Review for 10.1186/s12876-023-02838-9 (2023)

Title: Prevalence of Helicobacter pylori Genotypes: cagA, vacA (m1), vacA (s1), babA2, dupA,
iceA1, oipA and Their Association with Gastrointestinal Diseases. A Cross-Sectional Study in
Quito-Ecuador
Version: 2 Date: 05 May 2023
Reviewer's report:
Dear Editorial office
Here are my reviews on paper entitled “Prevalence of Helicobacter pylori Genotypes and
Their Association with Gastrointestinal Diseases: A Cross-Sectional Study in Quito-Ecuador”
submitted to the BMC Gast.
In principle, the paper is well written and scientific sounds good but it needs some corrections
before final decision.
1- I would suggest to add the most prevalent genotypes in the paper title, that makes it attractive.
2- Bacterial names should be italic throughout the paper (Helicobacter pylori)
3- Page 2, (analytical research) we do not have cross- sectional and analytic research! Please
remove the second part in your revised version.
4- Page 2, abstract: again, non-italic names for bacterium and for gene (H. pylori, cagA)
5- Page 2, abstract: conclusion: expression??? Did the authors investigate the gene expression?
I doubt it. This conclusion is not completely associated with core finding in this research, so I
would invite you to redo it.
6- Page 3, introduction: “Seven distinct strains of H. pylori can be distinguished based on
their geographic origin according to the structure's high genetic variability” here the authors
are talking about variations in both bacterial identity and human genetic polymorphism that
contribute in determining the ultimate gastrointestinal disorders. The text is not enriched with
any references, so I recommend to add up the below inserted papers to support the idea provided
by the authors.
** Abadi, A. T. B., Ierardi, E., & Lee, Y. Y. (2015). Why do we still have Helicobacter pylori
in our stomachs. The Malaysian journal of medical sciences: MJMS, 22(5), 70.
*** Hussain, Syed Arshad, and Shamila Hamid. "Helicobacter pylori in humans: Where are we
now?" Advanced biomedical research 3 (2014).
7- The main purpose of this study should be clearly stated at the end of the paper, thanks
8- The process of statistical analysis can be clearer, I feel. Please add more clarification in your
revised version. I think the grouping in your analysis can be different since you have chosen to
use the chi square test. Possibly, you need to check it with statistical-expert, not sure.
9- The table 2 can be omitted since the whole data can be accessed via reference you already
provided, so I suggest to delete them.
10- The methods and results sections seem fine and I have no more word out of them.
11-  Table 3, (
40-50 41(18.2) 12(29.3) 29(70.7) 0.019
), what is you explanation for such significant number? I think it is not important  since nothing
new in it but the statics can always brings us some strange association/causation! I want to clarify
it for the authors and of course future readers.
12-  Same story as above for “
High school 102(45.3) 27(26.5) 75(73.5) 0.012
13-  The sequence used to detect oipA (CAAGCGCTTAACAGATAGGC) will mainly give you
the 100% positive among the hp strains, I checked it, please clarify why you report 93.6%? Or
somewhat like this.
14-  Fig 2 is not necessary and I suggest to go only for text in your revised paper without fig 2.
15-  I did not see the comparison between histopathologic finding and genotypes investigated
in this paper. Please ad up a passage about them with deep concept whether we need it or not
in future discussions. Histopathological analysis is always critical to help the authors for new
message while they used the clinical data like this.
16-  This is absolutely not expression ! “iceA1 expression has been linked to the onset of peptic
ulcers due to the gene's ability to cause excessive production of the pro-inflammatory cytokine
I”"  I strongly recommend to remove this type of wording allover the text.
17- Conclusion: I think this section should be rewritten based on comments provided in above.