PONE-D-23-22834Impact of paediatric schistosomiasis control programmes in sub-Saharan Africa: A systematic reviewPLOS ONE

Dear Dr. Vere,

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- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377019/

- https://www.frontiersin.org/articles/10.3389/fitd.2023.1116831/full

- https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07829-x

- https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0189400

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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: No

Reviewer #3: Yes

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

Reviewer #1: Yes

Reviewer #2: N/A

Reviewer #3: N/A

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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

Reviewer #3: Yes

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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

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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: Dear Authors,

Your work is extremely important, especially now when schistosomiasis endemic countries are working towards controlling and eliminating the disease.

The review followed the standard guidelines and was comprehensive. I only have minor suggestions.

1. Lines 215-218 - Is it possible to state the specific countries in the mentioned regions?

2. Line 227-Give a brief sentence of what reference 47 is about.

Best Wishes.

Reviewer #2: Thanks for your draft, below you can find my observations to this work.

INTRODUCTION:

a. I'd urge authors to be careful with various strong statements observed in the text:

- Lines 50-53: "there is decent exposure in pre-school aged children (PSAC) (≤5 years), in spite of the age group being excluded from schistosomiasis studies". That is not correct. PSAC have often been studied. Unclear what the statement indicates.

- Lines 65-68: "With 75% coverage, three years of annual treatment of SAC with praziquantel could achieve elimination", that cannot be asserted conclusively as in the text.

b. Parts of the narrative are not clear:

- Lines 74-78: It alludes to a review of impacts of MDAs without explicitly mentioning the reference. The text remains unclear.

- Line 78-83: It is unclear why a review of snail control is expected to allude to the impact of friendly dosages of praziquantel for children.

c. Overall observation - Lack of stated objectives & contribution: In no part of the introduction there is clear statement indicating what is the specific objective of the review and what would be the academic contribution to ongoing debates of paediatric treatment for schistosomiasis control and elimination.

METHODS:

a. Methodology consistency: The review indicates that it only accepted peer-reviewed publications but at the same time the search included the review of grey literature. Were those references included in the end somehow? Why were those searches considered necessary?

b. Review process: The authors indicated that they made a screening of papers based on titles only and then proceeded to screen based on abstracts. That's highly problematic since titles do not provide sufficient evidence to discard publications. The entire selection process of this review would need to be revised as a result.

c. Overall observation - Lack of clarity about outcome measures: Generally speaking, the authors declare they would like to assess the impacts or effectiveness of paediatric interventions for SCH control / elimination. However, at no moment they specify what they mean by "impacts / effectiveness". There is no operationalisation of outcome measures and hence there is no clarify in any section of the paper of what they are trying to assess. This is profoundly problematic for the overeall structure of the review.

RESULTS:

a. PRISMA chart inconsistency: The PRISMA chart indicates that there were 198 studies selected for full asessment and that 158 were excluded. If that's the case, the review would end up discussing 40 publications, not 30 as stated in the text. The consistency of the charts needs to be reviewed and amended.

b. Graphs: There is no clarity as to why all graphs provide country-based comparisons / descriptions if the results section does not proeed to assess such differences. It is unclear what information they are trying to provide and how this is relevant to the overall study.

c. Overall observation - Results section fails to actually ellaborate on the results: The section includes substantive opinion and discussion. Actual references to the studies reviewed, beyond what is contained in the summary table, is minimal. This is not standard for a results section that demands authors to focus on expanding their findings from their review. The various references to opninion pieces, recommendations, or policy / technical guidelines should be moved to the discussion section. The entire results section should be revised in this regard.

DISCUSSION:

a. Overall concern: I am afraid that the discussion section is, as it stands, not fit for purpose. Since the results section has failed to provide any meaningful summary of key messages and since the overall assessment has not specific any specific outcomes measures to be revieweed, there are many uncertainties with regards to what is the core message that is being ellaborated and what pieces of evidence may support it. Some examples of problematic assertions guiding the discussion section can be found below:

- Lines 365-367: "The review showed that despite preventive chemotherapy lowering schistosomiasis prevalence, chances of re-infection remained high in endemic areas" This is not entirely accurate. Re-infection is mentioned in the table but not in the core results narrative. In addition, there's no clarity as to how the risk of reinfection was assessed in this review. Some references sometimes only mention re-infection without providing any specific indicators.

- Lines 379-382: "Preventive chemotherapy must be combined with other schistosomiasis control programmes such as improved sanitation, hygiene, snail control, behaviour change and positive attitudes and practices that can

collectively achieve the end of transmission." Generally, I agree with the sentiment. However, the evidence provided in the review neither supports such a strong assertion nor it is really referred to in the results section. Note, morever, that the Zanzibar studies that you consider support this statement in fact do not provide any conclusive evidence of the kind. This is either a misinterpretation of the results of such studies or a misuse of such references.

- Lines 389-392: "The review indicates that including vector control in schistosomiasis control programmes will definitely lead to end of transmission especially in areas where there is high prevalence and noncompliance to MDA" Same as previous paragraph, the body of evidence to back such a strong claim is not presented in the text.

b. One final coment is that, as mentioned in the introduction section, there is a lack of clarity of what the contribution of the review is. The authors should make an effort to assess how and to what extent their results differ or expand on existing overall recommendations for elimination.

Reviewer #3: Dear authors,

Certainly, the article is extremely important for the epidemiological context of schoolchildren in Africa, since schistosomiasis is still an important public health problem. However, some considerations should be made in the text to make it clearer.

Introduction

1) As the authors robustly described the infection in children, I suggest making it clearer in the introduction what the upper limit of the age range of schoolchildren.

2) Line 63-64 – authors could consider exploring what environmental improvements should be implemented as prevention for reinfection. For example, WASH interventions.

Materials and method

A few methodological points for the authors to consider:

3) It is appreciable and important that the authors took care to register the systematic review in the PROSPERO database. However, it would be very important to describe some key information in methodological writing for readers, such as the guiding question of the work and the temporality or years considered.

4) The authors mention that several terms were used in the research, however, in the main text it would be more useful to leave the details to the supplementary file outline and cite the supplementary file in the text. Describe the groups of terms used: for example, the following search terms was used: schistosomiasis OR agents AND control strategies. And write a sentence about which control strategies were used. Were no secondary terms used in the search to target countries of interest?

5) Inclusion criterion 3: please, consider explaining better what types of case study/series? Was a clinical case report article considered? Or was it considered a case report related to a specific community, neighborhood, or city? Since the authors talk about the impact of control programs, it would be of interest to also include information in the main text of the methodology, which study designs were considered.

6) In the description of data extraction, there was no behavioral information. Please consider describing that the information extracted considered behavioral data related to the disease.

7) Line 120-126: please, consider mentioning that the inclusion and exclusion criteria defined for the study were observed in all phases.

8) Line 135-136: evaluate and place this information in the “results” section.

9) Line 139-144: this information refers to the “selection process” section.

10) Line 149: was only intervention studies considered? Observational with comparison groups?

11) Line 153: were interventions at the household level not considered? Please, justify.

Results

12) Fig1.: please, consider describing the number of articles for each of the exclusion reasons (n=3257).

13) In the extracted data, there was no mention of extracting data on behavioral changes.

14) Consider describing the publication dates of the studies in one sentence and the follow-up date of the study control program; The review process and the temporal effects of a disease control program are crucial.

15) Please, consider better describing the scenario before and after implementing program control actions. The title of the article presupposes an assessment of “impact” on infection rates, which leads us to understand that there would be “before” and “after” evaluation in relation to the application of the program/strategy. Maybe use “effect” instead of “impact”.

16) Consider using the description of strategies (text after table 1) to describe with more focus what was used in the included studies. For example, the included study (23) used behavioral change strategies, but in the text of lines 283-302 there is a more general description.

17) There was no more detailed description of the methodological section in the “Critical Appraisal and Risk of Bias” section. Please, consider including in the text or supplementary material with indication in the text.

Discussion

18) Line362: the authors use the term “effects” and not “impact”. Please standardize and consider revising the term in the article title.

19) The authors make a very satisfactory and important discussion from the point of view of the findings. The article is important because it is the first to address the topic in the region and an integrated pediatric strategy.

20) Recommendations (Lines 428-438): please, consider including recommendations for all features described in Line 150.

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Reviewer #1: No

Reviewer #2: No

Reviewer #3: No

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PONE-D-23-22834R1Effects of paediatric schistosomiasis control programmes in sub-Saharan Africa: A systematic reviewPLOS ONE

Dear Dr. Vere,

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. One reviewer still has some inquiries for you, please adress these questions accordingly prior for acceptance of your manuscript. 

Please submit your revised manuscript by Mar 08 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.

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,

Raquel Inocencio da Luz, Phd

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:

Dear Authors,

Thank you for adressing the questions to the reviewers.

there are still a few inquiries before acceptance of the manuscript,

if you are able to repond to the reviewers comments

Best regards,

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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 #3: (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 #3: Yes

**********

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

Reviewer #1: N/A

Reviewer #3: N/A

**********

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 #3: Yes

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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 #3: 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: My comments were fully addressed.

1. The countries were studies were done were included in lines 211-214 as follows: '.... the review2

includes studies from, Eastern(Kenya, Tanzania and Ethiopia), Western (Nigeria, Senegal,

Togo, Cote’ d’Ivoire and Niger), Southern (Zimbabwe and Madagascar) and Northern Africa

(Sudan).

Reviewer #3: (No Response)

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Reviewer #1: No

Reviewer #3: No

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Attachments

Attachment

Submitted filename: PONE 2 09 JAN.docx

Effects of paediatric schistosomiasis control programmes in sub-Saharan Africa: A systematic review

PONE-D-23-22834R2

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Kind regards,

Raquel Inocencio da Luz, Phd

Academic Editor

PLOS ONE