PONE-D-24-10318Predicting Harmful Alcohol Use Prevalence in Sub-Saharan Africa between 2015 and 2019: Evidence from Population-based HIV Impact AssessmentPLOS ONE

Dear Dr. Goma,

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.

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ACADEMIC EDITOR:

I would like to commend you on the thoroughness and rigor of your study. Your investigation into the prevalence of harmful alcohol use in Sub-Saharan Africa provides valuable insights into a critical public health issue.

However, there are minor revisions that need to be addressed:

Background and Method Sections: Clearly define harmful alcohol use in both the background and method sections to ensure clarity for readers.

Figure and Table Titles: Ensure that figure titles are placed below the figures, while table titles should be positioned above the tables for consistency and readability.

Machine Learning Model Validation: Describe whether the machine learning model used in your analysis was validated. Additionally, indicate any limitations associated with the model used for this analysis.

Terminology: Ensure consistency in terminology usage. For instance, use "HIV" or “HIV/AIDS” instead of "HIV/ART".

Definition of Excessive Alcohol Use: Clearly define what constitutes excessive alcohol use to provide readers with a clear understanding of this important terminology in your study.

Inclusion of Ethiopia in the Study: Acknowledge the absence of Ethiopia in the study population and discuss the implications of this omission. Additionally, if your study included findings on harmful alcohol use in Ethiopia, ensure that this is accurately reflected in the manuscript.

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We look forward to receiving your revised manuscript.

Kind regards,

Yimam Getaneh Misganie, PhD

Academic Editor

PLOS ONE

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Reviewer #1: Yes

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

Reviewer #1: Yes

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Reviewer #1: Yes

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Reviewer #1: Yes

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5. Review Comments to the Author

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Reviewer #1: General Comments

1-The article would benefit from proofreading for grammatical errors, repetition, and clarity.

2-Consideration should be given to the structure and organization of the article to improve flow and coherence.

3- Citations should follow a consistent format throughout the article.

Major Comments

1-The abstract is repetitive, appearing three times with the same content. This should be corrected to provide a concise summary of the study objectives, methods, key findings, and implications.

2-The introduction provides a good overview of the significance of harmful alcohol use and its association with HIV/AIDS globally and in SSA. However, it could be more concise and focused.

3-It would be helpful to clearly state the specific objectives of the study at the end of the introduction.

4- - The methods section lacks clarity in terms of the exact methodology employed for data analysis. It mentions the use of chi-square tests, logistic regression, and machine learning methods, but it doesn't provide details on how these were applied.

5-Providing more information on the variables included in the analysis and justification for their selection would enhance the methodological clarity.

6-The data management process is described briefly; providing more detail on how missing data were handled and how variables were recoded would improve transparency.

7-It's important to specify the criteria used for harmful alcohol use classification based on AUDIT-C scores.

8-The section on ethical considerations should be moved to the beginning of the methods section.

9-The results section is detailed and provides a comprehensive overview of participant characteristics and prevalence rates. However, it's quite lengthy and could be condensed

10-The presentation of results would benefit from clear subheadings and tables to improve readability.

11-The discussion of factors associated with harmful alcohol use could be more structured, perhaps separated into subsections based on demographic and health-related variables

12-The discussion should focus on interpreting the findings in relation to existing literature, explaining the implications of the results, and discussing limitations and future research directions.

13-There's an opportunity to explore potential mechanisms underlying the observed associations and to discuss the implications for public health interventions-It would be helpful to compare the findings of this study with previous research on harmful alcohol use and HIV/ART status in SSA.

14- The Authors should summarize the key findings of the study and their implications for public health practice and policy and Suggestions for future research based on the study's limitations and unanswered questions should be provided.

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Reviewer #1: Yes: Sakarie Mustafe Hidig MD

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Predicting Harmful Alcohol Use Prevalence in Sub-Saharan Africa between 2015 and 2019: Evidence from Population-based HIV Impact Assessment

PONE-D-24-10318R1

Dear Dr. Mtumbi Goma, 

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.

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Kind regards,

Yimam Getaneh Misganie (PhD, PhD)

Academic Editor

PLOS ONE