Title: Knowledge, attitude, and uptake of human papillomavirus vaccine among adolescent
schoolgirls in Ethiopia: A systematic review and meta-analysis
Version: 0 Date: 23 Jan 2023
Reviewer's report:
Thank you for submitting your manuscript ” Knowledge, attitude, and uptake of human
papillomavirus vaccine among adolescent schoolgirls in Ethiopia: A systematic review and
meta-analysis” to BMC Women's Health.
This is a very interesting and well-written study providing evidence to improve healthcare
policies and practices aimed at addressing the HPV vaccination coverage gaps in adolescent
schoolgirls in Ethiopia.
Some minor revisions are suggested as follows:
On page 2 Abstract
Please review and modify the results, it was unclear that how the results presented here seemed
different from what was presented in the main body of the manuscript.
In the Abstract it stated, “A total of 8 studies comprising 3936 study participants for knowledge
and attitude, and five studies with 2,481 study participants for uptake of HPV were used to
estimate the pooled proportion of good knowledge, a positive attitude, and uptake of HPV
vaccine.”
While on page 8, in Result it stated, “We included 10 studies to evaluate the pooled proportion of
good knowledge, positive attitude, and uptake of the HPV vaccine and associated factors among
adolescent schoolgirls in Ethiopia.”
On page 6 Data synthesis and statistical analysis
Please capitalize the first letter of “Egger’s regression test”.
On page 8 Result, Characteristics of included studies
Please include some details on how the risk of bias was determined. It might also be better to have
study quality information included in S3 Table unless it was not the assessment results from the
Newcastle-Ottawa quality assessment tool. Table 1 could then be used as a table summarizing
the general characteristics of included studies.
On page 17 Factors associated with the uptake of HPV vaccine
Please review and revise the pooled effect of having good knowledge being significantly
associated with the uptake of the HPV vaccine, the OR value, and its interpretation were different
from what is presented in Figure 7 and the 5th paragraph in Discussion on page 19.
On page 20 Discussion
Please capitalize the first letter of “china”. The majority of the Discussion reported consistency
and inconsistency of study findings, it might be better to discuss and expand further on the
implications of the review and analysis instead of repeating the results.
S1 table: PRISMA 2009 Checklist
Please review and modify the table content and make sure that the reported page # is correct.
S2 Table: Searching strategies for some databases to assess the pooled Knowledge, attitude, and
uptake of human papillomavirus vaccine among adolescent schoolgirls in Ethiopia.
Please also add the findings from the African Journal of Online (AJOL) as indicated in Methods
in Abstract on page 2 and Databases and search strategies on page 4.
S3 Table: Quality assessment of articles using Newcastle - Ottawa quality assessment Scale
(NOS): (Adapted for cross-sectional studies)
Please add notes below the table to describe the meaning of the asterisk in the table. Or it might
be better to use exact points instead of the asterisk to make it clear that how the total scores for
the assessment are calculated.
Additionally, please use different levels of headings throughout the manuscript to separate and
classify manuscript sections.