Gaps, challenges and opportunities towards achieving the 95-95-95 targets in Cameroon: A systematic review and meta-analysis protocol

Ezechiel Ngoufack Jagni Semengue; Alex Durand N. K. A.; Pamela Patricia Tueguem; Christelle Aude Ka’e; Evariste Molimbou; Lum Yah Forgwei; Naomi-Karell Etame; Aurelie Minelle Kengni Ngueko; Désiré Takou; Aristide Stephane Abah Abah; Alice Ketchadji; Pamen Bouba; David Kob Same III; Oscar Etogo; Basile Keugoung; Abdelkader Bacha; Phanuel Habimana; Martin Samuel Sosso; Alexis Ndjolo; Carlo-Federico Perno; Vittorio Colizzi; Rogers Ajeh; Anne-Cecile Z-K Bissek; Nicaise Ndembi; Joseph Fokam

doi:10.1371/journal.pone.0317850

Peer Review History

Original SubmissionJune 14, 2024
4 Jul 2024 Decision Letter - Yimam Getaneh Misganie, Editor PONE-D-24-15119Gaps, challenges and opportunities towards achieving the 95-95-95 targets in Cameroon: A Systematic review and meta-analysis Protocol PLOS ONE Dear Dr. Ngoufack Jagni Semengue, 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. Specifically As data elements are to be captured for 95-95-95, the second 95 is about linkage to ART which is not the right definition for the second 95. The second 95 deals with the proportion of people alive and on treatment. Revise this data element. In the same way, HIV diagnosis is not the right definition for the first 95. Stick with the global definition for 95-95-95. How you plan to do the SWOT analysis is not clear What randomized and non-randomized trial types of studies do you expect for this review of 95-95-95? Hence, it does not apply to this analysis Authors frequently used Diagnosis/Testing for the first 95%, the actual definition is “Know their HIV status” which means “test and result delivered” which means “aware of their status”. That is not about test coverage. Be consistent with the definition of diagnosis/testing which are different in their context. Hence, I strongly suggest you stick with the global definition for the 95-95-95 …..Having evidence from studies focusing on diagnosis/testing, access to test results, patient referral to optimal therapeutic protocols, and viral suppression rates; conducted from 2017 to 2024”……, authors can’t get complete information about the 95-95-95. Revise the participants as per the data elements and definition of the 95-95-95 ……Intervention: all intervention towards the achievement of any of the 95-95-95 …. Qualify what type of interventions would you require to collect Good to finally see the Outcomes of this review which are correct! How do authors plan to handle dual language publications for analysis, do they plan translation of one of the languages? From the data items to be captured I can't see the second 95 (proportion of people on treatment) I still can’t see what data elements will be captured to analyze the SWOT analysis Data analysis considers only the first 95%, you don’t have a plan to analyze the second and third 95? ============================== Please submit your revised manuscript by Aug 18 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, Yimam Getaneh Misganie (PhD, PhD) 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. We noticed you have some minor occurrence of overlapping text with the following previous publication(s), which needs to be addressed: https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-020-01356-z https://doi.org/10.1371/journal.pone.0272839 https://doi.org/10.1002/14651858.CD006495.pub4 In your revision ensure you cite all your sources (including your own works), and quote or rephrase any duplicated text outside the methods section. Further consideration is dependent on these concerns being addressed. 3. Please provide a complete Data Availability Statement in the submission form, ensuring you include all necessary access information or a reason for why you are unable to make your data freely accessible. If your research concerns only data provided within your submission, please write "All data are in the manuscript and/or supporting information files" as your Data Availability Statement. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions? The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field. Reviewer #1: Yes Reviewer #2: No ******** 2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses? The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory. Reviewer #1: Yes Reviewer #2: No ****** 3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable? Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible. Reviewer #1: Yes Reviewer #2: No ****** 4. Have the authors described where all data underlying the findings will be made available when the study is complete? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. 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: No ****** 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 Reviewer #2: No ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics. You may also provide optional suggestions and comments to authors that they might find helpful in planning their study. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: This paper investigated the manuscript " Gaps, challenges and opportunities towards achieving the 95-95-95 targets in Cameroon: A Systematic review and meta-analysis Protocol" I have many suggestions for improving the presentation before accepting it for the Journal: PLOS ONE. The following comments are provided for the authors: 1- The authors should make an effort to provide figures and graphs in the manuscript. 2- The authors should compare the results with those of other countries. 3- The authors should mention the national and international organizations that may be interested in the study. 4- The authors should highlight the recommendations. 5- What are the included and excluded criteria in this study? Reviewer #2: very vaguely written protocol, not at all fit for a systematic review and meta analysis. There is no specific study research question, no specific search criteria. ****** 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 Reviewer #2: No ******** [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. https://doi.org/10.1371/journal.pone.0317850.r001
Revision 1
8 Aug 2024 Author Response RESPONSES TO REVIEWERS 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. Specifically, • As data elements are to be captured for 95-95-95, the second 95 is about linkage to ART which is not the right definition for the second 95. The second 95 deals with the proportion of people alive and on treatment. Revise this data element. In the same way, HIV diagnosis is not the right definition for the first 95. Stick with the global definition for 95-95-95. Response 1: We thank the editor for the comment. We have revised accordingly in the text as suggested (see lines 36-37 & 81-83, pages 2-3). • How you plan to do the SWOT analysis is not clear Response 2: We thank the editor for the comment. We have provided more explanation on how we plan to do the SWOT analysis in the text as requested (see lines 207-210, page 7). • What randomized and non-randomized trial types of studies do you expect for this review of 95-95-95? Hence, it does not apply to this analysis Response 3: We thank the editor for the comment. Indeed, our objective is to include studies based on their focus on at least one of the 95-95-95 targets; so we are expecting to include randomized or non-randomized studies providing figures on either HIV-diagnosis, HIV-treatment or viral suppression in Cameroon. Up-to this point we have successfully retrieved data from one randomized study addressing viral suppression in Cameroon (the NAMSAL study). • Authors frequently used Diagnosis/Testing for the first 95%, the actual definition is “Know their HIV status” which means “test and result delivered” which means “aware of their status”. That is not about test coverage. Be consistent with the definition of diagnosis/testing which are different in their context. Hence, I strongly suggest you stick with the global definition for the 95-95-95 Response 4: We thank the editor for the comment. We have revised accordingly in the text as suggested (see lines 36-37 & 81-83, pages 2-3). • …..Having evidence from studies focusing on diagnosis/testing, access to test results, patient referral to optimal therapeutic protocols, and viral suppression rates; conducted from 2017 to 2024”……, authors can’t get complete information about the 95-95-95. Revise the participants as per the data elements and definition of the 95-95-95 Response 5: We thank the editor for the comment. We have brought clarity and revised as follows: “we will include studies focusing on either the proportion of PLHIV who are aware of their status, the proportion of PLHIV under antiretroviral treatment or the proportion of PLHIV achieving viral suppression; conducted from 2017 to 2024” (see lines 107-110, page 4). • ……Intervention: all intervention towards the achievement of any of the 95-95-95 …. Qualify what type of interventions would you require to collect Response 6: We thank the editor for the comment. We have revised as follows: “No intervention will be assessed in this systematic review. Rather, any data highlighting the achievement of any of the 95-95-95 targets will be of interest in this review” (see lines 111-113, page 4). • Good to finally see the Outcomes of this review which are correct! Response 7: We thank the editor for the comment. • How do authors plan to handle dual language publications for analysis, do they plan translation of one of the languages? Response 8: We thank the editor for the comment. All data extracted will not be translated as we perfectly understand both languages (French and English). However, all the summary and the reporting will be done in English for harmonization purposes. We have added a note addressing this important point (see lines 129-130, page 5). • From the data items to be captured I can't see the second 95 (proportion of people on treatment) Response 9: We thank the editor for the comment. We have revised accordingly (see lines 174-176, page 6). • I still can’t see what data elements will be captured to analyze the SWOT analysis Response 10: We thank the editor for the comment. We have revised as follows: “… additional data (specific interventions or programmatic actions) will be extracted and grouped to capture the strengths, weaknesses, opportunities and threats for achieving these UNAIDS’ programmatic goals in Cameroon” (see lines 182-184, page 6). • Data analysis considers only the first 95%, you don’t have a plan to analyze the second and third 95? Response 11: We thank the editor for the comment. We have revised accordingly (see lines 194-195, pages 6-7). 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 Response 12: We thank the editor for the comment. We have revised accordingly throughout the manuscript. 2. We noticed you have some minor occurrence of overlapping text with the following previous publication(s), which needs to be addressed: https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-020-01356-z https://doi.org/10.1371/journal.pone.0272839 https://doi.org/10.1002/14651858.CD006495.pub4 In your revision ensure you cite all your sources (including your own works), and quote or rephrase any duplicated text outside the methods section. Further consideration is dependent on these concerns being addressed. Response 13: We thank the editor for the comment. We have revised accordingly in the manuscript. 3. Please provide a complete Data Availability Statement in the submission form, ensuring you include all necessary access information or a reason for why you are unable to make your data freely accessible. If your research concerns only data provided within your submission, please write "All data are in the manuscript and/or supporting information files" as your Data Availability Statement. Response 14: We thank the editor for the comment. We have revised accordingly as suggested (see line 300, page 10). https://doi.org/10.1371/journal.pone.0317850.r002
27 Aug 2024 Decision Letter - Yimam Getaneh Misganie, Editor PONE-D-24-15119R1Gaps, challenges and opportunities towards achieving the 95-95-95 targets in Cameroon: A Systematic review and meta-analysis Protocol PLOS ONE Dear Dr. Ngoufack Jagni Semengue, 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 Comments: Describe how you plan to handle translation bias from the French articles, in addition to the English. Overall, this is not a systematic review to address SWOT towards 95-95-95, rather this is a protocol to conduct the review hence the objective of this protocol is to provide a standardized document to the scientific community for future use for similar review. Include the potential limitation of this protocol, indicated below, or clarify in the manuscript how you plan to mitigate the issues: Data Availability: There may be limitations in the availability or quality of data reported in the included studies, which could affect the ability to perform robust meta-analysis. Heterogeneity: High variability between studies in terms of design, methodology, and participant characteristics could impact the synthesis of results and the ability to draw generalizable conclusions. Publication Bias: The review may be influenced by the publication bias of including only published studies and conference abstracts, which might not represent all relevant data. Quality Assessment: The assessment of the quality and risk of bias in studies could be subjective and dependent on the tools used (e.g., ROBINS-I, ROBIS). Variability in assessment could affect the interpretation of the evidence. Context-Specific Findings: The findings of the review will be context-specific to Cameroon, which may not be generalizable to other regions or countries with different healthcare systems and epidemiological profiles. Protocol Rigidity: The protocol might be rigid and not easily adaptable to new evidence or changes in the research landscape. Updates to the protocol or search strategy might be necessary to address emerging data or shifts in the field. Resource Limitations: The review might face constraints related to time, resources, or access to certain databases and literature, which could affect the comprehensiveness of the review. ============================== Please submit your revised manuscript by Oct 11 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, Yimam Getaneh Misganie (PhD, PhD) Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments: 1. Describe how you plan to handle translation bias from the French articles, in addition to the English. 2. Overall, this is not a systematic review to address SWOT towards 95-95-95, rather this is a protocol to conduct the review hence the objective of this protocol is to provide a standardized document to the scientific community for future use to conduct similar review. 3. Include the potential limitation of this protocol, indicated below, or clarify in the manuscript how you plan to mitigate the issues: • Data Availability: There may be limitations in the availability or quality of data reported in the included studies, which could affect the ability to perform robust meta-analysis. • Heterogeneity: High variability between studies in terms of design, methodology, and participant characteristics could impact the synthesis of results and the ability to draw generalizable conclusions. • Publication Bias: The review may be influenced by the publication bias of including only published studies and conference abstracts, which might not represent all relevant data. • Quality Assessment: The assessment of the quality and risk of bias in studies could be subjective and dependent on the tools used (e.g., ROBINS-I, ROBIS). Variability in assessment could affect the interpretation of the evidence. • Context-Specific Findings: The findings of the review will be context-specific to Cameroon, which may not be generalizable to other regions or countries with different healthcare systems and epidemiological profiles. • Protocol Rigidity: The protocol might be rigid and not easily adaptable to new evidence or changes in the research landscape. Updates to the protocol or search strategy might be necessary to address emerging data or shifts in the field. • Resource Limitations: The review might face constraints related to time, resources, or access to certain databases and literature, which could affect the comprehensiveness of the review. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions? The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field. Reviewer #3: Yes ******** 2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses? The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory. Reviewer #3: Yes ****** 3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable? Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible. Reviewer #3: Yes ****** 4. Have the authors described where all data underlying the findings will be made available when the study is complete? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. 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 #3: 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 #3: No ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics. You may also provide optional suggestions and comments to authors that they might find helpful in planning their study. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #3: The authors should make sure that the manuscript is written in standard English before it is accepted for publication. Authors should justify the time frame of their review and add the review question. ****** 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 #3: No ******** [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: Final draft - Protocol - 3(95)Cameroon.BN.15.8.24.docx https://doi.org/10.1371/journal.pone.0317850.r003
Revision 2
12 Sep 2024 Author Response Responses to reviewers: Academic Editor Comments: 1. Describe how you plan to handle translation bias from the French articles, in addition to the English. Response 1: We thank the Editor for this comment. However, there will not be any translation bias from English to French articles/reports as both languages are adopted at national level and are perfectly mastered by all co-authors. 2. Overall, this is not a systematic review to address SWOT towards 95-95-95, rather this is a protocol to conduct the review hence the objective of this protocol is to provide a standardized document to the scientific community for future use for similar review. Response 2: We thank the Editor for this comment. We have revised and clarify the aim of this protocol accordingly. 3. Include the potential limitation of this protocol, indicated below, or clarify in the manuscript how you plan to mitigate the issues: • Data Availability: There may be limitations in the availability or quality of data reported in the included studies, which could affect the ability to perform robust meta-analysis. • Heterogeneity: High variability between studies in terms of design, methodology, and participant characteristics could impact the synthesis of results and the ability to draw generalizable conclusions. • Publication Bias: The review may be influenced by the publication bias of including only published studies and conference abstracts, which might not represent all relevant data. • Quality Assessment: The assessment of the quality and risk of bias in studies could be subjective and dependent on the tools used (e.g., ROBINS-I, ROBIS). Variability in assessment could affect the interpretation of the evidence. • Context-Specific Findings: The findings of the review will be context-specific to Cameroon, which may not be generalizable to other regions or countries with different healthcare systems and epidemiological profiles. • Protocol Rigidity: The protocol might be rigid and not easily adaptable to new evidence or changes in the research landscape. Updates to the protocol or search strategy might be necessary to address emerging data or shifts in the field. • Resource Limitations: The review might face constraints related to time, resources, or access to certain databases and literature, which could affect the comprehensiveness of the review. Response 3: We thank the Editor for this comment. We have revised our protocol limitation exactly as suggested. https://doi.org/10.1371/journal.pone.0317850.r004
24 Sep 2024 Decision Letter - Yimam Getaneh Misganie, Editor PONE-D-24-15119R2Gaps, challenges and opportunities towards achieving the 95-95-95 targets in Cameroon: A Systematic review and meta-analysis ProtocolPLOS ONE Dear Dr. Ngoufack Jagni Semengue, 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. ============================== The current version of the manuscript contains substantial changes that extend beyond addressing the reviewers' and editor's comments from the previous version. As this manuscript has already undergone two rounds of review, the authors are requested to focus strictly on the feedback provided by the reviewers and editor. The decision has been changed from "minor revision" to "major revision" due to the emergence of new issues during the review process, resulting from the revisions made by the authors, which brought to light concerns that were not initially apparent. ============================== 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, Yimam Getaneh (MSc, PhD, PhD) Academic Editor PLOS ONE [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. https://doi.org/10.1371/journal.pone.0317850.r005
Revision 3
7 Nov 2024 Author Response Responses to Editor’s Comments: Academic Editor Comments: 1. Describe how you plan to handle translation bias from the French articles, in addition to the English. Response 1: We thank the Editor for this comment. However, there will not be any translation bias from English to French articles/reports as both languages are adopted at national level and are perfectly mastered by all co-authors. In effect some authors have English as first-language for expression whereas others have French as first-language for expression. We have added a comment on that light (see lines 130-132, page 5). 2. Overall, this is not a systematic review to address SWOT towards 95-95-95, rather this is a protocol to conduct the review hence the objective of this protocol is to provide a standardized document to the scientific community for future use for similar review. Response 2: We thank the Editor for this comment. We have revised and clarify the aim of this protocol accordingly (see line 39, page 2; and lines 88-89, page 3). 3. Include the potential limitation of this protocol, indicated below, or clarify in the manuscript how you plan to mitigate the issues: • Data Availability: There may be limitations in the availability or quality of data reported in the included studies, which could affect the ability to perform robust meta-analysis. • Heterogeneity: High variability between studies in terms of design, methodology, and participant characteristics could impact the synthesis of results and the ability to draw generalizable conclusions. • Publication Bias: The review may be influenced by the publication bias of including only published studies and conference abstracts, which might not represent all relevant data. • Quality Assessment: The assessment of the quality and risk of bias in studies could be subjective and dependent on the tools used (e.g., ROBINS-I, ROBIS). Variability in assessment could affect the interpretation of the evidence. • Context-Specific Findings: The findings of the review will be context-specific to Cameroon, which may not be generalizable to other regions or countries with different healthcare systems and epidemiological profiles. • Protocol Rigidity: The protocol might be rigid and not easily adaptable to new evidence or changes in the research landscape. Updates to the protocol or search strategy might be necessary to address emerging data or shifts in the field. • Resource Limitations: The review might face constraints related to time, resources, or access to certain databases and literature, which could affect the comprehensiveness of the review. Response 3: We thank the Editor for this comment. We have revised our protocol limitation exactly as recommended (see lines 247-271, page 8). Once again, we thank the Editor for the constructive remarks and are very much confident that the current version is suitable for publication. All other comments in the manuscript have also been addressed accordingly (see lines 104-105, page 4; and lines 129-130, page 5). Attachments Attachment Submitted filename: Responses to reviewers.docx https://doi.org/10.1371/journal.pone.0317850.r006
7 Jan 2025 Decision Letter - Yimam Getaneh Misganie, Editor Gaps, challenges and opportunities towards achieving the 95-95-95 targets in Cameroon: A Systematic review and meta-analysis Protocol PONE-D-24-15119R3 Dear Dr. Ezechiel, 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, Yimam Getaneh (PhD, PhD) Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0317850.r007
Formally Accepted
16 Jan 2025 Acceptance Letter - Yimam Getaneh Misganie, Editor PONE-D-24-15119R3 PLOS ONE Dear Dr. Ngoufack Jagni Semengue, 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. Yimam Getaneh Misganie Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0317850.r008

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