Reviewer’s report
Title: 
Economic Burden of Moderate to Severe Burns and its Association with
Health-related Quality of Life of Nigerian Women
Version: 
0 
Date: 
24 Sep 2020
Reviewer's report:
BMC WH 424
The authors provide an interesting paper on the economic burden of burn
injuries, and its relation to HRQOL. This is a highly relevant topic and deserves
publication.
However, the paper is not yet ready for publication. 
Abstract:
A
The number of participants is a result and should be presented in the result
section.
Introduction:
The formulation of the aim of the study can be improved. What is meant with:
'the weight of cost of hospitalization? I suggest to use 
the economic burden of
hospitalization after burns The research questions then are threefold: 1) the costs
of hospitalization
2) the sources of fund
3) HRQOL, and its relation to SES
The hypotheses are not derived from the literature and in this way meaningless.
Please rewrite. Or delete these hypotheses and present the study as a study
exploring the relationship between economic burden and HRQL at one side and
related socio demographic characteristics on the other. 
Methods: 
Please move results on number of admission and participants to results section.
Power analysis is unclear: on what outcome is this analysis built?
Please present instruments and their validity in the same paragraph. 
Please add
some more information on the EBB-Q (content)
Please specify the cost analysis. What are the type of cost categories (direct
medical and non medical costs?), and costs components (hospital days,surgery?)
and sources for cost calculations?
Please specify the source of the income data: who provided this estimate at
which moment?
The procedure for data collection is quite lengthy, please be more concise. 
Please include subheading: statistical analysis, p9
Results:
Please include a flowchart of eligible patients and participants (see STROBE for
examples).
Please use subheading to present the different parts of the results (patient
characteristics- economic burden, sources, HRQOL.
A major issue is the extensive data presentation: The authors present very
extensive tables with multiple subgroups and testing. In addition, details are
repeated in the text. However, the overall EQ-5D for the total population is not
presented? 
Please check the necessity of the details and the tables and limit the description
in the text to the main findings. 
Discussion
The structure of the discussion needs adaptation. The 1st paragraph should
present the aim of the study and the main findings.
Next, the main findings should be discussed in relation to the literature. This
should not be confined to the Nigerian literature but to other LMIC countries as
well, to inform a broad public of readers. The HRQL results should be compared
to other studies; this will result in a clear view on the very low cores of the
participating women.
I would expect a short discussion of the strengths and limitations of the study.
P3. Line 19 death due to burns?
P3. Line 23: the instrument should preferably be introduced in the methods
section 
P4 line 23: why do the authors use thrust? Instead of aim?
P5: the authors state that his study will add to QUALY information. This is not
the case, please omit.
P6, line 23 Please add reference EQ.
P7, procedure face and construct validity rather vague
P7 reliability: procedure is unclear Please add type of reliability testing. Why is
n=8 sufficient? 
P12line 14 Since differences between groups are not tested, one cannot state that
x is higher than y.
P13, t7: please analyse mean health scores instead of comparing health status
groups.
P15, please introduce NHIS. I suggest to include a short introduction to the
national health system of Nigeria in the methods section.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
No
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Yes
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes