Reviewer's report
Title:Understanding cervical cancer: an exploration of lay perceptions, beliefs
and knowledge about cervical cancer among the Acholi in post-conflict northern
Uganda Amos Deogratius Mwaka1, Elialilia Sarikiaeli Okello2, Juliet Kiguli3,
Elizeus Rutebemberwa4 Amos Deogratius MWAKA (mwakaad@yahoo.com)
Elialilia Sarikiaeli OKELLO (Elialilia@yahoo.co.uk) Juliet KIGULI
(jkiguli2002@yahoo.com) Elizeus RUTEBEMBERWA (ellie@musph.ac.ug)
Corresponding author: Amos Deogratius Mwaka. Department of Medicine,
School of Medicine, College of Health Sciences, Makerere University, P.O Box
7072, Kampala, Uganda. Email: mwakaad@yahoo.com 1. Department of
Medicine, School of Medicine, College of Health sciences, Makerere University,
Uganda and Visiting Research Scholar, Department of Health Services
Research, Institute of Public Health, University of Cambridge, UK. 2. Department
of Psychiatry, School of Medicine, College of Health Sciences, Makerere
University, Uganda. 3. Department of Community Heal
Version:4Date:31 May 2014
Reviewer: Theophilus Nwankwo
Reviewer's report:
Major collections:
1. Introduction: from lines 67 to 81, you dwelled on kleinman’s and colleagues
illness model, I don’t that devotion of a paragraph to this is necessary. Explaining
the model for your research may be better in the method.
2. Your references should be at the end of your sentences except where you
probably started with the names of authors e.g Peter and Paul et al ( 1)
Method:
3. the bulk may need to be reduced. You need to elaborate a little about your
sampling method. You made exclusion criteria clear but inclusion criteria were
vague, so state your inclusion criteria. This convenient sampling may introduce a
lot of bias which may skew your research findings.
4. What informed the number of research participants, how many males and
females? Men don’t have cervical cancer while were they included? What
informed your age range selection?
5. Key Informants: Apart from the 3 people that were members of the cultural
committee, what are the bases of selecting others?
6. Exclusion criteria: excluding those that are relative of women who had had
cervical cancer may not be appropriate because their knowledge, experience and
perception would also influence knowledge perception and belief in a close up
community.
7. FGD: you mentioned that the process was guided. One may want to know
some key issues in this. Were they leading questions? Give may be 1 or 2
examples. Table 2 or some of the expression there may be shown in the method.
Table two should be summarized here.
8. Data analysis: quantitative analysis often gives more insight into physical
science research and would have been good here. You mentioned the use of
ATLAS.ti 6.1 model in your analysis. This if properly used can help you give
some quantitative expression to your data analysis. E.g the proportion of
respondenst with appropriate knowledge or wrong perception. Can you do that?
9. Definition of terms: you need to define some of the terms used e.g Lay people:
who constitute a lay person in this regard?
10. Results:
1. In line 218: majority of FGD, respondent were aware. Does this imply all
respondents or most respondents? I think the analysis should be focused on the
respondent as you did on many occasions.
2. Respondents’ sociodemographic characteristics are sketchy. E.g marital
status, level of education etc. may need to be shown. These are factor that may
influence knowledge and perception.
3. Your methods of reference to FGD along key statements may need guiding
statement in the methods. (KI,rural man, aged 89 years) in the statement below.
E.g “When a man sleeps with an infected, bleeding woman . . . the infection the
man has
4. 226 picked will be on his penis and when he sleeps with his wife or
somebody’s wife then
5. 227 he transfers the infection to that woman, (KI, Rural; man, aged 89 years)”.
6. Local name and meaning: The local named by Acholi people of cervical cancer
, which you reported was based on symptoms, may not be referring to one
disease entity, as it may imply that any of the genital diseases manifesting with
abnormal vaginal bleeding is describe with that name. This may be why the use
of pills and injectable hormonal contraceptive which can also actually lead to
menstrual irregularities was reported as a cause. You need to show how this
potential mix up was handled.
11. Discussion: I could not link your major findings to the post conflict situation in
that region. Which of your findings suggest influence of this on study outcome?
12. Conclusion: statements between lines 412 – 414 not part of you research
conclusion there unnecessary.
13. References: review the references especially those inserted inside sentences
in method, and delete those that have been covered by general method of
analysis.
14. Tables: the last two tables are unnecessary because they ought to be
summarized in the methodology.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I have no competing interest.