Exploring the impact of child underweight status on common childhood illnesses among children under five years in Bangladesh along with spatial analysis

Khondokar Naymul Islam; Sumaya Sultana; Ferdous Rahman; Abdur Rahman

doi:10.1371/journal.pone.0311183

Peer Review History

Original SubmissionDecember 2, 2023
11 Jun 2024 Decision Letter - Md. Moyazzem Hossain, Editor PONE-D-23-39825Exploring the impact of child underweight status on common childhood illnesses among children under five years in Bangladesh along with spatial analysisPLOS ONE Dear Dr. Rahman, 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. It is recommended to add the crude odds ratio along with AOR in Table 4. Please submit your revised manuscript by Jul 26 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. 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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 ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: No Reviewer #2: Yes ****** 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: 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: No Reviewer #2: 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: Comments to authors This article offers insights into childhood illness, exploring its prevalence and determinants through spatial analysis. While the merits of the study lie in its spatial analysis, some of the other findings presented are rather conventional and have been previously uncovered by other researchers. The English language in the paper requires significant improvement, as there is a noticeable inconsistency in the use of past and present tenses throughout the text. I have some specific concerns: 1. Abstract is missing important findings regarding spatial analysis. Further, what types of children’s, mother’s and household characteristics are associated with the childhood illness should briefly mentioned. 2. The paragraphs in the introduction are lack of coherence. Very scattered presentation of information not well synchronized. 3. Introduction is lacking intellectuality in organizing the rational of the study. Some studies addressed the relationship between child underweight and childhood illness in Bangladesh. Please see “Islam, M.S.; Chowdhury, M.R.K.; Bornee, F.A.; Chowdhury, H.A.; Billah, B.; Kader, M.; Rashid, M. Prevalence and Determinants of Diarrhea, Fever, and Coexistence of Diarrhea and Fever in Children Under-Five in Bangladesh. Children 2023, 10, 1829.” Authors should add strong justification to counter the objectives. 4. Treatment of missing values employed in this study was not a standard approach. 5. The outcome measures were poorly defined. Did all outcomes clinically diagnose or any treatment approach use to confirm having illness? 6. Authors could use random effect model to determine the childhood illness as the survey followed multistage sampling technique. 7. Most of the findings and interpretations in results and discussion section are well known and previously identified. 8. Strength and limitation of the study is a bit strange. “one is impacted by others, however, in this study we do not consider the mixed illness……………………………. The authors the prevalence of the diseases considered in this study.” Why authors did not do these in this study? The narration of this section was very poorly written and should check grammatical expression. 9. Further the study lacks important recommendations and policy implications. Reviewer #2: The manuscript is well descriptive with the support of detailed statis analysis. It also include literature from LMICs. However, it is suggestive to add following points: 1. Add "Inclusion Criteria" heading to further understand which populations were added to the study. 2. Add methodology process as to how these populations were contacted and obtained data. 3. Explain why Muslim communities has higher prevelences of fever as compare to non Muslim communities. 4. Add relation/influence of financial status of these families on their buying capacity of hygienic food, impact on nutritional status, vaccination affordability etc 5. Add "Recommendation" heading to expalin strategics/interventions to decrease these high prevelences, role of SDG, NGOs, local health centers, role of government etc. 6. As mentioned in the limitation, further research is required to explore relation of BCG and fever, it is highly advisable to researchers to conduct such study. This is unfold many causes such as and might be problem to cold chain maintainance, manufacturong of BCG vaccine, technique of administration and comparing such data with other LMICs. ****** 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 Reviewer #2: Yes: Zaibunissa karim ******** [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. 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Revision 1
9 Aug 2024 Author Response Reviewer’s comment Reviewer #1: Comments to authors This article offers insights into childhood illness, exploring its prevalence and determinants through spatial analysis. While the merits of the study lie in its spatial analysis, some of the other findings presented are rather conventional and have been previously uncovered by other researchers. The English language in the paper requires significant improvement, as there is a noticeable inconsistency in the use of past and present tenses throughout the text. I have some specific concerns: 1. Abstract is missing important findings regarding spatial analysis. Further, what types of children’s, mother’s and household characteristics are associated with the childhood illness should briefly mentioned. Reply: The findings regarding spatial analysis are now added to the abstract. Additionally, children’s, mothers’ and household characteristics that are associated with the childhood illnesses are also mentioned briefly in the abstract, as per your suggestion. 2. The paragraphs in the introduction are lack of coherence. Very scattered presentation of information not well synchronized. Reply: We have tried to reorganize the writing style of the paragraphs in the introduction section so it ensures smooth flow and the synchronization. 3. Introduction is lacking intellectuality in organizing the rational of the study. Some studies addressed the relationship between child underweight and childhood illness in Bangladesh. Please see “Islam, M.S.; Chowdhury, M.R.K.; Bornee, F.A.; Chowdhury, H.A.; Billah, B.; Kader, M.; Rashid, M. Prevalence and Determinants of Diarrhea, Fever, and Coexistence of Diarrhea and Fever in Children Under-Five in Bangladesh. Children 2023, 10, 1829.” Authors should add strong justification to counter the objectives. Reply: We have made necessary corrections to the introduction, rewrote the necessary subsections to enhance the study's intellectual depth and ensure its rationality. Though some studies addressed the relationship between child underweight and childhood illnesses, they did not consider all four illnesses as we do. The study you suggested us to review only deals witha fever, diarrhea, and the co-occurrence of these two conditions. However, we have additionally identified the association between child underweight status and cough and the existence of at least one of the four common illnesses among under-five children in Bangladesh, which is a new finding to address. 4. Treatment of missing values employed in this study was not a standard approach. Reply: Since our main focus was on identifying the geographical distribution of childhood common diseases, we excluded the missing values of the study variables (fever, cough, diarrhea, and ARI) and the missing values of the explanatory variable, which were less than 1% of the dataset. We merged the missing values from more than 1% of the dataset and the "don't know" categories into a new category caled "#Others," this ensures the prevalence of the illnesses to appear more appropriate. In order to create the "#Others" category, we reviewed several other existing studies, such as "Kundu S, Kundu S, Seidu AA, Okyere J, Ghosh S, Hossain A, Alshahrani NZ, Banna MH, Rahman MA, Ahinkorah BO. Factors influencing and changes in childhood vaccination coverage over time in Bangladesh: a multilevel mixed-effects analysis." 5. The outcome measures were poorly defined. Did all outcomes clinically diagnose or any treatment approach use to confirm having illness? Reply: All of the outcomes were self-reported by the mothers in the BDHS dataset, confirming children's diseases according to BDHS reports (https://dhsprogram.com/publications/publication-FR344-DHS-Final-Reports.cfm). To address this issues we have mentioned it under the "outcome variables" section. 6. Authors could use random effect model to determine the childhood illness as the survey followed multistage sampling technique. Reply: Since the main focus of our study was to find the spatial pattern of the common childhood diseases, we did not perform a random effect model. However, we focused on estimating the prevalence of childhood common diseases in unsampled areas. 7. Most of the findings and interpretations in results and discussion section are well known and previously identified. Reply: Most of the findings and interpretations in the results and discussion section are well known and previously identified based on the applied logistic regression model's odds ratios. Since no other Bangladeshi study worked with the geographical distribution of illnesses which we were focusing. Additionally, in line with our goal, our study reveals a unique relationship between children's underweight status and cough, as well as between children's underweight status and the presence of at least one of four common illnesses. 8. Strength and limitation of the study is a bit strange. “One is impacted by others, however, in this study we do not consider the mixed illness……………………………. The authors the prevalence of the diseases considered in this study.” Why authors did not do these in this study? The narration of this section was very poorly written and should check grammatical expression. Reply: Studying the coexistence of different illnesses is crucial for gaining a deeper understanding of the factors that associate with childhood illnesses. Due to a lack of time and resources, we did not consider different combinations of other illnesses as our study variables. However, we tried to enhance both the writing style and grammatical expression in the section's narration. 9. Further the study lacks important recommendations and policy implications. Reply: New recommendations and potentially important policy implications are added in the revised manuscript. Reviewer #2: The manuscript is well descriptive with the support of detailed statistics analysis. It also include literature from LMICs. However, it is suggestive to add following points: 1. Add "Inclusion Criteria" heading to further understand which populations were added to the study. Reply: According to your suggestions, a new section is added in the revised manuscript under the heading called "Inclusion Criteria". 2. Add methodology process as to how these populations were contacted and obtained data. Reply: As per your suggestion, we have added the process of sampling and contacting the population to obtain data to the methodology section. 3. Explain why Muslim communities has higher prevalence of fever as compare to non-Muslim communities. Reply: Based on previous scientific studies, a tentative explanation for the higher prevalence of fever and other illnesses among Muslim children compared to non-Muslim children is established, which we also addressed in the revised manuscript. 4. Add relation/influence of financial status of these families on their buying capacity of hygienic food, impact on nutritional status, vaccination affordability etc. Reply: Following your suggestion, we have mentioned the influence of these families' financial status on their ability to purchase hygienic food, its impact on their nutritional status, and the affordability of vaccinations in the revised version of the manuscript. 5. Add "Recommendation" heading to explain strategies/interventions to decrease these high prevalence, role of SDG, NGOs, local health centers, role of government etc. Reply: We have included the section titled "Recommendation," which suggests involving SDGs, NGOs, local health clinics, and the government as a means to decrease the widespread occurrence of common infant illnesses. 6. As mentioned in the limitation, further research is required to explore relation of BCG and fever, it is highly advisable to researchers to conduct such study. This is unfolding many causes such as and might be problem to cold chain maintenance, manufacturing of BCG vaccine, technique of administration and comparing such data with other LMICs. Reply: We regret the inconvenience caused by the limitations of this study; additional research is required to investigate the correlation between BCG and prevalent childhood illnesses. In this study, we conducted a thorough examination of the BCG vaccination's status in order to ascertain its influence on the aforementioned common childhood illnesses. We have removed the statement from the section and have modified it accordingly. https://doi.org/10.1371/journal.pone.0311183.r002
16 Sep 2024 Decision Letter - Md. Moyazzem Hossain, Editor Exploring the impact of child underweight status on common childhood illnesses among children under five years in Bangladesh along with spatial analysis PONE-D-23-39825R1 Dear Dr. Rahman, 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, Md. Moyazzem Hossain 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 ******** 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: Partly ****** 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 ****** 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: No ****** 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: The authors have addressed all comments. I do not have further comments to authors. Now the decision is up to editor for further action. ****** 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: No ******** https://doi.org/10.1371/journal.pone.0311183.r003
Formally Accepted
18 Sep 2024 Acceptance Letter - Md. Moyazzem Hossain, Editor PONE-D-23-39825R1 PLOS ONE Dear Dr. Rahman, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. 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. If we can help with anything else, please email us at customercare@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Professor Md. Moyazzem Hossain Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0311183.r004

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