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-22-16420Using mobile audiometry (Wulira app) to assess noise induced hearing loss among industrial workers in Kampala, Uganda: A Cross-sectional studyPLOS ONE

Dear Dr. Semulimi,

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 16 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,

Paul Hinckley Delano, Ph.D.

Academic Editor

PLOS ONE

Journal Requirements:

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

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

2.  Thank you for stating the following financial disclosure:

“This study was funded by the Government of Uganda through the Research and Innovation Fund Makerere University, Fund MAKRIF/ DVCFA/ 026/ 20. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Research and Innovation Fund.”

Please state what role the funders took in the study.  If the funders had no role, please state: "The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."

If this statement is not correct you must amend it as needed.

Please include this amended Role of Funder statement in your cover letter; we will change the online submission form on your behalf.

3. Thank you for stating the following in the Competing Interests section:

“Dr. Charles Batte is part of the team that developed the Wulira App. Dr. Charles Batte, Joab Mumbere, and Dr. Andrew Weil Semulimi serve as employees of Wulira Health Limited in which Wulira App is a subsidiary. The other authors have no conflict of interest to declare.”

Please confirm that this does not alter your adherence to all PLOS ONE policies on sharing data and materials, by including the following statement: "This does not alter our adherence to  PLOS ONE policies on sharing data and materials.” (as detailed online in our guide for authors http://journals.plos.org/plosone/s/competing-interests).  If there are restrictions on sharing of data and/or materials, please state these. Please note that we cannot proceed with consideration of your article until this information has been declared.

Please include your updated Competing Interests statement in your cover letter; we will change the online submission form on your behalf.

4. We note that you have stated that you will provide repository information for your data at acceptance. Should your manuscript be accepted for publication, we will hold it until you provide the relevant accession numbers or DOIs necessary to access your data. If you wish to make changes to your Data Availability statement, please describe these changes in your cover letter and we will update your Data Availability statement to reflect the information you provide.

5. We noted in your submission details that a portion of your manuscript may have been presented or published elsewhere. [DETAILS AS NEEDED] Please clarify whether this [conference proceeding or publication] was peer-reviewed and formally published. If this work was previously peer-reviewed and published, in the cover letter please provide the reason that this work does not constitute dual publication and should be included in the current manuscript.

Additional Editor Comments:

Reviewer were diverse. In order to be considered for publication the authors should give more analysis and discussion about differences between left and right ears. Take into account all the comentaries raised by reviewers. Include an example figure.

[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: Yes

Reviewer #2: No

Reviewer #3: Yes

**********

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

Reviewer #1: Yes

Reviewer #2: No

Reviewer #3: Yes

**********

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

Reviewer #3: Yes

**********

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: Yes

Reviewer #2: Yes

Reviewer #3: Yes

**********

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: It is a very good study but I have a doubt. The industry had 900 employees, 300 were excluded for not working exposed to noise. That gives me 600 and not 400 employees exposed to noise. Is it a mistake?

Reviewer #2: There is a difference in the rate of hearing loss between ears. Was this significant? The authors include this fact in the discussion, nevertheless, this an unexpected finding in workers exposed to noise coming from several sources simultaneously.

There was a difference between low-frequency and high-frequency hearing loss, the former being more prevalent. This is also an unexpected finding since occupational hearing loss is characterized by high-frequency hearing loss.

The last two comments lead me to check the original publication about the Wulira app. The paper previously published by the authors showed that the app had a good sensitivity and specificity to detect subjects with normal hearing. But, the sensitivity dropped to approximately 53% when subjects had mild hearing loss, and even below 50% for more severe cases. Maybe the app should be employed as a screening tool for identifying subjects with normal hearing levels, but the use as a diagnostic method of levels of hearing loss is still questionable. This issue could explain the findings of differences between ears and the higher prevalence of low-frequency hearing loss.

This is the reason I do not recommend this paper for publication

Reviewer #3: The paper study the prevalence of occupational hearing loss among workers of metal manufactoring company located in Kampala, Uganda. The assesment was performed using the Wulira App. It was found that about 10 percent of the workers of this company had occupational hearing loss. The results highlight the importance of hearing loss screening among this populations and the usefulness of the Wulira App as an alternative to pure tone audiometry as a screening tool.

The paper is well written and clear. The methodology is sound and the results are interesting. For these reasons, I recommend accepting the paper after the following issues are addressed:

* Major Issues

- Show some examples of the audiometries obtained with the Wulira App. For instance, show one audiometry of a subject with occupational hearing loss and one of a subject without it. This will allow the reader to get a better understanding of the kind hearing loss observed in the population studied.

- Use a bar plot for figure 2. See https://en.wikipedia.org/wiki/Pie_chart#Use_and_effectiveness for the rationale about avoiding pie charts. I suggest checking this reference (in particular section 6.1) for some guidelines about appropriately presenting bar graphs: https://clauswilke.com/dataviz .

- Line 202: Explain why reporting the religion is relevant. And if it is, please also report the other religions of the population.

- In the paragraph starting at line 239 you compare the prevalence of your results with other studies, and suggests some reasons to explain the differences. One factor that you do not consider to explain the difference is the use of the Wulira App. Is it possible that differences in the results are because you use a different tool to get the audiogram? Please comment about this issue in the discussion section.

* Minor Issues

- Line 68: Change "Occupational hearing loss" by "Occupational Hearing Loss."

- Line 91: The sentence "Much as the Constitution ..." is hard to read. Please re-write to facilitate the understanding.

- Line 94: Add a coma before and after of "which is the gold standard for hearing loss screening."

- Line 97: Add a coma before and after "which is hearing loss screening using mobile phones and tablets."

- Line 197: Change "achieved. (Figure 1)" by "achieved (Figure 1)."

- Line 225: Change "respectively. (Table 4)" by "respectively (Table 4)."

**********

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: Yes: Carolina Der

Reviewer #2: Yes: Mariela C. Torrente

Reviewer #3: Yes: Alejandro Weinstein

**********

[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.

Using mobile audiometry (Wulira app) to assess noise induced hearing loss among industrial workers in Kampala, Uganda: A Cross-sectional study

PONE-D-22-16420R1

Dear Dr. Semulimi,

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,

Paul Hinckley Delano, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

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 #3: All comments have been addressed

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 #3: Yes

Reviewer #4: Partly

**********

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

Reviewer #3: Yes

Reviewer #4: 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 #3: Yes

Reviewer #4: 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 #3: Yes

Reviewer #4: 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 #3: (No Response)

Reviewer #4: The article presented a study of the prevalence of occupational hearing loss among workers in a metal industry company in Kampala district. All recommendations have been addressed by the authors in the current version of the manuscript.

**********

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 #3: Yes: Alejandro Weinstein

Reviewer #4: No

**********