PONE-D-22-28886Perceived feeding practices, dietary adequacy and dietary diversities among caregivers with under-five children: A descriptive cross-section study in Dodoma region, TanzaniaPLOS ONE

Dear Dr. Millanzi,

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 Feb 18 2023 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,

Charles Odilichukwu R Okpala

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:

“NO - This work did not receive any specific grant from funding agencies in the public, commercial, and or non-profit sectors. It was privately sponsored”

At this time, please address the following queries:

a)        Please clarify the sources of funding (financial or material support) for your study. List the grants or organizations that supported your study, including funding received from your institution.

b)        State what role the funders took in the study. If the funders had no role in your study, please state: “The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.”

c)        If any authors received a salary from any of your funders, please state which authors and which funders.

d)        If you did not receive any funding for this study, please state: “The authors received no specific funding for this work.”

Please include your amended statements within your cover letter; we will change the online submission form on your behalf.

3. Please amend the manuscript submission data (via Edit Submission) to include author “Rabia K. ABDALLAH1”

4.  Please amend your authorship list in your manuscript file to include author Bariki A. Ambrose

5. Please include your full ethics statement in the ‘Methods’ section of your manuscript file. In your statement, please include the full name of the IRB or ethics committee who approved or waived your study, as well as whether or not you obtained informed written or verbal consent. If consent was waived for your study, please include this information in your statement as well.

Additional Editor Comments:

Reviewers have provided useful comments that will improve this work. Please authors should carefully and diligently revise their work.

[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: No

Reviewer #2: Yes

Reviewer #3: Partly

Reviewer #4: Partly

**********

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

Reviewer #1: No

Reviewer #2: Yes

Reviewer #3: Yes

Reviewer #4: 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

Reviewer #4: No

**********

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: No

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: 1. Perception can not be quantified, Qualitative data collection is best to study perception.

2. Wrong order of authors at line 4.

3. No sampling procedure and sample size determination formula indicated.

4. Finding at abstract line 42, 43 contradict that at result in line 229.

5. Result is inadequate due to inefficiency of data collection tools. no evidence for line 320, 321 findings.

6. Recommendation- No new innovative ideas generated by the research.

7. Some findings are misplaced after reference.

Reviewer #2: REVIEWER’S COMMENTS

Perceived feeding practices, dietary adequacy and dietary diversities among caregivers with under-five children: A descriptive cross-section study in Dodoma region, Tanzania

PONE-D-22-28886

GENERAL COMMENTS

This is an interesting study that provides useful insights into perceived feeding practices, dietary adequacy and dietary diversities among caregivers with under-five children. The findings of the research are clearly presented and well-discussed. Comments have been made to improve the final version.

ABSTRACT

1. Line 43: “A 90.7% of children …” is ambiguous. Sentence should be rephrased.

2. Line 47 – 50: Rephrase the first sentence to ensure clarity of message. It is lengthy.

3. Line 52/53: Arrange keywords in alphabetical order.

INTRODUCTION

Line 79: and/or

METHODS AND MATERIALS

Well-written.

RESULTS

1. Line 207, 217: There should be unit for the (mean) age i.e., years

2. Line 209/210, 219: “A 68.2% …” is ambiguous. Sentence is confusing and should be rephrased.

3. Table 1 (2nd Row), Table 2 (5th Row), Table 4 (5th Row): Is that the mean age? If it is, it should be specified.

4. Line 252: Preferably, do not commence sentences with figures written as numbers.

5. Table 3, Table 4: P-values which are statistically significant should be signified.

DISCUSSION

Well-written.

CONCLUSION

The Conclusion should be specific and straightforward. It should provide answers to the main objective of the study. It should be rewritten.

Line 334: Recommendations

Line 345 – 349: Rephrase. Sentence is too long.

Reviewer #3: General Comments: The background created a gap, but the study is a bit complex. First, perception in this study is not well understood. How was perception measured? All I can deduce is feeding practices of caregivers. So, the study should be on “Feeding practices, dietary adequacy and dietary diversities among caregivers with under-five children: A descriptive cross-sectional study in Dodoma region, Tanzania” if the present study would remain as it is. Second, two manuscripts could emerge from this study to make each sharper and simple. For example, one could be on “Feeding practices and dietary diversities among caregivers with under-five children” and the second could be on “dietary adequacy”. I strongly recommend this split.

Methods

• There should be a total population from where the sample was drawn. What is the population of under-five children in the study area? Then, how was the sample size calculated? What were the sampling procedure and techniques used?

• It is not also clear whether the respondents (caregivers) were met in their homes or in common venue. For example, this sentence “Caregivers were reached at their homes and data collection procedures were performed by the principal investigator and trained assistant researchers in an unoccupied venue available at the respective ward to assure privacy” is not clear.

Results

• The results section is cumbersome (four Tables and five figures) and that’s more reason to split the manuscript into two. This will affect the discussion.

Reviewer #4: Thanks for the opportunity to review this paper titled: “Perceived feeding practices, dietary adequacy and dietary diversities among caregivers with under-five children: A descriptive cross-section study in Dodoma region, Tanzania” This addresses an important issue in public health, however, the quality of the paper is marred by so many issues (including grammatical errors) which the authors need to address. For instance, there are so many verb agreement and punctuation mistakes throughout the manuscript, and I have tried to indicate some of them. Also, the paper requires major English editing. Therefore, the authors should subscribe to an editing service for adequate and professional editing of this paper.

Abstract

• The abstract should be presented in a clearer manner with more findings included in the result subsection.

• Line 29: ‘Feeding newborn while at health facilities assure…’(there is a verb agreement mistake in this clause)

• Line 35: (not clear)

• Line 44: ‘A 90.7% of children were fed group one 44 foods of which 59.1% (n =152) of them were not fed …’(there is an agreement mistakes in this

• Line 66: ‘Proper adherence to dietary adequacy, improvising dietary diversities and proper feeding practices is be’ (verb agreement mistake)

Introduction

• This needs better organisation for smooth flow. The messages are scattered all over the section. It’s good to start with global situation, then African/LMIC and finally Tanzania. Each paragraph should have just one message

• Line 68: Existing 68 knowledge uncover that (verb agreement mistake)

• The authors should make a stronger justification for the paper and show how the paper contributes to new knowledge.

Methodology

• Relevant characteristics of the study area/site are missing in this manuscript

• Considering the sampling technique, more details, such as the sampling interval and sampling ratio should be provided.

• How was the sample size calculated, and which software program was used?

• Write in details about the study participants, selection criteria (inclusion and exclusion).

• Were questionnaire structured?

Result

• The abstract and the methodology indicate that 298 caregivers were sampled and the response rate was 100%, why did the authors report only 289 in the result section?

• The interpretations of the results should be better stated for clarity

Discussion

• The discussion is weakly presented and did not address most of the findings in the result section.

• There is a mix up of different referencing styles (lines 301-310)

• The authors may consider starting the discussion with a summary statement that showcases the overall message of the study

• Line 358: apart from addressing a very important issue in maternal and child health, what are the strengths of this study?

Conclusion

This should be revised and better presented to capture the key findings of the study

• 320: ‘Even though many caregivers are empowered with nutritional knowledge during their reproductive health clinic (RCH) visits and various scholarly…’ this does not appear to be part of the finding of this study

Ethical Approval:

The number of the ethical approval from the Health Research Ethics Committee of the institution should be indicated.

**********

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: Kosisochi Chinwendu Amorha

Reviewer #3: Yes: Amelia Ngozi Odo

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-22-28886R1Feeding practices, dietary adequacy and dietary diversities among caregivers with under-five children: A descriptive cross-section study in Dodoma region, TanzaniaPLOS ONE

Dear Dr. Millanzi,

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: Minor revision required before it can be accepted for publication.

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

Please submit your revised manuscript by Apr 10 2023 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,

Charles Odilichukwu R Okpala

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:

The reviewers have attended to the revised manuscript. Please, kindly attend to the minor concerns remaining. Thank you.

[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: (No Response)

Reviewer #4: (No Response)

**********

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 #4: Yes

**********

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

Reviewer #2: 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 #2: 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 #2: 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 #2: GENERAL COMMENTS

The manuscript should be accepted for publication after the few corrections, stated below, have been addressed.

ABSTRACT

Results: Preferably, do not start sentences with figures written as numbers. Correct this, wherever applicable, in the manuscript.

INTRODUCTION

Lines 80, 83, 408: Include a slash “and/or”

RESULTS

1. Line 252: Preferably, do not commence sentences with figures written as numbers.

2. Table 3, Table 4: keynotes should include “P < 0.05 is statistically significant”

Line 419: “Recommendations” not Recommendation

Line 488: “Acknowledgements” not “Acknowledgement.

Reviewer #4: The authors have tried to improve the general quality of this manuscript in the revised version, and have attended to most of the issues I raised, following my first review of the paper. I commend them. However, I still have a couple of concerns that I would like addressed.

Study setting

This paper focuses on “dietary practices, adequacy and diversities…” among caregivers.

The high prevalence of stunting in the area was stated, but the authors failed to include such details as climatic conditions/vegetation in relation to food security and the socio-cultural beliefs related to infant and young child feeding, in the description of study setting.

“The region was sampled owing to the growing prevalence…”

How was it sampled? (Purposively? randomly? Etc.)…this should be under sampling technique

Study population

Inclusion criteria: “… a resident of Dodoma region for at least more than six months,”

What is your reason for choosing residency period of at least more than six months?

Exclusion criteria: Deaf, dumb, mentally unsound, reported sicknesses

What is the rationale for excluding these groups of people, especially the deaf and dumb? I think excluding the deaf and dumb among the study group raises some ethical questions of fairness. Kindly explain in details why deaf and dumb made the exclusion criteria. How will you establish those who are mentally unsound?

**********

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. Kosisochi Chinwendu Amorha

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.

Feeding practices, dietary adequacy and dietary diversities among caregivers with under-five children: A descriptive cross-section study in Dodoma region, Tanzania

PONE-D-22-28886R2

Dear Dr. Millanzi,

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,

Charles Odilichukwu R Okpala

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Thank you authors for revising your work. It is now acceptable for publication.

Reviewers' comments: