Submited on: 16 Feb 2015 08:54:36 PM GMT
Published on: 17 Feb 2015 09:55:50 AM GMT
 
HIV in Pregnancy Review
Posted by Ms. Kailyn Conner on 01 Nov 2017 08:26:12 PM GMT Reviewed by Interested Peers

  • What are the main claims of the paper and how important are they?

    The main aim of this paper is to compare pregnancy outcomes among early- and late-stage HIV infection in a population of mothers at a hospital in Orlu, Nigeria. The authors note that HIV is an important public health topic, but they do not expand on why. They also did not expand on why this population of patients was chosen, beyond noting that HIV prevalence in Nigeria is 4.1%. 


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    The authors do not give enough information to assess whether this is a novel claim.


  • Are the claims properly placed in the context of the previous literature?

    The authors found studies that reasserted their claims, but no comprehensive literature was completed in this paper; this information cannot be ascertained from the article.


  • Do the results support the claims? If not, what other evidence is required?

    No, the results do not support the claims because it is impossible to decipher the results based on the methodology presented.


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    The authors did not provide enough details in the methods section to verify whether any important deviations occurred or why. For example, no information was given regarding what statistical methods they used to generate their p-values. Were these chi-square tests/t-tests? You note that you use SPSS - how did you use it?

     

    The authors also do not cite the appropriate type of design utilized. They note that the study is a "prospective observational study" which, while true, is not AS true as noting that this is a cohort study. The population was chosen based on their exposure (in this case, HIV infection, whether early- or late-stage) and followed to particular outcomes.


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    No. The authors fail to provide details of their statistical methods and do not explicitly define their exposure or outcome variables. What did you consider early-stage HIV? What did you consider late-stage? What is the booking you talk about, and why could that be important? On what grounds did you choose these risk factors to analyze?


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    This paper would overwhelmingly benefit from a literature review and additional supplemental tables, as well as bolstering information presented in the methods section. A summary of literature in a table would confirm the placement of these results in the context of what has already been published. Explicitly stating the public health implications, as well as the individual health implications, would also dramatically improve the quality of the paper. In the methods section, if the authors could redefine what their exposure status means (what is the comparison group? What does it mean to have early or late stage HIV?) and expand on why these risk factors were chosen, the paper would improve. The authors also need to explicitly state the statistical test utilized. These are not difficult fixes for a descriptive study, just improving the quality of the epidemiological assessment.


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    These results are not yet outstanding. While they are inherently fascinating and inherently important, the authors do need to make some corrections to this paper before I would feel comfortable disseminating the information presented here.


  • Other Comments:

    An interesting topic! I applaud you for tackling such an important issue in public health.

     

    You do a good job presenting the results and interpreting the descriptive statistics; the primary issue is that I cannot ascertain exactly from where these values were derived and what method you used. Were these simple frequency analyses with a chi-square/t-test to obtain the p-value? Is there anything else you can do to bolster the statistics used in this study rather than just depending on frequencies and counts to demonstrate a point? Have you spoken with a statistician? What is your hypothesis? Your results seem lackluster given the simplicity of the statistics, and I am not certain you can draw the conclusions you draw.

     

    I also would like to see why this information is important to you and important to the public health community at large. Why do we need to know these results? How does this fit into the literature? How would you like to expand this research in the future? I would like to know more from this study than what I was told.

     

    Furthermore, one of the major issues with your results is generalizability to a more general population. The population at your hospital may not be comparable to more general populations elsewhere. You need to explicitly state this within the paper.

     

    Other than that, a few grammar clean-ups are needed, and I would consider specifying in your title that this is a single-center analysis.

  • Competing interests:
    .
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:

    .

  • Experience and credentials in the specific area of science:

    Master of Public Health, concentrating in Epidemiology

  • How to cite:  Conner K .HIV in Pregnancy Review[Review of the article 'HIV in pregnancy: Severity of maternal disease a determinant of pregnancy outcomes ' by Okeudo C].WebmedCentral 2017;8(11):WMCRW003379
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