Title: Evaluation of Female University Students’ Knowledge, Attitudes, and Practices Toward
Human Papillomavirus Infection and Vaccination.  Multicenter Cross#Sectional Study
Version: 2 Date: 04 Jul 2024
Reviewer's report:
Here are few comments to improve the quality of the manuscript
Abstract
- In Method, the Author stated ‘regarding HPV and its vaccine’. Rephrase this to ‘…regarding
HPV and vaccine against it’
- The Author stated ‘Having good knowledge about the virus (AOR:0.52; 95%CI: 0.17–1.07)
and its vaccine (AOR:1.60; 95%CI: 0.90–2.47) was associated with a favorable attitude toward
its vaccine.’  The upper CI for having good knowledge about the virus is 1.07 and the aOR is
0.52. This is not correct. For significant association between knowledge and favorable attitude
towards the vaccine, the upper CI should be less than 1. Similar is the case with knowledge on
vaccine. The author stated aOR 1.06 but the lower CI is 0.90. The lower CI must be greater than
1 to describe the association.
- The Author has also made same mistake while reporting good knowledge of HPV.
Introduction
- The author started the introduction with the definition of Infectious disease which is not relevant
to the objective of this research article. It would be better to describe the burden of HPV in
Ethiopia, what is percentages of cancers (cervical cancer, penile cancer, head and neck cancer)
in Ethiopia.
- Better to explain when was HPV vaccine introduced in Ethiopia, what is the target population,
id HPV vaccination part of the National Immunization Program etc.
- Please describe in mote detail the current scenario on HPV vaccine acceptance in Ethiopia
and what can this research study add to the current understanding or why is this research study
important
Methodology
- Why did the Author included only female participants in this study? HPV also causes cancer
in male population and awareness among male population is also equally important
- Please state the start of the study. It is mentioned that the study was conducted from June-
July 30, 2023.
- Other sections of the methodology are easy to follow
Results
- It would have been better to include university in socio-demographics factors, so that this
would provide insights on if there was a difference in the vaccine acceptance rate among two
universities. This would in turn assist in developing targeted interventions.
- What is the difference between internet and mass media? If author is referring to Radio, Tv,
Newspaper as mass media, this has to be stated in brackets.
- Results list only the frequency and percentages for the questions and the regression Analysis
tables are not included in the results. Please include the regression analysis tables and the
description in the results section. This is very confusing to see the interpretation of the results
directly in the discussion section.
- As mentioned in the abstract, the association between the variable in multivariate logistic
regression analysis is not done correctly. Please correct all the aOR and CI values which are
not stated correctly.
Discussion
- Please state the rate of HPV vaccine acceptance in Indonesia and how does this compare with
the countries in the region?
- Please state what does the findings add to policy making and how can this research study
contribute to design effective interventions to increase uptake of HPV vaccine
- Please list limitations of the study