PONE-D-24-10620Knowledge of Tuberculosis Preventive Treatment among People Living with HIV: A cross-sectional survey in selected regions of TanzaniaPLOS ONE

Dear Dr. Alexander,

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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Tanzani"

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Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: 

"Our study received funding support from the Global Fund to fight against HIV, TB and Malaria in Tanzania through the NASHCoP. However, the funder did not take part in the study design, data collection and analysis, decision to publish, nor preparation of this manuscript.

AMK received the fund. 

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Additional Editor Comments:

The authors have presented a paper evaluating the knowledge of TPT among PLWHIV in Tanzania.

Major comments

1. The calculated sample size for this study is 427 and the number of participants enrolled was 391. Not meeting the sample size means the results lack statistical power.

2. Another important factor to consider when evaluating knowledge about TPT is, "Time since enrolling into care" It is likely that those who have been in care longer and those who have actually received the TPT will be more knowledgeable. This variable needs to be evaluated.

3. There needs to be stronger justification by the authors why they think that PLWHIV should be knowledgeable about TPT. Patients do not prescribe this modality to themselves so knowledge about TPT is the purview of healthcare workers and not individuals that have received a diagnosis of HIV.

Minor comments

1. Consider having the paper reviewed for grammar. There are some grammatical errors that need to be corrected e.g. line 67, "Daily" should be, "daily" line 87, "Prevention" should be, "prevention"

2. Line 113: Define the abbreviation CTC in the paper before using it.

3. IPT and TPT cannot be used interchangeably. This paper evaluated IPT knowledge. IPT is a strategy for TPT. So, the title is not precise because it refers to TPT while the study evaluated IPT. Therefore even in the paper, the use of the acronym TPT has to be precise: line 117 and page 15 of the paper.

4. In line 142 please state who (9) and (10) are then reference them.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Comments to the Author

Reviewer #1: An interesting and, in the context of the authors' country, an important study has been conducted.

I have a few major questions that I would like to clarify:

• The manuscript lacks context about the TB and HIV situation in Tanzania. In lines 65-66 it is written "In 2022, the proportion of people with TB coinfected with HIV stood at 17%". Regarding this study, much more important information would be what proportion of HIV-infected persons have (had) active TB and what proportion of HIV-infected persons have latent TB infection?

• The authors do not mention anywhere the prevalence of latent TB infection and its diagnosis in Tanzania. Preventive treatment is given in the case of latent TB infection. Clarity is needed.

• In lines 66-69, the statement "The National TB and Leprosy Program (NTLP) adopted the WHO recommendations for TB prevention among high-risk populations thus recommending daily Isoniazid as the main preventive drug for PLHIV and under-five household contacts of people with active TB "unclear. Different situations are discussed in one sentence - HIV infection (with latent TB infection) and contact persons with a patient with active TB. Need to clarify.

Minor concerns:

• In line 70, the abbreviation ISP is not expanded.

• In line 14 is probably misspelled "Tanzani".

Reviewer #2: This study examines knowledge of TB preventive treatment among a sample of people living with HIV in Tanzania. Overall, the study was very well written and easy to understand. The study findings were presented in a clear way and all tables were well structured and easy to interpret. The study discusses an important topic in HIV prevention, and the authors give plausible explanations of the key determinants of TPT knowledge that their study identified (e.g., gender, location etc). I have no additional comments. The paper was well written and it successfully addressed its central questions.

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We look forward to receiving your revised manuscript.

Kind regards,

Tinashe Mudzviti, MPhil(MD)

Academic Editor

PLOS ONE

PONE-D-24-10620R1Knowledge of Tuberculosis preventive treatment among people living with HIV: A cross-sectional survey in selected regions of TanzaniaPLOS ONE

Dear Dr. Alexander,

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.

==============================

ACADEMIC EDITOR:  Authors need to include the limitation in the manuscript that there is a reduction in the power of the results which was a result of not meeting the sample size.

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Please submit your revised manuscript by Aug 03 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,

Tinashe Mudzviti, MPhil(MD)

Academic Editor

PLOS ONE

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Knowledge of Tuberculosis preventive treatment among people living with HIV: A cross-sectional survey in selected regions of Tanzania

PONE-D-24-10620R2

Dear Dr. Alexander,

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,

Tinashe Mudzviti, MPhil(MD)

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: