Self-care interventions to reduce, prevent or monitor physical disability in those affected by leprosy: protocol for a systematic review

PONE-D-25-10635

Dear Dr. Willis,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Academic Editor

PLOS ONE

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Additional Editor Comments

I have additional comments to improve your systematic review, which should be considered for inclusion in the final version of the manuscript:

Regarding the Background section, I recommend revising the sixth paragraph to enhance readers’ understanding of the Transtheoretical Model (TTM) stages, as only a few examples are currently provided. The last sentence of that paragraph should be moved to the following paragraph to strengthen the study’s justification.

All methods proposed by the authors align with established frameworks for conducting systematic reviews.

I recommend that the authors cleraly cite that meta-analyses and review articles will be excluded  from the study selection criteria and suggest including information on the types of lesions presented by the patients.

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?

Reviewer #1: Yes

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2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses??>

Reviewer #1: Yes

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3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable??>

Reviewer #1: Yes

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4. Have the authors described where all data underlying the findings will be made available when the study is complete??>

The PLOS Data policy

Reviewer #1: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

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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.

Reviewer #1: The rationale for the study is clear and valid. The study addresses the significant burden of physical disability caused by leprosy, even after microbiological cure, and highlights the importance of self-care interventions as a low-resource strategy to prevent, monitor, and manage disability. The protocol is technically sound and designed to effectively achieve its aims. It outlines a systematic review methodology following PRISMA guidelines.

The Transtheoretical Model is a useful starting point for understanding self-care behaviors, especially in personalized care planning. However, its effectiveness depends on how well it is adapted to include social, cultural, and systemic factors. As a standalone framework, it may fall short in addressing the broader determinants of self-care behavior.

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Reviewer #1: Yes:  Joydeepa Darlong

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