Factors associated with perinatal mortality in sub-Saharan Africa: A multilevel analysis

Meklit Melaku Bezie; Hiwot Altaye Asebe; Angwach Abrham Asnake; Bezawit Melak Fente; Yohannes Mekuria Negussie; Zufan Alamrie Asmare; Mamaru Melkam; Beminate Lemma Seifu

doi:10.1371/journal.pone.0314096

Peer Review History

Original SubmissionJuly 18, 2024
24 Sep 2024 Decision Letter - Alfredo Luis Fort, Editor PONE-D-24-24034Factors associated with perinatal mortality in Sub-Saharan Africa: A multilevel analysisPLOS ONE Dear Dr. Bezie, 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 Nov 08 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, Alfredo Luis Fort, M.D., M.Sc., Ph.D. Academic Editor PLOS ONE Journal requirements: When submitting your revision, we need you to address these additional requirements. 1. 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 2. Please note that your Data Availability Statement is currently missing the repository name and/or the DOI/accession number of each dataset OR a direct link to access each database. If your manuscript is accepted for publication, you will be asked to provide these details on a very short timeline. We therefore suggest that you provide this information now, though we will not hold up the peer review process if you are unable. 3. PLOS requires an ORCID iD for the corresponding author in Editorial Manager on papers submitted after December 6th, 2016. Please ensure that you have an ORCID iD and that it is validated in Editorial Manager. To do this, go to ‘Update my Information’ (in the upper left-hand corner of the main menu), and click on the Fetch/Validate link next to the ORCID field. This will take you to the ORCID site and allow you to create a new iD or authenticate a pre-existing iD in Editorial Manager. Additional Editor Comments: The study is of high importance and the methodology used is OK. However, there are a number of place where descriptions and sentence writing is not clear enough for a reader to understand, plus requiring some descriptions, etc. That's why it is sent back to the authors to ensure a person with high written knowledge of academic writing revises the manuscript entirely, and then resubmit to PLOS ONE. See a number of suggestions in the attached file. Thanks. [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. Attachments Attachment Submitted filename: PONE-D-24-24034-AF.pdf https://doi.org/10.1371/journal.pone.0314096.r001
Revision 1
10 Oct 2024 Author Response Author response PLOS ONE Journal Manuscript title: Factors associated with perinatal mortality in Sub-Saharan Africa: A multilevel analysis Manuscript ID: PONE-D-24-24034 Dear editor/reviewer. Dear all, We would like to thank you for the constructive, building, and improvable comments on this manuscript that would improve the content of the manuscript. We considered each comment and clarification question of editors and reviewers on the manuscript thoroughly. Our point-by-point responses for each comment and question are described in detail on the following pages. Further, the details of changes were shown by track changes in the supplementary document attached. Reviewer comments 1. Abstract These variables will have to be put in special case, e.g., Media Exposure, or with inverted commas, e.g., "Media Exposure" (as it was in the report), so that it is clear to the reader... Authors’ response: Thank you reviewer for the comments. We have accepted all the comments and revised them according to your suggestions. (See the Revised manuscript) 2. Background - It would be good to put some figures here, so the reader can focus on differences between regions. Authors’ response: Thank you reviewer for the suggestions. We have added the figures for the perinatal mortality rate. "Annually, nearly 7 million perinatal deaths occur globally, including 3 to 4 million stillbirths and 3 million early neonatal deaths, with approximately 99% of these deaths taking place in low- and middle-income regions, predominantly in sub-Saharan Africa". (See the revised manuscript) - By which institution has this been advocated...WHO?...Important to instruct the reader... Authors’ response: Thank you reviewer for the comment. We have included which institution advocated the ENAP. “Several interventions to lower the Perinatal Mortality Rate (PMR) have been implemented globally, aiming to reduce stillbirths and neonatal deaths to 12 per 1,000 births by 2030 through the adoption of the Every Newborn Action Plan (ENAP) [12, 26, 27]. Launched in 2014 by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF), ENAP seeks to prevent newborn deaths and stillbirths while improving maternal and child health worldwide. However, PMR in sub-Saharan Africa remains alarmingly high compared to developed nations”. (See the Revised manuscript). 3. Methods - The sentence is unclear. Here it seems to mean that the birth record dataset was also used to extract data on "independent variables". Needs rephrasing. Authors’ response: Thank you reviewer for the comments. We used the Births Record (BR) dataset. As you know there are several DHS datasets including the women, men, kids, births, couples, and household datasets, and the type of dataset to be used depends on the objective of the research. For the child and birth outcomes, we can use either the births record or kids record data. As per the DHS recode manual and guide to statistics, we used the BR dataset to extract the outcome and independent variables. "Data on perinatal mortality and independent variables were extracted from the Births Record (BR) dataset.”. - Again, variables should be written differently from the sentence words, e.g., by capitalizing them, e.g., No, Yes, or better, by using inverted commas (e.g., "Yes", "No"). Authors’ response: Thank you reviewer for the comment. We have accepted the comment and made the revision. (See the Revised manuscript) - "and deviance"? Is this an incomplete sentence? Please re-word/improve. Authors’ response: Thank you for the comment. We have revised it. We used the deviance (-2LLR) for model comparison because the models were nested models where the lower the deviance value the better the model fits the data. A model with the lowest deviance value was chosen as the best-fitted model. We have added some details about deviance in the methods. "Four models were fitted, and model comparison was conducted using deviance (-2 Log-likelihood Ratio (-2LLR)), with the lowest value indicating the best-fitting model for the data. Deviance, expressed as the -2 Log-likelihood Ratio (-2LLR), is a statistical metric used to compare nested models in logistic regression and other likelihood-based approaches [31]. For nested models, it assesses whether the more complex model provides a better fit to the data than a simpler model by determining if the additional parameters in the complex model significantly enhance its performance. When it approaches zero, it indicates that the model fits the data exceptionally well”. (See the Revised manuscript) - De-identified DHS data, with what? Author's response: Thank you for the comment. We have revised the ethical consideration statement. In DHS, data was de-identified using data anonymization and removal of personal identifiers to ensure the participant's privacy and confidentiality. "For this study, we have received an authorization letter from the Measure DHS program for using the data. DHS provides publicly available de-identified data, so ethical approval is not needed. DHS employs several approaches to de-identify the data to ensure the privacy and confidentiality of respondents, such as data anonymization and the removal of personal identifiers”. (See the Revised manuscript) 4. Results 1. For the benefit of the reader, develop/explain this more, e.g., a way to generalize the residual sums of squares, to show the "goodness of fit"...etc. Author's response: Thank you for raising your concern. For our study, we used LLR and deviance for model comparison. As you may know, deviance is -2 times the log-likelihood ratio of the model. Given our outcome variable is binary /categorical, the model fitness/adequacy is ideally assessed using LLR because the model is based on the maximum likelihood estimation, unlike the linear regression where least square regression is used. So, the residual sum of squares is the key metric for assessing the model fitness of linear regression models where the residuals are the difference between the predicted and observed values. Therefore, the residual sum of squares can not be used for the logistic regression model. So, for our study, we used the model fitness using the LR test and deviance. For further reading see https://stats.stackexchange.com/questions/237702/comparing-models-using-the-deviance-and-log-likelihood-ratio-tests. General comments We have accepted all the editorial comments and revised them accordingly. (See the revised manuscript) Attachments Attachment Submitted filename: Author response.docx https://doi.org/10.1371/journal.pone.0314096.r002
6 Nov 2024 Decision Letter - Alfredo Luis Fort, Editor Factors associated with perinatal mortality in Sub-Saharan Africa: A multilevel analysis PONE-D-24-24034R1 Dear Dr. Bezie, 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, Alfredo Luis Fort, M.D., M.Sc., Ph.D. Academic Editor PLOS ONE Additional Editor Comments (optional): Thank you for making the necessary adjustments and edits to improve your manuscript. It is now ready to be submitted to PLOS ONE for publication. Please see the attached file for one minor error to be corrected. Thanks. 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 Editor: OK ******** 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 Editor: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Editor: 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: No Editor: Yes (as declared) ****** 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 Editor: 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 #1: The manuscript was well-written. The authors addresses the factor from the introduction to the discussion. However, I was wondering if the media exposure is related to the level of education of the mothers. Also if the mothers that are advanced in age and are highly educated with good media exposure are still at risk of maternal mortality. What will be the implication to the government policy. Editor: Please see in file attached a minor error requiring correction. ****** 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 ******** Attachments Attachment Submitted filename: PONE-D-24-24034_R1-AF.pdf https://doi.org/10.1371/journal.pone.0314096.r003
Formally Accepted
12 Nov 2024 Acceptance Letter - Alfredo Luis Fort, Editor PONE-D-24-24034R1 PLOS ONE Dear Dr. Bezie, 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 Dr. Alfredo Luis Fort Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0314096.r004

Open letter on the publication of peer review reports

PLOS recognizes the benefits of transparency in the peer review process. Therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. Reviewers remain anonymous, unless they choose to reveal their names.

We encourage other journals to join us in this initiative. We hope that our action inspires the community, including researchers, research funders, and research institutions, to recognize the benefits of published peer review reports for all parts of the research system.

Learn more at ASAPbio .