PONE-D-20-17556

The epidemiology of extrapulmonary tuberculosis in China: A large-scale multi-center observational study

PLOS ONE

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Hasnain Seyed Ehtesham

Academic Editor

PLOS ONE

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Reviewers' comments:

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Comments to the Author

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Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: The article is good as it presents a huge data collected from 21 hospitals in the country. In the limitations the authors have mentioned that they could not compare the demographic details as income, housing, smoking etc. They also mentioned that they could not procure much data about paediatric tuberculosis.

They have only mentioned number of tuberculosis cases and concurrent pulmonary tuberculosis cases.

However, the following points need to be mentioned:

1. BCG vaccination policy of China and the vaccination status of the patients.

2. Immune status of the patients with underlying illnesses.

3. The number of cases with previous TB infection.

4. Rate of cure and mortality.

The authors have presented huge amount of data but they haven't correlated the data with the above mentioned points and have not related to any demographic details, that is required to be done.

Reviewer #2: Comments:

As per title and objective, the article written by Kang et al. provides full illustration of epidemiology of EPTB in China. This observational study represented about 202,998 EPTB inpatients with collaboration of 21 hospitals from 15 provinces in China.

However, following suggestive comments will also construct this article stronger and beneficial for the readers:

Abstract:

• Word limits excided as per Journal guidelines. Should be modified while considering word limit.

• Abbreviations of PTB are missing.

Introduction:

• It is advised to add few points with recent references regarding diagnostic modalities and difficulties in diagnosing EP specimens as it is missing form introduction section.

Method:

• Author must specify about bronchial tuberculosis (14.96%), because this may consider under PTB.

Results:

• Risk of EPTB is related to the degree of exposure to the pathogen and host immune factors like HIV, diabetes, malignancy etc. It’s my opinion that if author have the related data then this could make article more encouraging to readers.

Discussion:

• Line no. 282: Mycobacterium tuberculosis , write in italic.

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Reviewer #1: No

Reviewer #2: No

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The epidemiology of extrapulmonary tuberculosis in China: A large-scale multi-center observational study

PONE-D-20-17556R1

Dear Dr. Tang,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Hasnain Seyed Ehtesham

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

I have gone through this revised manuscript and also the Author response to the comments of the Reviewers. Required information has been added to the Ethics Section and also ethics statements have been added to the Methods of the manuscript by the Authors. Missed Abbreviations of PTB is modified as required and Authors have also added the diagnostic modalities and difficulties in diagnosing EP specimens which was missing from the introduction section.The authors have satisfactorily addressed all the comments made by the reviewers and added all required information, and have revised the manuscript accordingly. I recommend this manuscript for publication.

Reviewers' comments: