Reviewer's report
Title:Prevalence and associated factors of anemia among non-pregnant women
of reproductive age in Bangladesh: Multilevel logistic regression analysis
Version:3Date:10 March 2015
Reviewer: Ha Trinh
Reviewer's report:
The authors studied an interesting women’s health issue in understudied
population using multilevel logistic regression analysis. Relying on nationally
representative sample from the Bangladesh Demographic and Health Survey
currently collected in 2011 and objective measure of anemia from the blood
sample, the study was promising to shed light on the accurate prevalence of
anemia and its social determinants. However, the manuscript needs much
revision and improvement to be considered to publish in BMC Women’s Health.
The following comments should address all the weaknesses of this manuscript in
details.
Major compulsory revisions:
1. The section on “Measurements” needs to be added to this manuscript. The
authors only specified how they categorized anemia (dependent variable) into
three groups of “severe”, “moderate” and “mild.” The authors listed residence,
women’s education, husband’s education, breastfeeding, currently amenorrhea,
working, source of drinking water, toilet facility, living with husband, religion,
wealth index, body mass index, age group, age at first marriage, number of ever
born children and their coding in Table 2 and 3. But very little is known for the
measurements of these variables, for example if they were recoded or in their
original forms. Please specify.
2. Line 241: In Table 2 and 3, authors specified that contraceptive use was
dichotomized as “Yes” and “No.” Can authors compare anemia risks between
“oral contraceptive use” and “intra-uterine device use” based on their results?
Please verify.
3. Authors need to interpret results with caution as this study only employed
cross-sectional data (BDHS-2011). Any conclusions regarding causality need to
be eliminated.
Minor essential revisions:
1. Line 75: Add “the” to United States
2. Line 98: Use “nationally representative” rather than “national-level population”
3. Line 109: What do you mean by “the present authors”?
4. Line 118-119: Incomplete sentence
5. Line 122: Specify ICC score for this study and the conclusion of whether to
use multilevel analysis
6. Line 157-186: Specify that Chi-square results shown in Table 2
7. Line 188: Specify that multilevel logistic regression results shown in Table 3
8. Line 189-191: The conclusion that multilevel analysis was appropriate for this
study (with ICC score) must be stated in the Statistical Analysis section
9. Check format for Table 3. Rather than reporting exact p-values, authors should
report significant level of p<0.05, p<0.01, p<0.001.
10. Authors do not need to report results in Discussion section. Authors should
only discuss relevance of their studies compared to previous studies on the same
subject.
11. Line 228: Citation needed for “Education is another factor that influences the
general health status of the public”
12. Line 234: What does it mean by “of girls”?
13. Line 235-236: Citation needed for “Eradication of poverty and improving level
of education among women are two essential components that should be able to
reduce the prevalence of anemia”
14. Line 238: What does it mean by “suture evaluations”?
15. Same as #10, authors do not need to report results in Conclusion
16. Line 258-259: Is it relevant to conclude about “ongoing socio-economic
development by the government” based on the results on individual anemia?
Please revise.
Discretionary revision:
1. Authors can choose to report either coefficients or odds ratios, standard errors
or confidence intervals as these concepts are similar. Based on the text
explaining results from Table 3, authors should only report odds ratios and
confidence intervals in the table.
2. What is the purpose of comparing anemia prevalence between countries in the
Discussion section? Does it serve any ‘policy implication’ purpose?
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
Not applicable