Reviewer ’s report  
 
Title: Cervical cancer knowledge, attitudes, beliefs and practices of women aged at least 25 
years in Harare, Zimbabwe  
 
Version: 0 Date: 03 Mar 2019  
Reviewer: Amos Mwaka  
Reviewer's report:  
Dear Authors,  
 
This study makes for an important addition to the body of knowledge in the field of cervical 
cancer early detection. Once attitude s towards cervical screening is well understood, it is 
possible to design targeted interventions that could increase screening uptake, thereby increasing 
proportions of women detected with precancerous lesions as well as early stage asymptomatic 
invasive c ervical cancers.  
 
I have a few serious and minor concerns that could help you improve the manuscript and make 
readers understand better your work.  
1. Serious concern.  
Under methods, there is no explicit mentioning or sections designated as: study setting; S tudy 
design. I do think we need these, particularly when it becomes a hurdle for readers to figure out 
whether this was a case -control study employing both qualitative and quantitative approaches to 
data collection and analyses, Or a some other design, whi ch you may want to expound on for 
better understanding by the readers. Please explicitly state the rationale for including both cases - 
women with cervical cancer, and women without cervical cancer in the same study. The way 
cases and controls are selected  in a typical case -control study is critical to the integrity of the 
study and its findings, as well as interpretations. The manner in which you presented results in 
table 2 is typical of a case -control study - but participants' selection is not well expla ined as for 
case-control study.  
In addition, please state the rationale for the inclusion of the categories of the healthy 
participants. How related or different are the communities from which patients came from to the 
one where healthy participants were selected?  
 
2. Minor concerns  
1. Under background, line 54 - you say Thailand authors! A rather rare expression. And you 
end up citing only one study, in a field of study yet you the opening statement is so very 
general. There are Thailand authors in other f ields; do they subscribe to the notion you report 
here?  
2. Under discussion; Prevention - line42; Contracts seems to be contrasts! Cross check meaning 
portrayed.  
3. Under discussions; Treatment: lines31 - 33. Your results seem to show that the people with 
low socioeconomic status are the one with more knowledge. But you seem to argue to the 
contrary in this section. Please review the sentence and message intended.  
4. Punctuations; in a number of areas, you need to review use of punctuations and "the" so the  
understanding of sentences are not altered. For example, under discussions; beliefs ". . .  the 
cervical cancer may have . . ." line 39.  
5. Limitation.  
a) ". . . this study was conducted in Harare . . ." what is it about Harare that readers need to take 
into account while interpreting this study findings? A study will always be conducted in a 
some place anyway, or in a couple of sites. So what is the message here that makes this 
findings a limitation because the study was conducted in Harare?  
b) You state  the same was small, but you do not explain why the sample was small. 
Convincingly state why you used a small sample, which at the end of the process becomes a 
limitation to the full process.  
c) ". . . and for policy recommendations mixed methods provide b etter outcomes". Please cite 
evidence to this effect at end of this statement.  
Kind regards  
Are the methods appropriate and well descri bed?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interes ts 
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publ ication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you current ly applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give det ails below.  
 
I declare that I have no competing interests.  
 
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which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal