Scoping review of hearing loss attributed to congenital syphilis

Aleena Amjad Hafeeez; Karina Cavalcanti Bezerra; Zaharadeen Jimoh; Francesca B. Seal; Joan L. Robinson; Nahla A. Gomaa

doi:10.1371/journal.pone.0302452

Peer Review History

Original SubmissionOctober 6, 2023
22 Nov 2023 Decision Letter - Sangamanatha Ankmnal Veeranna, Editor PONE-D-23-32597 Scoping review of hearing loss attributed to congenital syphilis. PLOS ONE Dear Dr. Robinson, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we have decided that your manuscript does not meet our criteria for publication and must therefore be rejected. I am sorry that we cannot be more positive on this occasion, but hope that you appreciate the reasons for this decision. Kind regards, Sangamanatha Ankmnal Veeranna, Ph.D. Academic Editor PLOS ONE Additional Editor Comments: The authors have put a lot of effort into this article. But the manuscript is not conveying the important message of this scoping review. A lot of key information is missing in the introduction, results, and the discussion section. What is the purpose of this scoping review? What are the authors trying to convey from this scoping review? Do the authors think that there should be a systematic review conducted based on a scoping review? How does congenital syphilis cause hearing loss? Hearing loss is the sequelae? or medicine given to treat syphilis causes hearing loss? What is the current gap in the knowledge base on congenital syphilis? What is the available evidence in individuals with congenital syphilis? I did not see the overview or the map of evidence on congenital syphilis. How was the hearing research conducted in the past and currently? [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 ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: N/A ****** 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 ****** 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 ****** 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: Title of the Manuscript: "Scoping Review of hearing loss attributed to congenital syphilis." Overall Evaluation: The paper offers valuable insights into hearing loss attributed to congenital syphilis. The authors put a lot of effort into finding the relevant literature and conducting the scoping review. Overall, I find the work satisfactory. However, I find changes are required to the text. There were a few spelling and grammar mistakes. I recommend improving the organization of the content in the paper. Major Contributions: Relevance of Topic: The topic is of high importance and is aptly chosen. Comprehensiveness: The review covers a wide array of studies and provides a comprehensive overview. Originality: The topic that the authors selected is a novel research area. There is adequate information; however, I suggest improvements to further identify gaps and mention potential areas for future research. Areas for improvement: A document with suggestions for improvements is attached. Please refer to the document. The document also contains the paper with corrections and questions marked in red. Please refer. Summary and Recommendation: Overall, this manuscript is a commendable effort in synthesizing the current knowledge on hearing loss attributed to congenital syphilis. It provides an insightful overview, though some areas require refinement for clarity and depth. With revisions, particularly in the introduction, methodology, and discussion sections, this manuscript will be a valuable addition to the literature. I recommend acceptance of the manuscript after revisions. ****** 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 ******** [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.] - - - - - For journal use only: PONEDEC3 Attachments Attachment Submitted filename: PONE-D-23-32597_reviewer.pdf https://doi.org/10.1371/journal.pone.0302452.r001
Revision 1
19 Dec 2023 Author Response Thank-you for agreeing to review a revision of our manuscript. We have addressed the comments of the reviewers as follows: A. Editor’s Comments: The authors have put a lot of effort into this article. But the manuscript is not conveying the important message of this scoping review. A lot of key information is missing in the introduction, results, and the discussion section. 1. What is the purpose of this scoping review? Response: The submitted version of the manuscript stated in the introduction: “There are no published data on the incidence or characteristics of hearing loss from CS. We therefore performed a scoping review to better characterize this entity. This will inform the studies that need to be done to determine the incidence and age of onset of hearing loss from CS, the severity of hearing loss, and interventions that warrant further study”. To make our objectives clearer, we added the following to this paragraph: Our specific questions were: • How often is hearing loss due to congenital syphilis? • What is the incidence of hearing loss in children with congenital syphilis? • When hearing loss occurs from congenital syphilis, what is the usual age of onset? Is it unilateral or bilateral? How severe is it? How rapidly does it progress? • Is there evidence for any interventions for treatment of hearing loss attributed to congenital syphilis? We also added a sentence to make it clearer that there are no guidelines for ongoing management of hearing loss with CS. 2. What are the authors trying to convey from this scoping review? Do the authors think that there should be a systematic review conducted based on a scoping review? Response: We agree that we should have made it clearer that the scoping review showed a great need for higher quality studies. We have added the following sentence to the first paragraph in the discussion: “One cannot determine the incidence or characteristics of hearing loss from CS or the efficacy of interventions from this review. It seems unlikely that a systematic review would yield answers to any of these questions.” 3. How does congenital syphilis cause hearing loss? Hearing loss is the sequelae? or medicine given to treat syphilis causes hearing loss? Response: We agree that we could have explained this better and added to the first paragraph: “The Centers for Disease Control and Prevention state: “Otosyphilis is caused by an infection of the cochleovestibular system with T. pallidum and typically presents with sensorineural hearing loss, tinnitus, or vertigo. Hearing loss can be unilateral or bilateral, have a sudden onset, and progress rapidly.” Penicillin is the only treatment used and it is not known to be an ototoxic drug. We now state “Almost all cases of CS are treated with penicillin which is not known to be ototoxic.” 4. What is the current gap in the knowledge base on congenital syphilis? Response: As noted above, the introduction of the submitted version of the manuscript stated: “There are no published data on the incidence or characteristics of hearing loss from CS.” 5. What is the available evidence in individuals with congenital syphilis? Response: It is not clear what the editor is asking. Our scoping review summarizes the evidence on hearing loss. Did they want us to talk about all aspects of congenital syphilis? 6. I did not see the overview or the map of evidence on congenital syphilis. Response: We used the Cochrane methods for our scoping review (See Scoping reviews: what they are and how you can do them \| Cochrane Training ). I do not think that an overview or a map of evidence are a mandatory part of a scoping review. A review article on evidence mapping (Miake-Lye IM et al. What is an evidence map? A systematic review of published evidence maps and their definitions, methods, and products. Syst Rev. 2016 Feb 10:5:28. doi: 10.1186/s13643-016-0204-x) states: “… scoping reviews include “a descriptive narrative summary of the results” whereas evidence maps identify evidence gaps, and both use a tabular format to depict a summary of literature characteristics “. Given the lack of evidence we uncovered, it would be very difficult to make a useful evidence map. 7. How was the hearing research conducted in the past and currently? Response: We are sorry but we could not determine what the editor is asking. We tell the reader that all but one study were observational studies so there is not a specific methodology. B. Reviewer’s Comments: Overall Evaluation: The paper offers valuable insights into hearing loss attributed to congenital syphilis. The authors put a lot of effort into finding the relevant literature and conducting the scoping review. Overall, I find the work satisfactory. However, I find changes are required to the text. There were a few spelling and grammar mistakes. I recommend improving the organization of the content in the paper. Major Contributions: Relevance of Topic: The topic is of high importance and is aptly chosen. Comprehensiveness: The review covers a wide array of studies and provides a comprehensive overview. Originality: The topic that the authors selected is a novel research area. There is adequate information; however, I suggest improvements to further identify gaps and mention potential areas for future research. Areas for improvement: A document with suggestions for improvements is attached. Please refer to the document. The document also contains the paper with corrections and questions marked in red. Please refer. Summary and Recommendation: Overall, this manuscript is a commendable effort in synthesizing the current knowledge on hearing loss attributed to congenital syphilis. It provides an insightful overview, though some areas require refinement for clarity and depth. With revisions, particularly in the introduction, methodology, and discussion sections, this manuscript will be a valuable addition to the literature. I recommend acceptance of the manuscript after revisions. 1. An explicit statement of research questions and objectives is not provided. I recommend rethinking and clearly rewriting the text. Please use bullet points and proper formatting. It helps the reader to understand clearly. Response: Thanks for pointing out that our objectives were not as clear as we thought that they were. We added the following to the introduction: Our specific questions were: • How often is hearing loss due to congenital syphilis? • What is the incidence of hearing loss in children with congenital syphilis? • When hearing loss occurs from congenital syphilis, what is the usual age of onset? Is it unilateral or bilateral? How severe is it? How rapidly does it progress? • Is there evidence for any interventions for treatment of hearing loss attributed to congenital syphilis? 2. State the process for selecting sources of evidence (i.e., screening and eligibility) included in the scoping review. Reviewer says: The selection process is clear. However, I recommend re-think and clearly describe in the text. Use bullet points and proper formatting. Formatting issues were identified. Response: I am sorry but it was not clear what the reviewer wanted us to change. It is not common to use bullet points when describing the sources that were searched for a systematic or scoping review. 3. For each source of evidence, present characteristics for which data were charted and provide the citations. Reviewer states: Charts are included. I recommend moving the charts below to relevant sections in the text. Otherwise, it was challenging to scroll down and go back to the text to relate what the authors are trying to describe. Response: I apologize for this error. I clearly did not read the author instructions carefully. The tables have been moved. 4. Discussion - Found complex sentence structures. Look into the text again and think of clear explanation. Response: We tried to make the text clearer throughout the discussion. 5. The reviewer asked that we tell the reader the number of articles included in the “Design” section of the abstract. Response: It is customary not to divulge results until the “Results” section of the abstract. 6. The reviewer suggests adding a reference to the sentence “Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum.” Response: It seems unlikely that the reader would require a reference to believe that this statement is correct. We can add one if required. 7. We were asked to double-check whether the statistics that we quote in the introduction from previous studies are correct. Response: We have no way of verifying this but have quoted the studies accurately. 8. Methods – We were asked where the keywords are. Response: As far as we can tell, PLOS ONE does not request keywords. We can add some if required. 9. Articles published in English were screened by two reviewers independently [AH, KC], and conflicts were resolved by a senior author [JR, NG]. Articles published in French had a single reviewer [FS]. There were no Portuguese articles. Because of the small number of recent articles, preprints were included. The protocol has not been published.´The reviewer stated that perhaps we did not need to include this information and asked whether the protocol was in Prospero. Response: We can omit this information if requested. The protocol is not in Prospero as unfortunately they only publish protocls for systematic reviews – not scoping reviews. 10. Figure 1 is far away from the text. Response: Instructions to authors request that figures be submitted as a separate file. 11. “ One study from the modern era showed an incidence of 6% (22/342) (Besen et al., 2022).” Reviewer states: “not required or explain in words”, I think referring to 22/342. Response; We think that it is helpful for the reader to not have to look at the table to determine the sample size for this statistic, but can omit that if requested. 12. Multiple minor changes were made in the text as requested. Attachments Attachment Submitted filename: Response to reviewers Dec 11.docx https://doi.org/10.1371/journal.pone.0302452.r002
16 Feb 2024 Decision Letter - Bolajoko O. Olusanya, Editor PONE-D-23-32597R1Scoping review of hearing loss attributed to congenital syphilis.PLOS ONE Dear Dr. Robinson, 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 Apr 01 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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Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. If data are owned by a third party, please indicate how others may request data access. 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 (if provided): [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: All comments have been addressed Reviewer #3: 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 #2: Yes Reviewer #3: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #2: N/A Reviewer #3: 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 #3: 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 #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 #2: The previous comments have been addressed. I have just a few additional comments: 1. The manuscript adheres to PRISMA-ScR reporting guidelines although on lines 79 and 80 of the revised manuscript, it states that ‘the methodology is based on Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies: The PRISMA-DTA’. 2. Table 1 is more of a critical appraisal than a quality assessment and the title should reflect that. 3. The legend states that the purple shape is 'unclear or moderate' while the JBI checklist rates the risk of bias as low, high, unclear or not applicable. 4. Lines 150 and 151 in Results section, 'hearing loss is first noted in adolescence...' - is this a finding or part of the discussion as the statement is referenced. 5. The layout (orientation) of Table 5 needs to change to Landscape as with Tables 4A & B. Reviewer #3: Thank you for this important article highlighting a knowledge deficit in the actual incidence, prognosis, response to therapy of/for congenital syphilis. The recent increase incidence of congenital syphilis in the USA and Canada with unknown incidence in LMICs make filling this knowledge gap even more important as we move forward. I feel the reviewers comments/concerns have been adequately addressed. I do wonder why the authors chose not to have a second reviewer for articles in French. It would be informative to identify which articles were in French but not critical to do so. ****** 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: Zainab Imam Reviewer #3: 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. https://doi.org/10.1371/journal.pone.0302452.r003
Revision 2
27 Feb 2024 Author Response Thanks for agreeing to review a revised version of our manuscript. We have addressed the suggestions as follows: 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. Response: Changes were made to meet these requirements. 2. We note that your Data Availability Statement is currently as follows: This is a systematic review so all data can be derived from the included manuscripts. Please confirm at this time whether or not your submission contains all raw data required to replicate the results of your study. Authors must share the “minimal data set” for their submission. PLOS defines the minimal data set to consist of the data required to replicate all study findings reported in the article, as well as related metadata and methods (https://journals.plos.org/plosone/s/data-availability#loc-minimal-data-set-definition). Response: The manuscript contains all raw data required to replicate the results of the study. 3. 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. Response: Done ________________________________________ Reviewer #2: The previous comments have been addressed. I have just a few additional comments: 1. The manuscript adheres to PRISMA-ScR reporting guidelines although on lines 79 and 80 of the revised manuscript, it states that ‘the methodology is based on Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies: The PRISMA-DTA’. Response: Thanks for noticing this error. The manuscript and the accompanying reference have been corrected. We realized that our abstract was not compliant with this reporting guideline so minor changes were made to make in the abstract it compliant. 2. Table 1 is more of a critical appraisal than a quality assessment and the title should reflect that. Response: The title was changed as suggested. 3. The legend states that the purple shape is 'unclear or moderate' while the JBI checklist rates the risk of bias as low, high, unclear or not applicable. Response: We omitted ”or moderate” which was an error. 4. Lines 150 and 151 in Results section, 'hearing loss is first noted in adolescence...' - is this a finding or part of the discussion as the statement is referenced. Response: This is a summary of the results in the table. The sentence is now started with “In these reports…”. The reference was removed as it makes it seem like we are talking about a study that is not in the table. 5. The layout (orientation) of Table 5 needs to change to Landscape as with Tables 4A & B. Response: Done Reviewer #3: Thank you for this important article highlighting a knowledge deficit in the actual incidence, prognosis, response to therapy of/for congenital syphilis. The recent increase incidence of congenital syphilis in the USA and Canada with unknown incidence in LMICs make filling this knowledge gap even more important as we move forward. I feel the reviewers comments/concerns have been adequately addressed. I do wonder why the authors chose not to have a second reviewer for articles in French. It would be informative to identify which articles were in French but not critical to do so. Response: Only one of the authors is fluent in French. In the end, none of the studies in French met the inclusion criteria. Had there been many studies, we would have found another person who was fluent. 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. Response: Done Attachments Attachment Submitted filename: Response to reviewers - hearing loss.docx https://doi.org/10.1371/journal.pone.0302452.r004
21 Mar 2024 Decision Letter - Bolajoko O. Olusanya, Editor PONE-D-23-32597R2Scoping review of hearing loss attributed to congenital syphilis.PLOS ONE Dear Dr. Robinson, 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 May 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. 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, Bolajoko O. Olusanya, MBBS, FMCPaed, FRCPCH, 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 (if provided): This manuscript is much improved now. However, substantial essential edits are required before it can be accepted for publication. INTRODUCTION: Paragraph 2; Lines 3-5: “In 2021 in Canada, the incidence of infectious syphilis in females was 729% higher than in 2017.“ - This statement is incorrect. Authors should check and revise the percentage increase from 7 in 2017 to 96 in 2021. RESULTS Lines 1&2: Authors please clarify: “Screening led to 154 records for full-text review of which 36 met inclusion criteria (Figure 1).“ - This statement is unclear. Authors need to describe the process of study were selection after removing duplicates to arrive at 154. Screening of patients with hearing loss for congenital syphilis Line 1: “There were 5 studies where patients with hearing loss for were screened for CS.” - Delete “for” after hearing loss. Table 1: Delete “were” from the subtitles under Type of study column e.g. Children with HL were screened for CS Studies with interventions for hearing loss Line 2: “All were observational and typically included a penicillin with addition of…” - Authors to revise sentence DISCUSSION Opening sentence: “The scoping review shows that the literature on hearing loss due to CS is immature.” - The word “immature“ in the opening sentence is unclear. Authors should rewrite and clarify. Para 1, Last sentence: ”It seems unlikely that a systematic review would answers these questions” - change “answers” to ‘answer’ Para 4, Lines 2 & 3: “It is possible that hearing loss started years prior but was not recognized.” - Authors may also add the following sentence: “Particularly, if the hearing loss is delayed or progressive.” GENERAL The manuscript requires extensive language edits. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: [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. https://doi.org/10.1371/journal.pone.0302452.r005
Revision 3
22 Mar 2024 Author Response Response to reviewers: INTRODUCTION: Paragraph 2; Lines 3-5: “In 2021 in Canada, the incidence of infectious syphilis in females was 729% higher than in 2017.“ - This statement is incorrect. Authors should check and revise the percentage increase from 7 in 2017 to 96 in 2021. Response: We decided that it was simpler and clearer to remove percentages and remove maternal Canadian data and present actual data for congenital syphilis for the same years in Canada and the United States. We therefore changed this section to read: “The number of cases of confirmed early CS born to women aged 15-39 years in Canada rose from 17 in 2018 to 117 in 2022 [4]. Trends in the United States (US) mirror this with an increase from 1325 congenital syphilis cases in 2018 to 3755 in 2022 [5].” RESULTS Lines 1&2: Authors please clarify: “Screening led to 154 records for full-text review of which 36 met inclusion criteria (Figure 1).“ - This statement is unclear. Authors need to describe the process of study were selection after removing duplicates to arrive at 154. Response: Thanks for pointing out this error. It should have been 159 rather than 154 full articles that were pulled. We now added to the text “The figure outlines the reasons for exclusion of other records. “ We can outline the reasons in the text as well if the reviewer thinks that this is necessary.” Screening of patients with hearing loss for congenital syphilis Line 1: “There were 5 studies where patients with hearing loss for were screened for CS.” - Delete “for” after hearing loss. Response: Thanks for pointing out this error. It was corrected. Table 1: Delete “were” from the subtitles under Type of study column e.g. Children with HL were screened for CS Response: Done Studies with interventions for hearing loss Line 2: “All were observational and typically included a penicillin with addition of…” - Authors to revise sentence Response: This was changed to “All were observational. Most commonly patients were prescribed penicillin with addition of prednisone followed by ACTH if response was poor or transient.” DISCUSSION Opening sentence: “The scoping review shows that the literature on hearing loss due to CS is immature.” - The word “immature“ in the opening sentence is unclear. Authors should rewrite and clarify. Response: We changed “immature” to “limited and low quality.” Para 1, Last sentence: ”It seems unlikely that a systematic review would answers these questions” - change “answers” to ‘answer’ Response: Done Para 4, Lines 2 & 3: “It is possible that hearing loss started years prior but was not recognized.” - Authors may also add the following sentence: “Particularly, if the hearing loss is delayed or progressive.” Response: Thanks for the suggestion. We changed the sentence to read: “It is possible that hearing loss started years prior but was not recognized, particularly, if the hearing loss was slowly progressive.” GENERAL The manuscript requires extensive language edits. Response: Many edits were made. Attachments Attachment Submitted filename: Response to reviewers.docx https://doi.org/10.1371/journal.pone.0302452.r006
4 Apr 2024 Decision Letter - Bolajoko O. Olusanya, Editor Scoping review of hearing loss attributed to congenital syphilis. PONE-D-23-32597R3 Dear Dr. Robinson, 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 will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, 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, Bolajoko O. Olusanya, MBBS, FMCPaed, FRCPCH, PhD Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0302452.r007

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