Title: Analyses of human papillomavirus, Chlamydia trachomatis, Ureaplasma urealyticum,
Neisseria gonorrhoeae, and co-infections in a gynecology outpatient clinic in Haikou area, China
Version: 2 Date: 17 Dec 2022
Reviewer's report:
Reviewer’s comment
The sample size for this study is commendable. However, your study do not address any research
question? Your objective should be measurable.
ABSTRACT
#Consider rewriting the sentence on the 5th line under “method.”
METHOD
#2.2 Sample collection - consider rewriting the sentence like this, for clarity “All patient's
vaginal swabs were taken for CT, UU, NG DNA testing, and cervical exfoliated cells for HPV
genotyping.”
#2.3.2 HPV detection - Please, kindly remove the website link in the main text on line 6. You
can put it at the reference/bibliography page.
RESULT
#3.1 Detection of HPV, CT, UU and NG in 2,389 patient samples- Please rewrite the sentence
under this sub-heading.
#3.2 Detection of different subtypes of HPV - Consider rewriting this “all 21 HPV subtypes
detected in the kit were detected.”
#3.3  Detection of various pathogens in different age groups - Are the P-values for different age
groups the same? You should specify the exact p-value for each, if they differs, rather 0.05 for all.
#“The detection rates of HPV, CT, UU and NG in the 21-25 years old group were second only
to the 15-25 years old group,” This age group, 15-25 years is not in your table.
DISCUSSION
#Line 4 - “ ...............and cause recurring sickness.” Which can of sickness, be specific.
#Paragraph 3 - “...................frequently challenged by pathogens and dysbiosis1,2.” Is this a
reference?
#Paragraph 3 - Be consistent with the use of “cofactor or co-factor.”
#Paragraph 3 - Consider rewriting this change “and” with “or”  The findings of this study
demonstrated that when patients had HPV infection, there was a higher likelihood of finding
CT, UU, or NG in cervical samples.
#This statement is wrong please correct it. Your study design can not justify this statement “This
reveals that NG infection should be treated promptly and quickly since it can also raise the
chance of HPV infection.”
#This statement is unclear, please rewrite it  “Early identification of genital tract pathogens is
important for the prevention and treatment of cervical cancer [6,18] and has shown the value of
combined HPV, UU, CT and NG testing.”
#“CT, UU, and NG infections enhance HPV-mediated cervical malignant lesions.” This is not
a finding from your study, please cite the source.
#Please, review this sentence, “ From a biological perspective, adolescent females are more
likely to be infected with reproductive tract pathogens such as CT and HPV due to reduced
cervical mucus secretion and increased cervical ectopic.” [30]
#“According to one study,” This statement is vague, rewrite it.
#Write this sentence. You can consider breaking the compound sentence into a simple sentence
for a better understanding, “ In recent years, it has been shown that the time of sexual debut in
the teenage student population (15–24 years old) in China is earlier and the proportion is rising,
while the understanding of self-protection is insufficient [32], and a questionnaire survey related
to sexual behavior of adolescents aged 14-24 years old in Michigan in the United States pointed
out that the lack of family and school education as well as proper guidance by the media is the
cause of high-risk sexual behavior among adolescents [33]”
#“............suggesting that reproductive tract infections are trending younger,” rewrite this phrase.
#Rewrite this”...................., and more importantly, to draw high attention to reproductive health
education for younger young women,”
#Is the single centre study the only limitation in this study?
CONCLUSION
#Rewrite your conclusion focusing on your grammar. “UU are the genital tract pathogens with
the greatest detection rate in Haikou gynecological outpatients. HPV-positive carriers are more
likely to get mixed infections from genital tract pathogens, hence combined multi-pathogen
testing should be encouraged. The trend of reproductive tract infections is younger, and teenage
reproductive health education should be enhanced.
Please, revise your English and correct your punctuation