Post-COVID-19 Rabies Surveillance and Risk Factors in Rural Eastern Cape, South Africa: A One Health Perspective

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Diagnostic Surveillance And Risk Factors Of Rabies Virus In Rural Areas Of Eastern Cape: A One Health Approach is a well written written manuscript. I just feel the one health approach is not clearly illustrated. 

Areas for improvement:

1. Lines 48-49: Comment on availability of PEP particularly if there any stock outs in the study area,
2. Insert the word human before cases, line 51,
3. Is there an estimate of the current dog vaccination levels? If not indicate so. 
4. How many questionnaires were pretested and in which locality?
5. Lines 81-82: insert a map that just shows the locality of the study area. 
6. In the discussion - what are the indicators used to investigate rabies surveillance?

Author Response

The One Health approach is not clearly illustrated

Response: Thank you for the comment. We have now strengthened the articulation of the “One Health approach” by explicitly describing the human, animal, and system-level surveillance indicators used, and by clarifying how these domains were integrated analytically through the Surveillance Gap Index (SGI) and predictive models. Additional clarification has been added to the Methods and Discussion sections (Pages 2 and 3, lines 76-80 and 126-128).

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

The following queries be addressed to strengthen the manuscript:

1. Designing of the study and Size of the sample

   • This being a pilot study is based on a limited number of samples (n=109).  

   • What is the criteria employed for the selection of two rural communities. Justify that they are the true representatives of the eastern Cape Town. 

2. Methodology and Analysis

   • Normally, Machine learning tools are employed for large data sets. How do you justify employing the machine learning tool for such a small data of 109 samples.
     
     

3. Statistical Reporting

   • The confidence intervals be mentioned for all the ratios.

4. Ethical and Operational aspects

   • Ethical approval and informed consent procedures be stated.

   • Elaborate the practical aspects for One Health coordination at local government as well as community levels in the rural settings.

At the outset, although the study has  potential to make a relevant contribution to literature, moderate revisions in methodology, analysis and interpretation of the outcome are important.

Author Response

Reviewer 2

1. Sample size and selection of communities

Response: We acknowledge the pilot nature of the study and have strengthened the justification for both sample size and site selection (page 3, lines 105-110).

 

2. How do you justify employing the machine learning tool for such a small amount of data, 109 samples?

Response: We have clarified that machine learning was used exploratorily, alongside traditional regression (pages 4 and 9, lines 139-143 and 308-316).

 

3. Confidence intervals for all ratios

Response: All odds ratios are now presented with 95% confidence intervals in Tables 2 and 3, along with the corresponding text, and are highlighted accordingly.

 

4. Ethical procedures and One Health coordination

Response: Ethical procedures were included; however, we expanded the discussion on One Health coordination.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

This MS entitled "Diagnostic Surveillance and Risk Factors of Rabies Virus in 2 Rural Areas of Eastern Cape: A One Health Approach" is in general well written and interesting for the country where it was done. However, some few aspects can be clarify and improved: 

All figures must be re make since it is not possible to read them, for example: Figure 1. Impossible to read; Figure 2. Do not use abreviations, What means ROC?

It’s not clear enough in "discussion", how did they evaluate environment issues, which were they? and how they could be similar to other regions in the geographical area. 

 

Author Response

Reviewer 3

1. Figure 2 is not readable; define ROC

Response: All figures have been reformatted for clarity, font size increased, and abbreviations defined in figure captions and the Methods section (page 4, lines 143-145).

 

2. Environmental factors unclear

Response: It has been clarified that environmental risk was assessed indirectly through settlement patterns and access-related factors (page 9, lines 269-271).

 

 

 

Author Response File: Author Response.pdf