Title: FACTORS ASSOCIATED WITH DEPRESSION AMONG YOUNG FEMALE
MIGRANTS IN ETHIOPIA
Version: 2 Date: 05 Feb 2022
Reviewer's report:
Mental health disorders represent a significant share of disease burden for adolescents and young
people and depression is among the leading causes of morbidity within this age group.  This
paper measures levels of depression among young women who are rural-urban migrants in
Ethiopia, as well as factors associated with depression. The authors have brought forth a very
interesting and worthwhile subject matter and I commend their efforts. Having said this, i have
a few comments i think would make this work more digestable to the reads of the scientific
community.
1. The 9-question Patient Health Questionnaire (PHQ-9) is a diagnostic tool introduced in 2001
to screen adult patients in a primary care setting for the presence and severity of depression. (A).
Why didnt the authors consider a Domestic Migration Stress/anxiety/depression Questionnaire
(DMSQ), which would help to conduct a mediation modelling analysis on the rural-urban
transition of the study subjects. (B) is a facility based tool equally effective when used in a
community set up
2. line 39-40, why wasnt a Pearson's #2 test and/or logistic regression test used to compare
depressive symptoms between subgroups
3. in the data analysis section, Data analysis part?
Logistic regression assumes that there is no severe multicollinearity among the explanatory
variables. was this tested? similarly, another assumption is  that there are no extreme outliers or
influential observations in the dataset. The most common way to test for extreme outliers and
influential observations in a dataset is to calculate Cook’s distance for each observation. this
is very important espcially in a large data set. but the results of such tests are not presented in
the manuscript
4. Purposive sampling provides non-probability samples which receive selection based on the
characteristics which are present within a specific population group and the overall study.  but
the act provides a significant number of inferential statistical procedures that are invalid. how
were you able to adress this concern? nothing is stated in the manuscript.
5. line 131-132 'In each of the study cities, we identified neighborhoods where migrant young
women were known to live, mainly low-income areas '. How were you able to do this... please
clarify in the manuscript
6. lines 140-142 Who was the research team? Were the data collectors trained? if yes on what?
who did the training, at where and when, and for how long?
7. line 153 'A structured questionnaire was developed, pretested  and translated into local
languages.  ' WHere was the beta test done? on how many samples?
8. was the translation of the data collection tool a Literal or verbatim translation or a cross-
culutral/conceptual translation? as you collected the study in mlutiple cities, was the translation
done to the lingua franca (amharic) or to each language spoken in the 7 cities?
9.line 225-226. if you want to measure relative wealth using housegold assets a more robust
analysis would be conducting a PCA
10. lines 267-269, what is the ethical implication of a regression analysis along religious lines?
What recommendations will this lead to?
11. Discussion, The discussions section is devoid of analytical discussion. Comparing just results
are not sufficient. The public health relevance of the findings should be discussed. Moreover,
Some of the discussion points/sentiments are not backed up by citations