PONE-D-23-41533Pattern and predictor of hookworm re-infection among schoolchildren in three districts of Amhara Region, northwest EthiopiaPLOS ONE

Dear Dr. Jember,

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2. We note that another paper by the same author group and with the title [“Performance Evaluation of Three Diagnostic Methods for Soil-Transmitted Helminth Infections among Schoolchildren in Amhara Region, Northwest Ethiopia] was recently published. It has been noted that the two submissions may have some overlap with regard to the population cohort.

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Additional Editor Comments:

Dear Dr Tadesse H,

Thank you for submitting your manuscript to PLOS ONE. Now the reviewer has evaluated the manuscript and suggested it be revised before deciding whether it is published or not. Therefore, address all the comments raised by the reviewers. A point-by point response for each comment should be submitted.

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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: Partly

Reviewer #2: Yes

Reviewer #3: Yes

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

Reviewer #1: Yes

Reviewer #2: I Don't Know

Reviewer #3: I Don't Know

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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: No

Reviewer #2: Yes

Reviewer #3: 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

Reviewer #3: No

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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 study by Belay et. al., titled "Patterns of Hookworm Reinfection Rates and Predictors among Schoolchildren in Northwest Ethiopia" aims to investigate the re-infection rates and predictors of hookworm among schoolchildren in northwest Ethiopia. While the study addresses an important public health issue, there are a few queries related to its design and methodology to assess the robustness of the findings and the implications for future research and interventions.

Major Queries:

External Validity: To what extent can the findings of the study be generalized to other populations of schoolchildren in Ethiopia or similar settings with high hookworm prevalence? What measures were taken to ensure the representativeness of the study sample?

Methodological Rigor: How were potential sources of bias, such as selection bias or measurement bias, addressed during the study design and data collection phases? Were steps taken to minimize the risk of misclassification or misreporting of predictor variables?

Longitudinal Dynamics: Given the short follow-up period of six months, how do the observed re-infection rates and predictors align with longer-term patterns of hookworm transmission and control? What implications do these findings have for the sustainability of intervention strategies over time?

Comprehensive Assessment: Are there additional predictor variables or potential confounders that were not included in the analysis but may significantly influence hookworm re-infection rates among schoolchildren? How could future research efforts broaden the scope of predictor assessment to capture a more comprehensive range of factors?

Intervention Strategies: Based on the identified predictors of hookworm re-infection, what targeted intervention strategies or public health interventions could be implemented to reduce transmission rates and improve outcomes among schoolchildren in northwest Ethiopia? How can these strategies be tailored to address the specific needs and challenges of the local community? Some discussion about them should be included in the manuscript.

Minor point : Line 124 -the word principal investigator is misspelled as "investigettor".

Overall, while the study contributes valuable insights into hookworm re-infection rates and predictors among schoolchildren in northwest Ethiopia, it also advances our understanding of hookworm transmission dynamics and improves public health outcomes in affected communities.

Reviewer #2: The authors performed a study regarding hookworm re-infection among schoolchildren in northwest Ethiopia. This is an interesting study, but it needs some revisions-clarification:

1) Please use the update data and references for lines 38-40.

2) Did you consider nutritional habits, such as eating raw vegetables, etc, for the selected cases.

Reviewer #3: PONE-D-23-41533

Pattern and predictor of hookworm re-infection among schoolchildren in three districts of Amhara Region, northwest Ethiopia

PLOS ONE

Reviewer’s Comments

The manuscript describes the findings of baseline faecal surveys conducted among school children in three districts of Amhara region, northwest Ethiopia, and follow up faecal surveys conducted among hookworm (HW) positive subjects at 4th and 6th month after deworming with albendazole with the objective of determining the reinfection rates of hookworm infection and predictive factors associated with HW reinfection. Although the methodology and results satisfy the study objectives there are many shortcomings in the manuscript preparation compromising the scientific validity of the manuscript. My queries and comments are herewith listed.

1. The Introduction describes the HW infection status as “high prevalence” in rural Amhara region. Is there any information in the literature regarding the species distribution of HWs causing infection in the region? Which may be useful to include in the Introduction.

2. Likewise, the endemicity of other geohelminth infections in the region if known should be included in the introduction.

3. Line 41-42, “despite control measures implemented…..” Please include a brief description of the control measures implemented under Introduction or discussion.

4. Under Methods, a brief description of the areas studied need to be included such as climatic conditions including vegetation, water supply, sanitary facilities, rural or urban (which has been mentioned) and routine deworming programs if any etc.

5. Brief description of sample size calculation to be included under methodology.

6. Under results, the baseline faecal surveys report only HW infections which is surprising in the presence of widespread faecal contamination of the environment as described in this manuscript. Probable explanations need to be included in the discussion as to why there is only a high prevalence of HW infections and absence of other geohelminth species.

7. There were multiple spelling and grammatical errors, some of which I have highlighted in the edited manuscript. The manuscript could be improved with English language editing.

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Reviewer #1: No

Reviewer #2: No

Reviewer #3: No

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Attachments

Attachment

Submitted filename: PONE-D-23-41533 edited.pdf

Pattern and predictor of hookworm re-infection among schoolchildren in three districts of Amhara Region, northwest Ethiopia

PONE-D-23-41533R1

Dear Dr.Tadesse Hailu Jember

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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Tsegaye Alemayehu, MSc

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

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.

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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 #2: Yes

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

Reviewer #2: I Don't Know

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4. Have the authors made all the 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

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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 #2: Yes

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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: Thank you for your responses and revisions to the manuscript. The manuscript is suitable for publication.

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Reviewer #2: No

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