PONE-D-23-18154Symptoms of Depression among Outpatients with Acute Respiratory Infection in Metropolitan Local Government Areas of Kaduna State, NigeriaPLOS ONE

Dear Dr. Umeh,

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. In addition to comments provided below by the 2 reviewers, please address the following comments: Data availability: please indicate why data is only available on request. Earlier, it was stated that data is available without restriction.Abstract: unclear why “future tense” is used for material and methods; this is a study with results and not a protocol.Methods: Sampling technique - stratified random sampling technique was used. Please define the strata and be explicit about this in relation to the PPS.Study tools (line 167) – the ARI screening using fever and cough and any of the other symptoms listed, was it a standard screening protocol for ARI? If yes, please provide reference.Informed consents: 13yrs are considered minors and consents for them should be different including interviews. Please provide details.Results:

• Lines 226 – 228: visits to primary versus tertiary healthcare facilities – were equal numbered sampled from these 2 categories of facilities and then screened for ARI? If not, then this statement should be adjusted.

Recommendation:

• Since no causality is inferred, the question readers may have is why trying to identify depression among patients with symptom of ARI? Why not patients with malaria or diabetes or any other illness? The community health officers can be trained to screen all OPD patients for depression.

General observations:

It is difficult to understand the intention of the authors about whether the manuscript is about C19 or other ARI. So much about C19 in introduction and 75% of the discussion is about C19 response, locally and internationally. BTW, C19 is not even part of the title. Though C19 is ARI, but it deserves to be mentioned in the title since it is a special ARI and the authors have devoted almost 75% of the paper to C19.

Please submit your revised manuscript by Mar 07 2024 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.

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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.

We look forward to receiving your revised manuscript.

Kind regards,

Ibrahim Jahun, MD, MSC, PhD

Academic Editor

PLOS ONE

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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: 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?

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

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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: The article is very useful literary material. It will be clearer if other underlying illnesses such as cardiovascular, disease, asthma and diabetes were used in classifying the subjects, beyond just cases and controls. ARI might not necessarily be the immediate cause of depression.

Reviewer #2: The manuscript has addressed an important research question considering the health indices of the research setting and the socioeconomic status of the study population. The manuscript is also well written in standard academic writing style. However, there are a few concerns the authors need to revise, which are stated below:

ABSTRACT

Background: The background should clearly state the research question, which is the prevalence of depression among patients diagnosed with ARI.

MATERIAL AND METHODS

This section should state the measuring instruments used in this study and the study period. A summary of the statistical analysis deployed should also be stated. The research question should be removed from this section and taken to the background.

RESULTS

The results is well written. However, the results may be revised to show the proportion of patients that had depression in each class. This way, we should be able to see that people with ARI were more likely to be depressed than those without ARI. It is good that the authors emphasized that causation is not implied by drawing a correlation between ARI and depression.

CONCLUSION

The conclusion is well written. The authors achieved the aim of the study.

INTRODUCTION

The introduction should be revised to show the risks and dangers of depression, which justify the study. There is a lot of talk about COVID, ARI, and the epidemiology of COVID. However, the central issue in this study is depression. Why are the authors worried about depression among patients with ARI given that only 5% of people in the general population in Kaduna have this problem?

MATERIAL and METHODS

Please describe the elements of the questionnaire and if possible, the questionnaire should be included as appendix or supplementary document.

Indicate if the translators of the questionnaire from English to Hausa were professionals. Also indicate the training the interviewer received.

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Reviewer #1: Yes: Ado Garba Abubakar

Reviewer #2: Yes: Dr. Yohanna Kambai Avong

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PONE-D-23-18154R1Symptoms of Depression among Outpatients with Acute Respiratory Infection (COVID-19) in Metropolitan Local Government Areas of Kaduna State, NigeriaPLOS ONE

Dear Dr. Umeh,

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.

Thank you for responding to all comments provided by the Academic Editor and the 2 reviewers. The response provided are acceptable and have addressed most of the issues raised during the review process. However, the edit provided in the title is unacceptable. The revised title reads "Symptoms of Depression among Outpatients with Acute Respiratory Infection (COVID-19) in Metropolitan Local Government Areas of Kaduna State, Nigeria.

Please note that COVID-19 is not synonymous with ARI. The patients have not been confirmed to have COVID-19, they are just presenting with symptoms that may or may not be COVID-19. However, since the period was during COVID-19 pandemic, then they apparently they were COVID-19 suspects. Therefore the tile should be something like "Symptoms of Depression among Outpatients with suspected COVID-19 in Metropolitan Local Government Areas of Kaduna State, Nigeria). Please note that this is just a suggestion to guide the authors and they are not mandated to use this title.

We look forward to receiving your revised manuscript.

Please submit your revised manuscript by Apr 05 2024 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.

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We look forward to receiving your revised manuscript.

Kind regards,

Ibrahim Jahun, MD, MSC, PhD

Academic Editor

PLOS ONE

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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.

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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: All comments have been addressed

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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: 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: Yes

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: The revised version looks good. It has addressed my questions in the previous version, particularly under the listed limitations by the authors.

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: Yes: Ado Garba Abubakar

Reviewer #2: Yes: Yohanna Kambai Avong

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[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.

Symptoms of Depression among Outpatients with Suspected COVID-19 in Metropolitan Local Government Areas of Kaduna State, Nigeria

PONE-D-23-18154R2

Dear Dr. Umeh,

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,

Ibrahim Jahun, MD, MSC, PhD

Academic Editor

PLOS ONE

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