Reviewer’ s report
Title: Burden of pelvic organ prolapse in Ethiopia: a systematic review and meta-analysis
Version: 1Date: 18 May 2020
Reviewer's report:Thank you for your paper which is on a very important topic. Unfortunately, I found it quite
difficult to understand some of what is presented in the paper due to the English.
Aside from that I had some specific comments and questions:*The introduction section was mixed up, going from information about prevalence to risk factorsand then back to prevalence.*When you talk about prevalence you don't make a distinction between anatomical prolapse andsymptomatic prolapse - the prevalence estimates for these are very different.*I was confused in the Quality Assessment section you mention data extraction and using Excel,but then later in the Data Extraction section you mention using Endnote and transferring to Excel.*Regarding the measurement of outcome section, it doesn't say how prolapse was to be measuredin included studies e.g. vaginal exam, symptoms. How did each study measure prolapse todetermine prevalence? This would impact on the prevalence estimate.*You don't say what risk factors did each study measure? Were there other risk factors in additionto age, BMI and residence investigated in the included studies? It is important to know what wasfound not to be a risk factor as well as what was.*JBI - this abbreviation is not explained. Presume Joanna Briggs Institute.*You didn't include anything in the results about the quality of the included studies other than alllow risk. Could you include the NOS scores and comment in more detail?*N=11 studies were excluded because you couldn't get the full text - so potentially the number of
included studies could have been doubled. Could you comment on this?
*I did not understand the reason why you thought lower BMI was found to be a risk factor forprolapse in this review (when other studies find the opposite).*In the conclusions you state "The pooled prevalence of pelvic organ prolapse was higher". Itwasn't clear what it was higher than.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
NoDoes the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Unable to assessAre the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you recommend an
additional statistical review?If an additional statistical review is recommended, please specify what aspects require furtherassessment 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:
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