectional study of the psychological impact of the COVID-19 pandemic on camped refugees in Ghana Dear Dr. Amoako Johnson: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. 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. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Guillermo Salinas-Escudero Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0277515.r008

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