Title: Prevalence and associated factors of early sexual initiation among female youth in East
Africa: Further analysis of recent demographic and health survey
Version: 2 Date: 04 Jun 2022
Reviewer's report:
Title: Pooled prevalence and determinants of early sexual initiation among female youth in East
Africa: A pooled analysis of recent demographic survey
General Comments: This is an insightful study. However, grammatical errors and spellings seen.
Moreover, you have to make sure about the outcome assortment (the age categories to say early
sexual initiation), strong evidence is needed to accept it.
Hence, the author needs to revise the manuscript again following the suggestions made.
Title The title should be “Prevalence and determinants of early sexual initiation among female
youth in East Africa: Further analysis of recent demographic and health survey from – to-.
- I am wonder if you get a pooled estimate using “metan commands” by meta-analysis and
further do a subgroup analyses using income status of the country and other common variables.
Abstract
• Background section; Please show the research gaps in Ethiopia
• Please differentiate the difference of associated factors and determinant factor? Which one is
appropriate word for your study?
• Please write the software you used to analyses.
• Please write the proportion appropriately in all section like this 21.14% [95 % CI: 20.00%,
21.50%].
• Please correct all parameters as the following [AOR = 3.72: 95% CI; 2.13, 6.51]
• Why you interested on “reading newspaper” only, because in DHS, TV, radio and others are
available. Even radio is better available than newspaper.
• I don’t like your carless presentation of the result, please make sure to write each grammar
and spelling appropriately.
• No have conclusion seen for your first objectives.
• Please add other recommendation, you only recommended for  only variable “education”
• key words: please change other key words “early initiation of sexual intercourse” not a word
rather than a phrase
Introduction
The background is so poor.
• You have start from the definition of early sexual…but you wrote it in line no 61.
• You should cite at the end of each sentences, and must review from multiple studies. A single
citation for such like common study is not good
• You are almost used one citation for a single sentences, which is not recommended. So please
used multiple citation.
• “The magnitude of early sexual initiation in East African countries varies in prevalence”.
Which means the prevalence is known, so why you need to do it?
• Moreover, most of your report were from east Africa with single country and you are also
going to done a research from the same area.  This is not good. You have to consider discussing
it from other pooled prevalence, which are out of East Africa countries.
• Generally detailed revision needed.
Te following sentences contradict your objectives
“…early sexual debut remained higher in East African countries”. So why you need to do pooled
prevalence if it is known and high.
“There were different factors identified in different countries; however, the interventions
followed to tackle the problem were not efficient enough to help the youngsters”.  Therefore are
you going to conduct interventional study to overcome this problem?
-Generally you have to refine the background.
Methodology
• Please define the time period
• Where is your inclusion and exclusion criteria for the countries in East africa  as well for your
outcome variables. e.g why you didn’t include Sudan, Eritrea, Djibouti etc.
• “Two-stage stratified…”, what are them and how it classified please explain in detail.
• Explain source and study population
• “Youth who began sex before the age of 15 were….” is it the cut point for all east africa
countries. Because WHO states early sexual initiation, when they start below 18 years.
• and other studies also used this categories. https://bmcpublichealth.biomedcentral.com/
articles/10.1186/s12889-019-7632-1
• Please define how you calculate such like variable “community women education…”
• How you manage missing data?
Results
• Please include all sociodemographic factor and others in table 1
• please rephrase and correct line 140
• How we know  the effect of  MOR unless the CI is shown , please put its 95%CI.
• (AOR = 0.65, % CI: 0.61, 0.69) Please put 95%
• please rephrase line 70 -78. You can write factors with extreme high /low estimate only
Discussion •
Moderate discussion needs a lot of review
• Please discuss in detail the first objective (pooled prevalence)
• Why less likely in aged 20–24 years group?
• When does we say “…early sexual initiation becomes significant public health issue?
• No have recommendation which is center of making this study
• Your conclusion lacks comparison with WHO, other regional prevalence etc.
• please conclude the community and individual factors separately
• please conclude using the categories of the variables weather positively/negatively associated..
.
Others: • You have to see rigorously this manuscript in spelling and grammar
Decision Major revision needed
Overall rating using the following: (4 = Excellent) (3 = Good) (2 = Fair) (1 = Poor)
Originality: 2
Contribution to the Field: 2
Technical Quality: 1
Clarity of Presentation: 1
Depth of Research: 2