Reviewer ’s report  
 
Title: DOUCHING PRAC TICES AMONG WOMEN IN THE BOLGATANGA 
MUNICIPALITY OF THE UPPER EAST REGION OF GHANA  
 
Version: 2 Date: 19 Mar 2018  
 
Reviewer: Margaret P. Kasaro  
 
Reviewer's report:  
 
Thank you for consideration of comments and the review on the manuscript so far. I have a few 
comments some maybe discretionary others maybe necessary to include. You may als o need to 
have that English review to ensure that small mistakes which may compromised the language of 
the paper are corrected.  
 
Abstract:  
I believe the objective of the study is to provide data in the area of vaginal hygiene practices in 
Bolgatanga Munici pality(GHANA) as there is currently not much research done in this subject 
area. The rationale is that health behaviors  are different and are influenced by culture and 
geography and therefore the need to do this research in this location. This must be wel l crafted in 
your abstract and introduction so that it is clear why this particular research has been done. If you 
agree, this is my suggested wording for the abstract:  
Vaginal douching is a common practice among women all over the world. Women douche for 
various reasons, despite evidence indicating the harmful health effects of the practice. There is 
lack of data on the practice in Ghana but health behaviors like vaginal douching may be 
influenced by differences in culture and geography. Therefore this stu dy sought to assess 
prevalence and predictors of vaginal douching practices among women of the Bolgatanga 
municipality of Ghana.  
For the sentence in the methods there is no need to repeat this - Two hundred participants were 
included into the study since y ou have already mentioned the number of women included.  
For the conclusion you can use the same wording from the main conclusion  
 
Background  
Line 34 Instead of saying "In sub -Saharan Africa, products such as herbs, chemicals, powder and 
papers are used by women for douching" you can say  "In sub -Saharan Africa ........ and papers 
are among substances inserted into the vagina" This is because the list you provide includes more 
than fluids, and that is now describing vaginal practices in general and not just douching  
Line 39 to 41 suggested edit to be definite with effect - Most of these products are found to be 
hazardous to women's health by causing irritation to the vaginal mucosa.  
Line 42 to 44 suggested edit - Water is the most commonly used product for the practice in 
Ghana.  And then combine it with paragraph starting at line 47 as this is discussing water for 
douching and its negative impact. Suggestion to however to leave out t he example of dental 
effect  
Line 22 to 25 suggested edit: This study was conducted in the Bolgatanga Municipality to 
estimate the prevalence and assess predictors of vaginal douching practices among women in the 
Municipality.  
 
Some comments on the ethics s ection:  
This comment on document translation doesn't need action but it is important to have translation 
done before data collection otherwise quality of data maybe compromised by differences of on 
spot translation  
What the consent verbal only? Is it a req uirement to put in the separate components of the 
informed consent as we know this is what you obtained/information gave out in the informed 
consent process.  
Are the methods appropriate and well described?  
If not, please specify what is req uired in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
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 statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment 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:  
 
Needs some language corrections before being published  
 
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  
organisation that may in any way gain or lose financially from the publica tion 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 manuscript, 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 patents 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?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If you r reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
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on my report to the authors and, if the manuscript is accepted for publication, my named report  
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