Country-Level Variations in Overweight and Obesity among Reproductive-Aged Women in Sub-Saharan Countries
, Chimezie Igwegbe Nzoputam 3,4 and Michael Ekholuenetale 5,*
Round 1
Reviewer 1 Report
Title: The authors should consider changing the ending of the title and taking out the sleep and disease, etc... because they don't pay enough sufficient attention to those results or make the case with sleep through their results.
The authors should consider including a definition of what countries constitute sub-saharan Africa (SSA) as well as maybe the map earlier on to assist readers with the visualization of what countries in SSA they are specifically referring to. It would also be helpful if the age range for women of reproductive age (WGA) came early in the background as well.
Sleep: It is the suggestion of the reviewer that the sleep piece be taken out and maybe have that entire suggested correlation be used for a second article. Otherwise there are several important definitions, clarifications, and connections that need to be made within the content that don't exist in its' current format. A definition of sleep quality and what it is, what is meant by sleep problems, the use of the national Sleep Foundation which is particular to the US and this reviewer is not sure it's recommendation can be extrapolated to other countries, cultures, and socioeconomic statuses.
SSA-Are there a mix of countries in SSA? it would seem that the authors would need to make clear the SSA countries that are considered LMIC and the one that are not to assist the reader in understanding the results.
This is a secondary data analysis using a large public data set, suggest saying that early on.
The font and spacing changes throughout the document, the review suggests uniform and consistent spacing and font size for the mansucript. please see the numerous grammatical changes needed as well in track changes.
Analysis: a forest plot is best used for a meta-analysis, not sure if that is the best representation of this material or analysis. Data analysis is not the reviewers expertise so I would suggest having the methods reviewed by some with more expertise in statistical analysis.
Author Response
Title: The authors should consider changing the ending of the title and taking out the sleep and disease, etc... because they don't pay enough sufficient attention to those results or make the case with sleep through their results.
Response: As recommended, we have expunged the last part of the title. Thank you
The authors should consider including a definition of what countries constitute sub-saharan Africa (SSA) as well as maybe the map earlier on to assist readers with the visualization of what countries in SSA they are specifically referring to. It would also be helpful if the age range for women of reproductive age (WGA) came early in the background as well.
Response: Thank you for your comment. We have now presented the map of sub-Saharan region in the beginning of methods section with constituent countries. In addition, we have included the age range for reproductive-aged women as recommended.
Sleep: It is the suggestion of the reviewer that the sleep piece be taken out and maybe have that entire suggested correlation be used for a second article. Otherwise there are several important definitions, clarifications, and connections that need to be made within the content that don't exist in its' current format. A definition of sleep quality and what it is, what is meant by sleep problems, the use of the national Sleep Foundation which is particular to the US and this reviewer is not sure it's recommendation can be extrapolated to other countries, cultures, and socioeconomic statuses.
Response: Thank you for the insightful comment. As recommended, we have expunged the sleep part from the background.
SSA-Are there a mix of countries in SSA? it would seem that the authors would need to make clear the SSA countries that are considered LMIC and the one that are not to assist the reader in understanding the results.
Response: SSA countries are all LMICs. We have included this statement in the background. Thank you.
This is a secondary data analysis using a large public data set, suggest saying that early on.
Response: We have stated that we conducted a secondary data analysis using large public dataset, as recommended. Thank you.
The font and spacing changes throughout the document, the review suggests uniform and consistent spacing and font size for the mansucript. please see the numerous grammatical changes needed as well in track changes.
Response: Thank you very much for the insightful comment. We are aware that if accepted, the production team will format appropriately in size and spacing. We are unsure where the grammatical are tracked. However, we have revised the manuscript for possible errors/typos.
Analysis: a forest plot is best used for a meta-analysis, not sure if that is the best representation of this material or analysis. Data analysis is not the reviewers expertise so I would suggest having the methods reviewed by some with more expertise in statistical analysis.
Response: Thank you very much. Besides meta-analysis, a forest plot could be used to represent and investigate variations in prevalence estimates.
Reviewer 2 Report
1. In the introduction part, you have put forward the major objective of determining the association between sleep quality and overweight/obesity in WRA in SSA. But in the results, discussion and conclusion, there is no data about sleep quality and any discussion regarding sleep quality. you have failed to meet your own aim and objectives.
2. Data collection was from 2006 to 2021. Why such a long time for data collection? Won't it affect the change in the population of obese and overweight people over this time?
3. Better to designate -
Western Sub-Saharan Africa
Eastern Sub-Saharan Africa
Central Sub-Saharan Africa
Southern Sub-Saharan Africa
in the map.
4. Re-write it
In Uganda, a study found that overweight people were 15.8 percent and 23.8 percent, respectively, and obese people were 3.9 percent and 17.8 percent
Author Response
- In the introduction part, you have put forward the major objective of determining the association between sleep quality and overweight/obesity in WRA in SSA. But in the results, discussion and conclusion, there is no data about sleep quality and any discussion regarding sleep quality. you have failed to meet your own aim and objectives.
Response: We have revised the manuscript appropriately such that only conclusions supported by the data are put forward. Thank you.
- Data collection was from 2006 to 2021. Why such a long time for data collection? Won't it affect the change in the population of obese and overweight people over this time?
Response: Thank you very much for the insightful comment. We indicated in the limitation of the study, the potential bias in outcome variables (overweight and obesity) estimates as a result of time/year differences in data collection/survey across the study countries. Note that we included as many countries as possible using the most recent dataset available in each country.
- Better to designate -
Western Sub-Saharan Africa
Eastern Sub-Saharan Africa
Central Sub-Saharan Africa
Southern Sub-Saharan Africa
in the map.
Response: We have dropped the maps instead. Thank you
- Re-write it
In Uganda, a study found that overweight people were 15.8 percent and 23.8 percent, respectively, and obese people were 3.9 percent and 17.8 percent
Response: As recommended, we have revised the statement. Thank you.
Round 2
Reviewer 1 Report
I am satisfied with the revisions.
Reviewer 2 Report
The comments have been well addressed.
