Title: Determinants of Pelvic Organ Prolapse at Public Hospitals in Hawassa City, Southern
Ethiopia, 2020: Unmatched Case Control Study
Version: 4 Date: 07 Apr 2022
Reviewer's report:
Thank you for inviting me to review the manuscript entitled “Determinants of Pelvic Organ
Prolapse at Public Hospitals in Hawassa City, Southern Ethiopia, 2020: Unmatched Case-
Control Study”. It might have an endeavor for the intervention to tackle one of the reproductive
organ health problems of women. The manuscript needs various modifications, especially
in following the logical framework of methodological aspects, and lacks stringent variable
measurement. By saying this, I have tried to forward the possible comments and suggestions
on the following page.
Title page: both authors 2 and 3 were from the same institution and the same department. So,
what is the importance of mentioning superscripts 2 &3 repeatedly?
Abstract section:
• Method: “Epi-data and SPSS were used for analysis”, how this could be happening?
• Make the conclusion and recommendation more novel and based on your findings
Background
• Well written
• “To the extent of my searching”…. This shows that you are the mere authors of this work
and others didn’t take part in it and just you were mentioning their names without their due
participation.
• Better to mention what initiatives and interventions have been done at the country level
Methods and material
• The subtitle “Study design, setting and period” and the statements narrated in it were
completely incongruent. It seems the “population of the study”. Be specific with your subtitle
• The  authors failed to elaborate the following basic parts of the “method and material” sections
independently, in a self-explanatory way:
# The population of the study
# Eligibility criteria
# Data collection tool, procedure, and personnel
# Data quality management
• All of the variables were not operationalized in a measurable way
# The variables like heavy usual workload, birth spacing, history of fundal pressure, history of
induced labor, Physical violence on reproductive organs, history of chronic cough, history of
constipation, BMI grouping, Respondents' history of smoking, and Alcohol taking…
So I recommend the authors to re-write the method section by giving due emphasis to the
aforementioned subsections if they have the chance to re-submit the revised version of the
manuscript
• Result
# The sample size was too small to infer the finding
# Table2 “Gen on aggravating factor of POP”…. Am not clear about that
# Table3:
• The history of abortion needs to be clarified with the frequency and type (safe/ unsafe, induced/
spontaneous)
• “place of birth for the first child”, why you were interested in the first child?
• “physical violence”: what type of physical violence? It is a broad term.
Table4
# Usual workload: Lightly loaded  and Heavy loaded: how did you measure
Discussion
• The whole discussion was about comparing and contrasting the findings from other studies
which are one part of the discussion but the authors completely missed showing the public health
importance of the findings.
• In the beginning, in the “Background” section of the manuscript, the authors mentioned there
were many studies in the area of interest across the country and overseas. But the discussion has
relied on a few studies and this might jeopardize the scientific plausibility of your result.
• Strength and limitations of the study
# “Physical violence on reproductive organ…” what type of violence, who was the perpetrator/
s? I couldn’t find out any statement that shows the way you measured this variable
Thank you!