Healthcare Workers’ Perception of Measures to Reduce the Risk of New Tuberculosis Infections: A Qualitative Study Report
and Lufuno Razwiedani 3Round 1
Reviewer 1 Report (Previous Reviewer 2)
This is the resubmitted manuscript. The overall paper is significantly improved, particularly the clarity of information provided in the introduction, aim, methodology, and results. The authors clearly took on board feedback provided by the reviewers.
Minor comments:
The English language still needs some proofreading, e.g. “a continent” cannot be “her”.
Perhaps authors can also add at least the lead author’s name when referring to reference 5 (line 54 page 2).
Please pay attention to details, if you start with a quotation mark, finish the sentence with one (166th line).
Some information does not need to be repeated again (355, page 9).
I still think that the study is interesting and in this improved version it is publishable. TB was somewhat forgotten in developed countries and may present a shock for newly qualified doctors, particularly those who will choose to work in less developed countries. It is important that up-to-date study can provide insight into the mortality rate of TB as well as perception of health workers directly involved in dealing with the disease.
Author Response
All comments raised were attended to point by point.
Author Response File: 
Author Response.pdf
This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.
Round 1
Reviewer 1 Report
Thank you for the opportunity to review the paper entitled Healthcare worker’s perception of measures to reduce the risk of new TB infections: A case of Collins Chabane Municipality of Vhembe District, South Africa
The article has potential but needs a few corrections to improve its quality.
Suggestions for authors:
1. Title:
The authors used TB abbreviation in the title. I suggest changing it to the full name "Tuberculosis".
2. Abstract.
The TB abbreviation should be explained when the first time was used in the text: abstract line 11.
3. Keywords should be changed:
Original keywords are: Collins Chabane; healthcare workers; Municipality; new TB cases; perception; implementation.
I suggest adding Tuberculosis and changing the geographical keywords: Collins Chabane and Municipality for South Africa as a last one.
4. Introduction is adequate for this kind of paper.
Należy się upewnić czy wszystkie skróty są wyjaśnione w tekście (WHO, AIDS/HIV and others)
5. Material and methods
I recommend order and dividing this section into few parts
Please see examples - articles in Nursing Reports:
https://www.mdpi.com/2039-4403/12/3/60/htm
https://www.mdpi.com/2039-4403/12/3/53
6. Results.
This section should start from the description of table 1 (above the table).
7. Please add limitations of the study.
8. In the References section Authors should correct punctuation according to instructions for authors.
Author Response
Peasee see the attachment
Author Response File: Author Response.pdf
Reviewer 2 Report
The authors raised an important topic of issues related to TB infections that are still present in the world, particularly in Africa. The link with HIV infection is appropriate and perhaps difficult to distinguish between co-infection with TB and TB alone. However, the article is very untidy with many errors related to spelling, grammar, proofreading and presenting results. This makes reading difficult in places.
My comments:
1. Can I please ask for the proofreading of the manuscript? There are spelling errors that I could pick up on. Please remove repetitive sentences and paragraphs, it looks as if it was copied and pasted without any proofreading. It is not clear what is actually said by the participants as not always quotation marks are used in a single paragraph. The lack of consistency in using italics for quotes makes the article difficult to read.
2. The article seems to confirm existing knowledge, and it would benefit from newer data. For example, the authors refer to 2017 and 2018, can the authors explain why other data are not available? Perhaps there is a reason for the lack of recorded cases in 2020-2021.
3. If you refer to “African Region” and cases per 100000, could you be more specific, do you refer to all countries in Africa and all regions? What do you mean by using this term? is very unclear and confusing in the light of later referral to data from “South Africa”.
4. If the authors relate to the methods of reducing TB, what are they, and why are they not as efficient as in other continents?
5. You refer to a very broad term of “scientific evidence” what do you mean by this? What studies/research do you refer to?
6. Introduction is too long and relies mostly on WHO data, this could be written in a more concise way.
7. The interview is appropriate for qualitative data gathering, but I am not clear what the authors mean by “pre-test”. I am not sure of the purpose of repeated interviews as they can obscure the initial data and opinions. What are the lead questions used?
8. When dividing by themes, how many of the interviewees were associated with a particular theme?
9. It seems that some of the data gathered e.g. “cough etiquette” could be related to poor healthcare advise and training and it opens an entirely different level of risks for TB and other infections.
The manuscript is confusing, with many errors in style and many repeated messages, some of which are well known to increase the risks of viral or bacterial infections. The discussion raises interesting points with a link with specific risks for patients (lack of attendance, delay in results etc). However, this could be more of a value if there is a distinction between rural and town- associated populations. Conclusions should be more specific and I am not sure if they really reflect a good perception of current strategies.
Author Response
Please see the attachment
Author Response File: Author Response.pdf
Reviewer 3 Report
Dear authors,
Your work on health professionals' perception of TB management is very interesting. Personal interviews can certainly reflect these kinds of feeling very well. I have some questions and suggestions that I need you to answer:
INTRODUCTION
- The epidemiological data are very interesting but are from 2017-2019. Can you provide more recent data?
- The objective is not well written. It does not seem very rigorous to say: "This study emanated to de-118 scribe health care workers...".
MATERIALS AND METHODS
- The authors have not specified when the data for the study was collected. It is important to describe this.
- The open-ended question posed is very broad. They have not specified data of interest: conditions under which the interviews were conducted; new issues that may have arisen during the interview; software to manage so much information; etc.
- You say that you have verified the information with 8 interviews that are conducted again. There are 20 people in the group. Why didn't you repeat the interviews for the whole group? You should justify your answer.
DISCUSSION
- The authors have not explained how to apply the research to clinical practice.
- The authors have not included study limitations.
REFERENCES
- Some references are incomplete or have errors. The authors should review this section.
Author Response
Please see the attachment
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
The authors made the necessary corrections as suggested. In light of these changes, I propose to publish an article.
Reviewer 3 Report
Dear authors,
Thanks for your reply. The explanations that you provide are satisfactory. The paper has greatly improved its quality.
Congratulations on your work.
