Title: Factors associated with uptake of Human Papilloma Virus Vaccine among school girls
aged 9-14 years in Lira City northern Uganda: A cross-sectional study
Version: 4 Date: 24 Apr 2023
Reviewer's report:
Kudos! to the authors, for taking the time to review the manuscript. To be fair to their efforts, I
will raise comments based on their attempts to address the previous comments and any remaining
gaps.
Previous Comment 1: Any claims made to other studies should be cited. Although the authors
addressed the possible effects of their sample size in their limitations, they asserted that it is
comparable to another study. Kindly cite the study. As an option, they may include the design
and sample considerations of the study.
Previous Comment 2: Thank you to the authors for revising thier sampling procedure. Do they
confirm that each subcounty had four schools? "Were selected out of the four schools in each
of the three subcounties." If so, good. If not, the authors may consider informing their readers
of the parent population for each, including those who were eligible.
Previous Comment 3: Addressed sufficiently.
Previous Comment 4: Addressed insufficiently. However, the authors should kindly correct
areas such as "WHO" vs "the WHO" - line 75, "uninvited full stops (doubled)" - line 97, spacing-
lines 169, 179, 180, Health "s"ystem vs Health "S"ystem, line 281, lines 149 and 275 are hanging,
etc. There are still many typos and grammatical errors that need to be corrected.
Previous Comment 5: Thanks to the authors for the changes. Kindly note that the authors should
base the abstract conclusion on the study area, not Northern Uganda. Northern Uganda would
be overreaching.
Previous Comment 6: Thanks to the authors. The background reads much better. It would be
great to cite more than one study where a statement begins such as "Studies" (see line 89-91,
i.e., 3rd paragraph of the background).
Previous Comment 7: The authors should be my response to the Previous Comment 2. In other
words, I propose that the authors start off by confirming that each subcounty had only four
primary schools, something I inferred from observation. But in the event that they don't, they
could have been a criteria of eligibility which the others may not have fitted, which has to be
defined. Rarely will one find an even number of schools in any of the city subcounties in Uganda.
If otherwise for Lira, I concede.
Previous Comment 8: Addressed sufficiently.
Previous Comment 9: The authors may need to justify why, of the 11 variables that were
statistically significant, only 5 were included in the multivariable analysis. Not that this was a
wrong decision, but rather the reader may need to know how the variables were chosen. Besides,
those dropped from the final model and reasons as to why can be stated in the table footers. On
the other hand, the tables may need to be structured much better, as observed in recent BMC
papers. For instance, Table 1 (frequencies) may not be necessary; it can be merged with Table 2
as Chi2 results can start with overall frequencies before showing the distribution. There are also
some sociodemographic characteristics that had no chi2 analysis (family type, tribe, religion,
etc.), see Table 1 vs Table 2. The authors may need to explain why. In a nutshell, 2 or at most
3 tables could be sufficient: Chi2 (starting off with frequencies then the distribution) and the
bi/multi Table.
Previous Comment 10: Addressed sufficiently.
Previous Comment 11: Addressed but insufficiently. The authors need to examine my concerns
raised above in my response regarding Previous Comment 9.
Previous Comment 12: Addressed but insufficiently. Paragraph 1:
Previous Comment 13: See comment on the abstract's conclusion.