Title: Factors associated with uptake of Human Papilloma Virus Vaccine among school girls
aged 9-14 years in Lira City northern Uganda: A cross-sectional study
Version: 1 Date: 15 Mar 2023
Reviewer's report:
Reviewer Reports
Thank you for submitting your research to BMC and for the opportunity to review the research.
I hope that I will give some constructive feedback about the study that can be used to make it
better.
The researchers examine “Factors associated with uptake of Human Papilloma Virus Vaccine
among school girls aged 9-14 years in Lira City northern Uganda”. HPV is for the most part a
virgin area in Uganda that needs research, such studies are crucial for the country. This study
addresses some of that gap, thank you, authors. Some considerations need to be made about the
manuscript. I itemize them below:
1. The study could have benefited from a powered sample size that would have improved the
reliability of the findings despite the use of an appropriate sample size estimation formula. This
limitation should be mentioned under the study limitation wherein non-school-going girls are
mentioned which is not necessary because the study was conducted specifically for school girls.
Besides, convenient sampling may not have been the best approach given that there must have
been a sampling frame (list of students and ages at the schools).
2. Abstract: This could benefit from highlighting the nature of the analysis performed. Also,
some corrections should be made regarding uninvited upper case letters after commas and in
other areas, for instance, Health Facilities vs ministry of health. The abstract conclusion should
be based on the findings of the research, out of school girls are not the focus of this study and
the study has no findings on them. The researchers should consider tuning the conclusions.
3. Background: I’d prioritize Uganda’s situation to be addressed in the third and third last
paragraphs such that the reader can follow Uganda through to Lira and the justification of the
study. Citations are also needed for statements such as the “horrible effects of the COVID-19
pandemic”. For instance, could the pandemic have influenced HPV vaccination in schools?
4. Data Collection Procedure: The researchers may need to justify why two schools were selected
per sub-county and why six schools were selected overall. Wouldn’t the total number of schools
sampled have to be based on the number of schools in the city? This information needs to be
included so that the reader would be aware of the representation of schools within the sample.
5. Additional typo correction… “Catholics and protestants by religion”.. In other words,
correcting upper and lower cases use as applicable throughout the manuscript even within tables.
6. Results: Include a confidence interval for the uptake of HPV to boost the rigour of the
findings. The Pie chart may not be necessary. I suggest that a multivariate analysis be conducted
irrespective of its findings because bivariate analysis may not be sufficient. Besides, the
limitation of the current analysis approach is not mentioned in the study.
7. Discussion: The discussion is a bit weak, for the most part, citations are only made in
comparison with the findings of other studies but none are made with an explanation of the study
findings and there are no concise implications. For instance, 1-2 references per paragraph are
oddly insufficient. The researchers could benefit from reading similar papers that can guide how
they can rework this area.
8. Conclusion: Not reviewed because it heavily relies on results and the discussion which are
currently insufficient.
9. Overall: Notwithstanding the hard work of the authors, in its current state, this paper doesn’t
meet the criteria for publication in BMC, the researchers could benefit from a major revision
that will help tune the paper. This would make it more informative and suitable for BMC.