Survival status and predictors of early neonatal mortality among neonates admitted to neonatal intensive care units in Addis Ababa Public Hospitals, Ethiopia: A retrospective cohort study

Ashenafi Seifu Gesso; Gemechis Kabe Gonfa; Meron Abrar Awol

doi:10.1371/journal.pone.0323600

Peer Review History

Original SubmissionJune 11, 2024
11 Jun 2024 Author Response https://doi.org/10.1371/journal.pone.0323600.r001
15 Aug 2024 Decision Letter - Mohammed Abdurke Kure, Editor PONE-D-24-21573SURVIVAL STATUS AND PREDICTORS OF EARLY NEONATAL MORTALITY AMONG NEONATES ADMITTED TO NEONATAL INTENSIVE CARE UNITS IN ADDIS ABABA PUBLIC HOSPITALS, ETHIOPIA 2023: A RETROSPECTIVE COHORT STUDY PLOS ONE Dear Dr. Gesso, 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 issues. Please submit your revised manuscript by Sep 29 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 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, Mohammed Abdurke Kure, MSc, Assistant Professor Academic Editor PLOS ONE Journal Requirements: 1. When submitting your revision, we need you to address these additional requirements. 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 note that your Data Availability Statement is currently as follows: "All relevant data are within the manuscript and its Supporting Information files" Please confirm at this time whether or not your submission contains all raw data required to replicate the results of your study. Authors must share the “minimal data set” for their submission. PLOS defines the minimal data set to consist of the data required to replicate all study findings reported in the article, as well as related metadata and methods (https://journals.plos.org/plosone/s/data-availability#loc-minimal-data-set-definition). 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Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. If data are owned by a third party, please indicate how others may request data access. 3. Your ethics statement should only appear in the Methods section of your manuscript. If your ethics statement is written in any section besides the Methods, please move it to the Methods section and delete it from any other section. Please ensure that your ethics statement is included in your manuscript, as the ethics statement entered into the online submission form will not be published alongside your manuscript. 4. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. Additional Editor Comments: Dear Dr. Gesso, Thank you for submitting the manuscript entitled "SURVIVAL STATUS AND PREDICTORS OF EARLY NEONATAL MORTALITY AMONG NEONATES ADMITTED TO NEONATAL INTENSIVE CARE UNITS IN ADDIS ABABA PUBLIC HOSPITALS, ETHIOPIA 2023: A RETROSPECTIVE COHORT STUDY" as Original Research Article. Your manuscript is suitable for the PLOS ONE Journal, for publication. However, it doesn't fulfill the publication criteria in its current stands. PLOS ONE is only considere the manuscript submitted with less typographic errors and standard English language. Please, revise the PLOS ONE authors'guidelines and re-submit your mansucript. For instance; your manuscript: -Has no line-numbers -Not double spaced -You did not follow the PLOS ONE guidelines to prepare the Figures and Tables -Has many typographic and editorial errors Therefore, we can proceed with the manuscript, only after all these issues are resvised and resolved. Regards Mr. Mohammed Abdurke Kure, MSc, Assistant Professor Academic Editor PLOS ONE Journal [Note: HTML markup is below. Please do not edit.] 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.0323600.r002
Revision 1
29 Sep 2024 Author Response Dear, academic editors of the PLOSE ONE journal, This is Ashenafi Seifu Gesso a corresponding author for the manuscript entitled “Survival status and predictors of early neonatal mortality among neonatal intensive care unit admitted neonates in Addis Ababa, Ethiopia 2023: A retrospective cohort study”. It’s a great honor to work with this journal and I have publications previously as well. This journal is one of the most respected and reputable journals we are considering to publish our scholarly articles. As such, I am recommending friends, and colleagues to join working with PLOSE ONE journal. Below points are point by point responses for editors comments. 1. When submitting your revision, we need you to address these additional requirements. Response- I was not strictly followed Plose one authors guidelines at the prior submission. Now, in the revised submission I did it as per the journal standards. 2.We note that your Data Availability Statement is currently as follows: "All relevant data are within the manuscript and its Supporting Information files" Response= In the revised version I stated it as “The datasets used and/or analyzed during the current study are available from the corresponding author without restriction”. 3.Your ethics statement should only appear in the Methods section of your manuscript. Response=Yes, it was stated almost twice in the prior submission, but corrected in the revised submission. 4. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly Response= The prior submission provided supporting information separately. The revised submission added captions for supporting information at the end of the manuscript file. Additional comments Please, revise the PLOS ONE authors' guidelines and re-submit your manuscript. For instance; your manuscript: -Has no line-numbers -Not double spaced -You did not follow the PLOS ONE guidelines to prepare the Figures and Tables -Has many typographic and editorial errors Response The former submission had no line-numbers, revised one has continuous line numbers The prior submission was 1.5 line spaced, but the revised one is double spaced The former submission did not followed captions for tables and figures, but the revised one was inline with PLOS ONE guidelines to prepare the Figures and Tables The first submission had some grammatical and punctuation errors, but the revised one solved those typographic and editorial errors. Attachments Attachment Submitted filename: A rebuttal letter for each comments raised by an a.pdf https://doi.org/10.1371/journal.pone.0323600.r003
2 Mar 2025 Decision Letter - Dawit Getachew Gebeyehu, Editor PONE-D-24-21573R1SURVIVAL STATUS AND PREDICTORS OF EARLY NEONATAL MORTALITY AMONG NEONATAL INTENSIVE CARE UNIT ADMITTED NEONATES IN ADDIS ABABA, ETHIOPIA 2023: A RETROSPECTIVE COHORT STUDYPLOS ONE Dear Dr. Gesso, 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 by the reviewers comments and suggestions. Please submit your revised manuscript by Apr 16 2025 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, Dawit Getachew Academic Editor PLOS ONE [Note: HTML markup is below. Please do not edit.] 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 Reviewer #2: (No Response) ******** 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 Reviewer #2: No ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: No ****** 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 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. 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: All my comments and suggestion given in the first version, addressed in this version, no adtional comments, concerns and suggestion on this version. Reviewer #2: Dear editor I would like to thank you for inviting me to review this paper done by Gesso et. al. The paper tried to investigate incidence and predictors of mortality of neonates in neonatal ICU in Addis Ababa, Ethiopia, using a retrospective chart review. This manuscript brings unaddressed challenge of public health. However, the manuscript lacks fundamental point to merit publication. Major issues 1. Lack of novelty: predictors of neonatal mortality in NICU have been well studied in various parts of Ethiopia including Addis Ababa. A study done by Getahun et. al (https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2024.1352270/full) assessed predictors of neonatal mortality in NICU using similar settings, study design, and analysis technique, making this manuscript a duplication of results. 2. Study design: Almost all previously conducted studies used retrospective cohort study (chart review) recommended to further conducting prospective studies in order to better estimate incidence and identify predictors of neonatal mortality in the NICU. However, this recent manuscript used retrospective chart review which makes the manuscript less attractive. 3. Length of follow-up in NICU: The authors described neonates stayed in NICU a minimum of 1 day to a maximum of 7 days. This seems unrealistic since neonates, especially on phototherapy, sepsis, and neonatal enterocolitis, might stay more than 7 days. This raises a question on data collection. 4. Result and Statistics: A poor presentation of results. It is not relevant to provide Log-rank test results id the authors run Cox regression. Not relevant to upload Kaplan-Meier graphs of categorical variables as a supplementary file. The authors did not assess variability across clinical settings using a statistical approach (This might lead to analysis with shared frailty model). In conclusion lack of novelty makes this manuscript less attractive. I recommend the author to consider prospective study. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean? ). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy . Reviewer #1: Yes: Esubalew Tesfahun 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.0323600.r004
Revision 2
6 Apr 2025 Author Response Point by point response to the editors and reviewers comments 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. Response: Yes we appropriately revised as per the comments given in the subsequent reviews . 2. Is the manuscript technically sound, and do the data support the conclusions? Response: Yes, absolutely the conclusions were drawn from the results presented. 3. Has the statistical analysis been performed appropriately and rigorously? Response: Yes, we performed survival analysis to see when will a neonate less than or equal to 7 days old would die after admission to neonatal intensive care units. 4. Have the authors made all data underlying the findings in their manuscript fully available? Response: Yes, we declared it in detail and we can provide every data sets used for this analysis without restriction. 5. Is the manuscript presented in an intelligible fashion and written in standard English? Response: Yes, we made this manuscript well articulated and informative through our publication experience and PLOS ONE standards. 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: All my comments and suggestion given in the first version, addressed in this version, no additional comments, concerns and suggestion on this version. Reviewer #2: Dear editor I would like to thank you for inviting me to review this paper done by Gesso et. al. The paper tried to investigate incidence and predictors of mortality of neonates in neonatal ICU in Addis Ababa, Ethiopia, using a retrospective chart review. This manuscript brings unaddressed challenge of public health. However, the manuscript lacks fundamental point to merit publication. Major issues 1. Lack of novelty: Response: We see the concerns over the novelty, but the previous study was simple cross sectional study with incidence and associated factors for NICU admitted neonates. The current study(ours) was survival study that looks when will the early neonate (from first day to day seven of life) die after admission to the NICU. Ou study was different in population, in methods, analysis and finding as well. 2. Study design: Almost all previously conducted studies used retrospective cohort study (chart review) recommended to further conducting prospective studies in order to better estimate incidence and identify predictors of neonatal mortality in the NICU. However, this recent manuscript used retrospective chart review which makes the manuscript less attractive. Response: The current study (our was also retrospective), we understand and we stated the limitations of retrospective study in the methods section of the manuscript. But the objective was to pick the predictors of early neonatal mortality (≤7 days of life) not for all neonates admitted to the neonatal intensive care units. 3. Length of follow-up in NICU: The authors described neonates stayed in NICU a minimum of 1 day to a maximum of 7 days. This seems unrealistic since neonates, especially on phototherapy, sepsis, and neonatal enterocolitis, might stay more than 7 days. This raises a question on data collection. Response: With regard to this concern, we put early neonatal mortality in operational definition in the manuscript. Accordingly, if a neonate stays for more than seven days we declared improved or stayed beyond 7th days of life, if not an event was recorded as died. 4. Result and Statistics: A poor presentation of results. It is not relevant to provide Log-rank test results if the authors run Cox regression. Not relevant to upload Kaplan-Meier graphs of categorical variables as a supplementary file. The authors did not assess variability across clinical settings using a statistical approach (This might lead to analysis with shared frailty model). Response:We understand the concern from the reviewer, but we added Kaplan-Meier graphs to increase clarity for the readers and to see time to death as long as this would not alter the cox-regression findings. Attachments Attachment Submitted filename: Point by point response to reviewers.pdf https://doi.org/10.1371/journal.pone.0323600.r005
11 Apr 2025 Decision Letter - Dawit Getachew Gebeyehu, Editor SURVIVAL STATUS AND PREDICTORS OF EARLY NEONATAL MORTALITY AMONG NEONATES ADMITTED TO NEONATAL INTENSIVE CARE UNITS IN ADDIS ABABA, ETHIOPIA 2023: A RETROSPECTIVE COHORT STUDY PONE-D-24-21573R2 Dear Dr. Ashenafi, 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, Dawit Getachew Gebeyehu, MPH Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0323600.r006
Formally Accepted
Acceptance Letter - Dawit Getachew Gebeyehu, Editor PONE-D-24-21573R2 PLOS ONE Dear Dr. Gesso, 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 You will receive further instructions from the production team, including instructions on how to review your proof when it is ready. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few days 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 Mr. Dawit Getachew Gebeyehu Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0323600.r007

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