Reviewer ’s report  
 
Title: Vaginal douching in Zambia: A risk or benefit to women in the fight against cervic al cancer:  
A retrospective cohort study  
 
Version: 2 Date: 12 Aug 2019  
 
Reviewer: Johannes Berkhof  
 
Reviewer's report:  
 
The manus cript has been improved a lot. My only suggestion is to keep the wording as neutral as 
possible when presenting the results of Table 3.  
 
For instance,  
"Adjustment variables included age, condom use, occupation, number of sexual partners and HIV 
status".   
=&gt; "Independent variables included ... ".  
 
"After adjusting for potential confounders, douching with either vinegar .... "  
=&gt; After adjusting for other independent variables, douching with either vinegar ....  
I trust the authors in making these  minor changes.  
 
Are t he methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an additional 
statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you receiv ed reimbursements, fees, funding, or salary from an organization that holds 
or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests i n relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' below. 
If your reply is yes to any, please give details below.  
 
Consultancy fees from merck, Roche and GSK incurred by my employer.  
 
I agree to the open peer r eview policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors'  responses. 
I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal