Review for 10.1186/1471-230X-10-62 (2010)

Reviewer's report
Title:Helicobacter pylori in apparently healthy children aged 0-12 years in urban
Kampala, Uganda: a community-based cross sectional survey.
Version: 1Date:20 November 2009
Reviewer: Dietrich Rothenbacher
Reviewer's report:
The paper by Hestvik and colleagues describes the results of a study in children
aged 0 to 12 years in an urban area in Uganda in a cross-sectional manner.
For specific instruction the authors might also consider the STROBE checklist
(www.strobe-statement.org). It gives very concrete guidance how information
stemming from observational research should be reported. In general, the
manuscript should be considerably shorted and efforts should be made to report
the results of this cross-sectional study more concisely.
Specific comments:
Background:
1) the references in the introduction are sometime quite historical and the authors
might consider using more up-to-date references, maybe even a more recent
review article that summarizes the recent knowledge. This way the interested
reader is guided towards a better source of more-up-to date information.
2) Some of the vague information related to time should be specified (i.e. line 12,
until recently) to give a clear message. Stool test are available since over 10
years. The same is true for the phrase later down “the new monoclonal HpSA
antibody test”.
3) It would be advisable to structure the text more clearly in paragraphs and it
might be possible to limit it to the information that helps to understand the
scientific background of the study. The novelty of the study is that it delivers data
from an urban area in Africa. Therefore the introduction should rather work
towards the gaps that exist from Africa and indicate the knowledge gap this study
tries to fill. Some of the information related to test performance is already very
special and might better fit into the discussion section.
Subjects and methods
1) A flow chart could help to better understand how participants were selected
into the study.
To me it is unclear why children with HIV and other chronic diseases were
excluded from study participation. They are also part of the source population.
2) The information under the heading “treatment” is already presenting results
and should not be displayed in the Methods section.
3) The treatment section seems out of the scope of the paper and not really be
related to the specific objectives of the study.
4) The description of the HIV testing is also very detailed and could be shortened
considerably. Again, why was it used as exclusion criteria and not as a potential
risk factor or as a simple comorbidity factor?
Results
1) How was the response quote among the approached children?
2) Before describing the prevalence results of the study, the sociodemographic
characteristics of the study population should be described (text of 2nd para
should come first). What was the min. age? It might be of interest to subgroup
the one year old in two separate categories or at least report the prevalence in
the children aged up to 6 months and between 6 and < 12 months.
3) Then the prevalence figure should be described. I might be useful to provide
the point estimates of the age categories (see figure 1) also with a 95 % CI.
4) The numbers related to abdominal pain should be shown.
Discussion
1) Again organize the text in paragraphs. The key results should be summarized
in the first paragraph. (Organize according to STROBE recommendation)
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.