Title: Urban -rural differential in the association between household wealth index and anemia
among women in reproductive age in Ethiopia, 2016.
Version: 2 Date: 11 May 2021
Reviewer's report:
Several grammatical, spelling and usage errors were present in the manuscript.
Please review the suggestions below and revise as appropriate.
Within the ABSTRACT, consider revising:
"Using a three-level random intercept model to explore associated factors..."
"Women of low household wealth index category were more anemic (29.6%) than those in the
middle..."
"Women who lived in rural areas were more anemic than those who lived in urban areas"
"Since the driver of anemia in this study is the place of residency...novel public health
interventions should consider urban residency for women..."
Within the INTRODUCTION, consider revising:
"Anemia can be caused by a genetic defect, infections (malaria, hookworm, and bone marrow
disease), deficiency of iron, vitamins..."
"Nutritional deficiency anemia is the most common type"
"Anemia is associated with a defect in birth outcomes miscarriage, preterm delivery, placental
abruption, low birth weight, higher risk of prenatal and maternal mortality"
"Anemia is one of the biggest public health concern worldwide affecting 27% (1.93 billion
people) of the world’s population in 2013"
"The symptoms of anemia have are strongly associated with..."
"Besides, due to sex-specific experiences, such as pregnancy, bleeding at childbirth, lactation,
and menstruation in women of reproductive age (15–49 years), there is an increased risk of iron
loss..."
"Anemia is diagnosed when hemoglobin levels fall below..."
"The two main causes of anemia are classified by timing; namely immediate and distal causes"
Consider deleting sentence beginning with "Besides these immediate risk factors of anemia..."
and continue with "Distal factors that operate at the household and community levels, include..."
"Former studies in Ethiopia focused on children, pregnant and lactating women nutrition and
associated factors (12,24,25) and identified factors linked to anemia such as residence, wealth
status, and contraceptive use"
Sentence beginning "Even though many of them showed us the wealth index and
residence area are..." is repetitive so consider deleting
"Additionally, these former studies did not explain..."
Within the METHOD, consider revising:
"The 2016 EDHS sample design involved a probabilistic two-stage sampling."
What does it mean by women who were available in the households? This needs to be more
specific.
"...anemia in non-pregnant women was definedby a hemoglobin concentration was below 12·0
g/dL..."
"Anemia in pregnant women was defined by hemoglobin levels below 11.0g/dL (30, 32)."
"The main anemia associated variable of interest were the household wealth index and place
of residence."
"Data were analyzed by Chi-square and binary logistic regression models using SPSS software
for Windows Version 20."
"Chi-square were carried out to test..."
"All study participants were required to provide informed written consent prior to undertaking
the survey."
In which mode did the data collectors provide the explanation? Was it verbal or written?
"Privacy and confidentiality were ensured by following the ethical requirements of research."
"Since this study was a secondary analysis of the Ethiopian Demographic
and Health surveys (EDHS) data, which are publicly available, our study did not require ethical
approval. DHS program authorization was requested to download the dataset."
"Other predictors of anemia were women who were not used hormonal contraceptives, younger
age category, no education, and married women..."
"The data also shows that using wealth index and women residency jointly or interactively in
the..."
Within the RESULTS, consider revising:
"The mean age was 28.2 ± 0.2 and the majority of anemic women lived
in rural areas (25.5%)."
"More women of low household wealth index categories were anemic (29.6%) compared to
those classified within rich wealth index categories. More women who live in a rural area were
(25.5%) were anemic than compared to those who live in urban areas (Table 2)."
"The bivariate model provided the unadjusted odds ratio..."
"More women of low household wealth index and live in a rural area were anemic compared to
women of high house wealth index and live in urban areas."
"In the interactive model, the odds ratio of anemia was higher for women who lived in rural
rather than urban residence."
"Other predictors of anemia were women who did not use hormonal contraceptives..."
Within the DISCUSSION, consider revising:
"The results suggest that level of household wealth was associated with anemia in women who
live in rural areas."