Title: Molecular Prevalence of Chlamydia trachomatis Infection among Women Attending
Gynaecological Clinic for Infertility Evaluation
Version: 0 Date: 01 May 2025
Reviewer:  Christian A. Enwuru
Reviewer's report:
Comments
General Comments
The manuscript is important and innovative; it addresses a public health important subject matter
that could generate data to improve women’s health.
The manuscript is well-written, concise, and coherently organized.  The title is clear enough. The
aim and objectives are well stated. The study rationale is good enough for public health reasons.
The design is good and well-controlled. The data collection tools are adequate and standard. The
sample size is adequate, although the method for arriving at the population size is lacking, and
appropriate data analysis was employed in the study. Good language was used, requiring some
editing. The references are correct and are comprehensive. So, the manuscript requires minor
editing as it says below.
Specific Comments
The authors should respond to the following observations and make adjustments where
necessary:
1. The title of the study, “Molecular Prevalence of Chlamydia trachomatis Infection Among
Women Attending Gynaecological Clinic for Infertility Evaluation”
Authors should modify the title containing an article that is capitalized and therefore contravenes
the ethos of script writing. “Among” should be written “among”
2. Abstract:
Objective: Line 21: The study investigates … the authors may reconsider the use of
active language. The use of passive language is usually the acceptable norm … The study
“investigated”
Between lines 28 and 29, the authors may consider inserting a sentence stating the statistical
analysis method/s employed in the study, to create a sequence for the abstract.
Line 29, Result: authors should add a possessive article: … out of the 35 women screened …
Lines 29 – 30, authors may consider recasting the sentence “The highest rate occurred in women
aged 18–26 years (31.6%) …” to read “The highest rate (31.6%) occurred among women of 18
– 26 years of age.
Line 31: “CTI” although previously defined on the abstract, is not a generalized acronym and
therefore the authors may not start a sentence with it.
Line 34- 35: The sentence is confusing … there is nothing scientifically known as “foul-smelling
discharge approached significance” when a scientific statistical test is carried out, the test is
interpreted based on the confidence interval, with a result either significant or non-significant.
Authors may consider recasting the sentence
Lines 35 – 37: “Logistic regression identified younger age (OR=0.46, p=0.007), STI history
(OR=0.24, p<0.001), and PID (OR=2.67, p=0.005) as significant predictors.” This sentence is
incomplete … significant predictors of what? One may ask. Please rephrase the incomplete
sentence.
Line 37:  “Tertiary education was protective (OR=0.42, p=0.028).” I cannot make out any
meaning from this sentence. How is tertiary education associated with or protective of CTI?
Please, authors, should recast the sentence with scientific nuance
Line 40: I guess the authors intend to say … predictors of disease and not infection, as
highlighted.
3. Introduction:
Line 48: … C. trachomatis should be italicized
Lines 51 – 54, and 59 “The prevalence of Chlamydia trachomatis infection (CTI) varies widely
across regions, with sub-Saharan Africa, including Nigeria, exhibiting particularly high rates of
infection among at-risk populations [6]. “Several studies across the country have documented
high rates of infection.”
The authors should be quantitative in their prevalence assertions, rather than qualitative; please
quote the particular high prevalence rates referred to here (sub–Saharan Africa & Nigeria).
Alternatively, the authors may expunge these qualitative assertions and make do with the
prevalence quoted and properly referenced
4. Materials and Methods
Study Design and Setting
Lines 97 - 99: expunge the aim from your design and setting; the authors may add the study
period covering the six months stated.
Study Population and Participant Selection
Line 103: The authors may modify the definition of primary infertility, such as “inability of
a woman to achieve pregnancy despite having regular, unprotected sexual intercourse for 12
months or more, without any prior successful pregnancies.”
Lines 104 – 105: Modify the definition of secondary infertility: “Inability of a female to conceive
or carry a pregnancy to term after previously having one or more successful pregnancies”.
Line 106 - 108: The authors did not state how they arrived at the sample size of n=135; the
authors should show a scientific way of arriving at the same size and state clearly the patients’
recruitment under “inclusion and exclusion criteria.”
Authors should create space for ethical approval immediately after the Exclusion criteria, just
before the current line 116, Sample Collection and Laboratory Analysis
And state approval date and number.
Genomic DNA Extraction
Line 124… until processed (use of passive language as against active one)
Detection of Chlamydia trachomatis
Line 130: authors should provide the gene sequence of the ompA gene primer of C. trachomatis,
a conserved region that encodes the major outer membrane protein as contained in the gene bank.
Line 138:  Let the authors provide reference/s where this method was cited from.
Statistical Analysis
Line 140: The authors should prove the year of the SPSS package used in the statistical analysis.
5.  Results
Lines 148 – 150: expunge “A total of 135 women attending the Gynaecological Clinic for
Infertility were recruited and screened for Chlamydia trachomatis infection using molecular
methods.” This is repetition
Line 151: The authors may delete the highlighted parts
Line 164: Table 1: Prevalence, demographic, and clinical characteristics of the study
participants.
The authors may consider modifying the table title to “Prevalence, demographic and clinical
characteristics of the population studied”.
Line 162: Table 2 Delete investigates and replace it with presents the relationship between …
Lines 173 – 175: The authors should modify this unscientific presentation as earlier expressed
within the abstract.
Line 176: … such as itching, irritation, or burning sensation (p=0.98). Authors should modify
the sentence as shown.
Lines 180 -181: Authors should consider expunging the title, as it appears incoherent.
Line 183: Authors should add “years of age …” as indicated in the manuscript
Line 191:  Authors may consider modifying the sentence as highlighted in the manuscript.
Line 193: Authors should explain how higher education can translate to a protective “coat”
against STIs; the expression is vague.
Line 194: Table 4, authors may consider the removal of the apostrophes
6. Discussion
Lines 204 -205: Zaria is in the Northern part, Port Harcourt is from the Southern part, and
the South East is from the Southern part. Authors may consider being more specific on the
study from the South East (e.g., Enugu, Nnewi, or Onitsha), which will align with the authors'
sequence.
Lines 207 -210: Authors should note that their claims on regional variation may be misleading;
regional comparisons and trends must be between similar population sets: sex workers, fertility
seekers, women within reproductive age, etc. Authors may wish to do a little more search to
equate and square the populations.
Line 216: Authors should add …years of age
Line 227: Authors should consider modification of the sentence “Interestingly, the study also
identified tertiary education as a protective factor against”
Lines 250 – 251: Authors should clarify whether what they mean by the implication of tertiary
education nuance implies that good hygiene practice and standard sex education knowledge may
reduce the risk of CTI
Declarations
Acknowledgement
I question why the authors stated that Acknowledgment does not apply to this study; ingratitude
is a moral failing. For the record, acknowledgment is a fundamental aspect of peer-reviewed
publications, as it recognizes individuals who contributed or assisted during the research process.
For instance, in this study, patients were asked to participate, the staff and management of the
teaching hospital granted approval, clinicians and nurses provided assistance, and laboratory
workers processed the samples and others