PONE-D-23-41465The prevalence of depression, anxiety, and stress and their risks and protective factors among secondary students in Rwanda during the first wave of the COVID-19 pandemic.PLOS ONE

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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: No

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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: Dear Authors,

With great interest, I reviewed your manuscript entitled “The prevalence of depression, anxiety, and stress and their risks and protective factors among secondary students in Rwanda during the first wave of the COVID-19 Pandemic.’’ I recommend that you address the following suggestions for further development. Minor comments

1. What is the rational for selecting equal number of participants (128 each) from three districts (disproportional recruitment)?

2. Line 152 “Qualified health experts from the schools selected for this study…”. Are there Health experts in primary school in Rwanda?, why?

3. Language editing by native speakers

Major comments

1. The first wave of COVID-19 occurred in late 2019 and early 2020, however this study was conducted three years later, in 2022. Participants may not remember the exact situation during the first wave after three years. This may have an impact on the study's generalizability.

2. Re design all tables and use appropriate font size for texts

3. Make the discussion more concise, keeping the main points

Reviewer #2: #PONE-D-23-41465

Title: The prevalence of depression, anxiety, and stress and their risks and protective factors among secondary students in Rwanda during the first wave of the COVID-19

Reviewer reports

Thank you for the opportunity to review the manuscript that reports “the prevalence of depression, anxiety, and stress and their risks and protective factors among secondary students in Rwanda during the first wave of the COVID-19”. I have included some points below that should be addressed before considering the paper for potential publication in the journal.

• Your study result showed that, common associated risk factors were domestic violence, the existence of some symptoms of COVID-19 such as cough and myalgia, co-morbidities between depression, anxiety and stress, religion, being female and direct contact with the people who positively tested covid-19. How religion is associated with anxiety, stress, and depression? Is it logical?

• Line 9, at the affiliation of authors, you used code 3, as “ 3Department of Business Administration, College of Business and Economics, University of 10 Rwanda, Kigali, Rwanda”, however no author with such code on list of authors. The contribution of the author from the Department of Business Administration, College of Business and Economics, appears to be outside their discipline. It may be necessary to clarify the relevance of their contribution to the research.

• Line 137, When substituting the values for p and 1-p in the sample size determination formula on line 137, ensure that the correct p-value is used. Double-check and correct any missing or incorrect values to ensure accuracy in the calculation.

• While determining sample size, why non-response rate is not considered? Non-response rate is often considered when determining sample size, as it can impact the representativeness of the sample. Ignoring non-response rate could lead to biased results and affect the generalizability of the findings.

Methods

• This institutional-based, cross-sectional study was conducted from 2nd January to 4th April 2022….. The duration of the study (January to April 2022) may impact the response, as the prevalence and severity of symptoms could have changed since 2019-2020. How do you solve this problem, since the duration may affect the response?

• Line 192, …..we found that the consistency was also good (Alpha of Cronbach, α=0.86) (Error! Reference source not found.). check table citation problem and correct it.

• It seems that prior study during pandemic https://doi.org/10.1007/s40615-021-01195-1 not discussed. Check and discuss with your study.

• Please add the direction for the future work based on your work and prior studies.

• Line 389, <<this conducted="" declaration="" following="" helsinki="" study="" was="">> I don’t think that putting reference for this declaration is important. I suggest to remove reference.

� It's important to thoroughly check the document for language, typos, grammar, and accurate interpretation of findings. This ensures the overall quality and credibility of the document.</this>

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Reviewer #1: No

Reviewer #2: No

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The prevalence of depression, anxiety, and stress and their risks and protective factors among secondary students in Rwanda during the first wave of the COVID-19 pandemic.

PONE-D-23-41465R1

Dear Dr. Niyonsenga,

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,

Wudneh Simegn, 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 #1: 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

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

Reviewer #1: 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

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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

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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 #1: (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: Asmamaw Emagn Kasahun

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