Title: Prevalence of Rhesus D Negativity among Reproductive Age Women in Southern
Ethiopia: A Cross-Sectional Study
Version: 0 Date: 03 Dec 2020
Reviewer:  Tesfaye Hambisa Mekonnen
Reviewer's report:
Review Report
Reviewer: Tesfaye Hambisa (MPH, (Assistant professor), University Of Gondar, Ethiopia.
General comments
This study investigated the prevalence of Rh factor negativity among reproductive age women
in Ethiopia. I can persuade little studies have been conducted in Ethiopia despite the clinical
relevance of the topic. However, several issues need major considerations and corrections in the
document for publication conformity. Below are my comments.
1. Abstract
Background
-The phrase ‘…..in the study area’ is vague.  I suppose the specific area needs to be mentioned.
Methods and materials
-Better to mention the study period and  are
-It is also worthy of mentioning the data collection technique used with the questionnaire
Result
-Better to show us major desriptive findings and response rate
-The overall answer for the study objective should also be mentioned
Conclusion
-It is not clear what 6.2% implies (lower, higher compared to some parameters (if any) )
-The recommendation   (mass screening) and the finding (6.2%) is inconsistent unless certain
implication is there.
I need the authors clarify and include corrections in conclusion section
2. Introduction
-Inconsistent use of citation (references)  style in the first paragraph. E.g. [1,2] is vancouver
whereas Landsteiner and Alexander S. Wiener in 1937 is Harvard.  I need to authors make this
consistent throught the document.
-There have also been several sentences lacking citations at apropriate periods (lead to
plagiarism). E.g
The sentences ‘In terms of their clinical significance, the five major Rh antigens include D, C,
c, E, and e ( ). However, the D antigen is the most immunogenic ( ). It causes the formation of
antibodies 50 times more often than the C and E antigens ( ). Should be cited. This applis to the
entire document and requires amendments where relevant.
-Here in the introduction, there should also be a clear hypothesis/objective of the study
3. Methods and materials
Study setting, design and population
- The ‘2007 Census’ needs citation as mentione above
-How many of the 82,330 women in the zone were in the reproductive age needs clarity
Sample size determination
-Why the authors used a ‘Rule Thumb’ assumption to estimate sample size while a number of
studies are there in the country? See your Discusion part References [21]- [25].
Sampling technique
* The major concern of this study is the type of sampling method the authors employed.
-Its quit strange why they used simple random sampling while the procedure they employed
never corroborate this method. The study could have deserved a multisatge sampling method
with a design effect (from district to kebeles) and the authors should justify why they selected
this method over the recommended one
-In Ethiopia, health post (HP) is the lowest structure of health system and below health centers
(HC). There are altleast 2-3 HCs in a given district based on the width of that district. Therefore,
the authors should elaborate why they skiped HCs and prefered to HPs or why also they did not
consider HCs additionally?
- It is also not clear why it was important to prepare sampling frame as one of the assumptions
for Simple random sampling is the availabiliy of frame.
*How the authors contacted the participants and from how many women (target /source
population) the sample 422 was selected is theoretical.
*And what was the inclusion critera to contact them? These two points are the other major
concerns.
Data collection methods
-How did the authors assess sociodemographic (and which) variables and why this is important?
This should be implicitly explained in this section.
Data quality control
-What where contents of the two days training?
-hat is the difference between Data quality control and data quality management? What measure
the authors could take if the data were incompletely filled?
Data processing and analysis
-The authors indicated that they used figures to present the finding. But nothing is presented in
the results using figures.
4. Results
- Blood group profile of the study population section needs to be discribed with important
sociodemographich characteristics
5. Discussion
-This section appears shallow and therefore is not tough
-It also seems merely descriptive
-The strength and limition of the study should also be discussed
* From discussion section, we can see a plenty of previous studies conducted in the country in
similar topic. Therefore, what is the novelty of   the current study?  And what gap has been filled
by this finding is also of great importance if explained by the authors.
6. The manuscript should be edited for language (several grammar and typo errors)
I summary, the manuscript requires a MAJOR REVISION, particularly in method sections
before consideration for decision.