Title: SEVERE MENOPAUSAL SYMPTOMS AND ASSOCIATED FACTORS AMONG
POST- MENOPAUSAL WOMEN IN AMBO TOWN, WEST SHEWA, ETHIOPIA: A
CROSS- SECTIONAL STUDY
Version: 1 Date: 28 Aug 2023
Reviewer's report:
Title: SEVERE MENOPAUSAL SYMPTOMS AND ASSOCIATED FACTORS AMONG
POST-MENOPAUSAL WOMEN IN AMBO TOWN, WEST SHEWA, ETHIOPIA: A
CROSS-SECTIONAL STUDY
The authors should correct the following comments and suggestion to further enrich their
manuscript. The manuscript also need thorough English language editions (i.e., the grammar,
punctuations, etc.)
Abstract
Line 24-25: Mention what is/are not known?
Method: population? How internal validity was maintained? Mention purpose of bivariate and
multivariable analysis.
Result: line 39, how much? How you measure alcohol consumption? How you measured
attitude? Author should have mentioned in the measurement part.
Conclusion: line 43-44: Write the predictors separately based on their direction of association. Is
physical activity the same as alcohol consumption? But, you reported above not having physical
activity contribute to SMS.
Tell us the specific intervention that you recommended based on your finding and it could be
implications.
Background:
Line 109-110: The authors better tell to readers what are not known. What is/are added value
to existing knowledge.
The background need refining and avoiding repetition of ideas. There should be logical flow
of the idea as well.
Method and materials
Line 118-120: what is the source of your data?
Why sample size was/were not calculated for factor(s)?
Why authors considered design effect despite SRS?
Any reason for not considering these population! HTN, DM etc.
How about those PMW that have incoherent speech due to age?
What make it multistage sampling?
What is kebele?
How did you identify 5642? If you identified through preliminary survey tell to readers.
Data collection should clearly explain tools used to collect data? Who did data collection and
how data were collected?
There should be separate subtitle for ‘variables and measurements’. Or check the journal
guideline.
Provide appropriate citation for measurements.
Authors should provide appropriate citation for their measurements.
How severity measured? What is the threshold of the severity?
Is the report of symptom is lifelong or since she experienced menopause or current one?
Who validated the tool and where? How authors controlled recall bias? Social desirability bias
etc.
What type of logistic and why?
Line 179-181: Why only those significantly associated considered?
Result
Line 199: What is poor knowledge? Authors should have clearly indicated what poor knowledge
in measurement.
Why do you think alcohol consumption this much? When do you consider individuals as alcohol
consumers?
How much is the severe menopausal symptom? Why you mention your outcome twice? Merge
with below subtitle.
Line 212: How you minimize recall bias? Why not you consider short period instead of month,
i.e., 24 hours, three days or weeks etc.
Line 217: Is it p < 0.25?
The interpretation of the odds ratio need slight correction
Discussion
Begin your discussion with summary of finding.
Line 235: So why you compare different population?
Here authors should have mentioned study setting than authors.
This study or reference 33, conducted elsewhere and did not support the evidence!
It need strong justification that Ethiopian menopausal women hide their severe menopausal
symptoms due to suppressive culture and taboos.
Same comment, mention setting instead of authors or mention both of them.
Line 250-256: This all evidences need appropriate citations!
Line 260-269: Evidence? Which articles really support these?
What is/are your study strengths?
Conclusion
Line 286-289: What do you mean? Where in your finding shows deterioration of quality of life
of menopause women?
Which risk factors do you mean? How your study identified risk factors?
Ethics
What authors did for those with severe menopausal symptoms?