PONE-D-22-05491A national household survey on HIV prevalence and clinical cascade among children aged ≤15 years in Kenya (2018)PLOS ONE

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“This survey was supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Centers for Disease Control and Prevention (CDC) under the terms of Cooperative Agreement #U2GGH001226. Additional support was provided by United States Agency for International Development (USAID) and the Global Fund to Fight AIDS, TB and Malaria.”

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Reviewers' comments:

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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?

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: 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: Overall well written and easy to understand. I would suggest adding a bit more demographic information earlier on to help with the flow of the paper. A lot of information is introduced in the method section e.g orphaned or living with parents, and guardian HIV status. Those can be briefly mentioned in abstract or introduction sections.

There are a few punctuation issues to be corrected as well.

Reviewer #2: I enjoyed the opportunity to review this manuscript, most notably, the strides made in tackling HIV prevalence and care among CLHIV. The use of a nationally representative sample provided great insight into who is most vulnerable and supports what is known about orphaned children. Overall a well written manuscript that outlines the need for continued efforts among those most at risk; rural and orphaned children. Insightful recommendations that those working in policy and in the community can use to identify those most vulnerable and target interventions effectively.

My feedback is really on structure and writing to make sure it is readable and findings easy to review.

• Tables 1 2 – work to make sure the titles are on one line somehow for easier reading, and maybe remove the “( )” in the 95% CI column

• Figures, I’d recommend those go/stay in the appendix section to avoid having an overly long manuscript

• Discussion section – a great job focusing on the study implications on orphaned children and the various initiatives implemented to tackle these, but maybe add a line on how effective these programs have been (given that your study shows this demographic continues to be at a significantly higher risk) and a recommendation for improvement based on your studies. You do this well in your next paragraph focused on adolescents to showcase effectiveness of the Operation Triple Zero.

• Writing – extra word “the” noted in data analysis paragraph; 3rd line from the bottom “The protocol was reviewed and cleared the by the Institutional”. As always be sure to review entire document to catch those hidden errors.

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Reviewer #1: No

Reviewer #2: No

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A national household survey on HIV prevalence and clinical cascade among children aged ≤15 years in Kenya (2018)

PONE-D-22-05491R1

Dear Dr. Mutisya,

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,

Caroline Kingori

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Authors provided great insight on the prevailing pediatric HIV incidence and prevalence rates in Kenya. It is concerning to see the staggering increase in pediatric HIV infections despite the success that Kenya has had in curtailing incidence rates across the populace. I am curious about the prevailing challenges post COVID-19 and how that has affected pediatric HIV infections. That could be a follow-up paper. For now, I support the reviewers comment and recommend the paper be 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 #1: All comments have been addressed

Reviewer #2: (No Response)

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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 #1: Yes

Reviewer #2: (No Response)

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

Reviewer #1: Yes

Reviewer #2: (No Response)

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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 #1: Yes

Reviewer #2: (No Response)

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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 #1: Yes

Reviewer #2: (No Response)

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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 #1: Succinct and thorough research. The writers addressed all review concerns and I have recommend the paper for publishing.

Reviewer #2: (No Response)

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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 #1: No

Reviewer #2: No

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