Reviewer ’s report  
 
Title: Perspectives of women participating in a cervical cancer screening campaign with 
community -based HPV self -sampling in rural western Kenya: A Qualitative study  
 
Version: 0 Date: 07 Mar 2019  
 
Reviewer: Patrick Petignat  
 
Reviewer's report:  
 
Reviewer 1:  
1. My only criticism of this manuscript is that as with most publications, readers will judge 
exploring the manuscript on the basis of the ABSTRACT. In this instance the abstract is plagued 
with technicalities and epidemiological "lingo" that belie the simple substance of the findings 
and would discourage the reader from persuing reading the entire work. Simplifying this 
ABSTRACT would greatly enhance the publication. The Methods section would very nicely 
suffice to  explain and inform of the technicalities. Rewriting the abstract in a more "reader 
friendly" fashion would greatly enhance viewership.  
Response:  Thank you for this comment. We agree that the abstract can be made more accessible 
and reader friendly. We h ave re -worked the methods, results and conclusion sections of the 
abstract to that end.  
The edits have been bolded and underlined for your referencing.  
Abstract methods section revision_ please see lines 32, 33, 34, 35, 36, 37, 40 and 41.  
Abstract resul ts section revision_ please see lines 51 - 58. 
Abstract conclusions section revision_ please see lines 61, 62, 64, 65,66,67,68.  
 
Reviewer 2:  
1. What kind of medium was used for HPV self -sampling? Dry or liquid? We have observed that 
with liquid transport ation medium, some patients report leaks of fluid during the process and do 
not trust the method.  
Response:  Samples were collected in 1mL of CareHPV collection medium. Since the specimen 
collection was completed on site, staff were able to assess for any  evidence of spillage. If so, 
women were requested to complete re -sampling on -site. Although quantitative data about 
frequency of leakage was not part of this analysis, it was a rare event, and we did not find 
reported concerns from women on spillage durin g sampling or transport in our data.  
2. Some patients prefer "pelvic exam", as they consider that it's more "medical" to exclude (or 
prevent) a cervical cancer than a self -test. Do you explore this issue?  
Response: We did not get any report from the women signaling preference of pelvic exam over 
the self -test though we did get responses from the women on preferring to have a health care 
provider present for any “medical” support/ advice in case of a HPV pos itive result.  
We have included a text and illustration on the result section.  
The edits have been bolded and underlined for your referencing. Please see lines 220 - 232 and 
table 1 in line 500 -501. 
 
3. Did you explore, if women prefer clinic - or home -based self -test? 
Response: In the parent cluster -randomized trial, we compared uptake of clinic or community -
based testing. In the main trial, we did explore home -based self -testing. However, based on 
experiences with other projects, we are assessing home -based self -testing in an ongoing study. In 
the in -depth interviews, women were asked to suggest preferred settings for sampling. Women 
did not suggest home -based testing as a preferred setting, likely because the question was asked 
in the context of describin g community or group settings. We did not directly ask women about 
self-sampling at home.  
 
Please find the following documents attached here in and uploaded to the BMW Women’s health 
editorial manager:  
1. Marked manuscript with track changes (bolded and u nderlined).  
2. Clean manuscript with the revisions incorporated.  
Are the 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 comme nts to the authors.  
 
Unable to assess  
 
  
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 manuscript or would you recommend an  
additional stat istical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language i n 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, fees, funding, or salary from an  
organisa tion that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscr ipt, 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 received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for paten ts 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 in relation to this paper?  
 
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below.  If your reply is yes to any, please give details below.  
 
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