Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo

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The tropical climate in the D.R. Congo provides parasites with an environment conducive to their proliferation. The prevalence rates of intestinal parasitosis remain poorly understood in the D.R. Congo. Objective This study aims to estimate the overall and specific prevalence of intestinal parasitosis and to determine an association between intestinal parasitosis and the season at CHUNDE. Methods From January 1, 2020, to December 31, 2021, patients for whom a direct stool examination was requested at the Notre Dame de l’Espérance University Hospital Center were included in this study. Stool samples were collected and examined under an optical microscope. Results During the period of the study, we recorded 187 patients aged 2 to 77 years. The prevalence of intestinal parasitosis was 75.40%. The specific prevalence rates for parasites were as follows: E. histolytica/dispar, the most common, with a prevalence of 55.08%, followed by P. hominis and G. lamblia with respective prevalence rates of 9.09% and 6.24%. A. lumbricoide had a prevalence of 27.81%, followed by S. mansoni, A. duodenalis, and E. vermicularis with respective prevalence rates of 3.74%, 1.60%, and 1.07%. There was no association between the season and the overall prevalence of intestinal parasitosis. Conclusion The prevalence of intestinal parasitosis was higher amang symptomatic patients at CHUNDE. There is no statistically valid association between the season and the prevalence of intestinal parasitosis. 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F1000Research 2025, 14 :50 ( https://doi.org/10.12688/f1000research.160135.3 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Revised Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] lufuluabu mpemba Alphonse 1 , Tshishimbi kalala Jean Hubert 2 , Tshodi bulanda Arsène 3 lufuluabu mpemba Alphonse 1 , Tshishimbi kalala Jean Hubert 2 , Tshodi bulanda Arsène 3 PUBLISHED 06 Oct 2025 Author details Author details 1 internal medecine, University of Mbuji-Mayi, Mbuji-mayi, Kasai oriental, Democratic Republic of the Congo 2 pediatrics, University of Mbuji-Mayi, Mbuji-Mayi, Kasai oriental, Democratic Republic of the Congo 3 gynecology obstetric, university of Mbuji-Mayi, Mbuji-Mayi, Kasai oriental, Democratic Republic of the Congo lufuluabu mpemba Alphonse Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Tshishimbi kalala Jean Hubert Roles: Conceptualization, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Tshodi bulanda Arsène Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background Intestinal parasitosis are one of the main causes of morbidity and mortality in Africa. The tropical climate in the D.R. Congo provides parasites with an environment conducive to their proliferation. The prevalence rates of intestinal parasitosis remain poorly understood in the D.R. Congo. Objective This study aims to estimate the overall and specific prevalence of intestinal parasitosis and to determine an association between intestinal parasitosis and the season at CHUNDE. Methods From January 1, 2020, to December 31, 2021, patients for whom a direct stool examination was requested at the Notre Dame de l’Espérance University Hospital Center were included in this study. Stool samples were collected and examined under an optical microscope. Results During the period of the study, we recorded 187 patients aged 2 to 77 years. The prevalence of intestinal parasitosis was 75.40%. The specific prevalence rates for parasites were as follows: E. histolytica/dispar , the most common, with a prevalence of 55.08%, followed by P. hominis and G. lamblia with respective prevalence rates of 9.09% and 6.24%. A. lumbricoide had a prevalence of 27.81%, followed by S. mansoni , A. duodenalis , and E. vermicularis with respective prevalence rates of 3.74%, 1.60%, and 1.07%. There was no association between the season and the overall prevalence of intestinal parasitosis. Conclusion The prevalence of intestinal parasitosis was higher amang symptomatic patients at CHUNDE. There is no statistically valid association between the season and the prevalence of intestinal parasitosis. READ ALL READ LESS Keywords University of Mbujimayi/Intestinal Parasitosis/Season/ Association/Protozoa/Helminths Corresponding Author(s) lufuluabu mpemba Alphonse ( [email protected] ) Close Corresponding author: lufuluabu mpemba Alphonse Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 Alphonse lm et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Alphonse lm, Jean Hubert Tk and Arsène Tb. Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.12688/f1000research.160135.3 ) First published: 09 Jan 2025, 14 :50 ( https://doi.org/10.12688/f1000research.160135.1 ) Latest published: 06 Oct 2025, 14 :50 ( https://doi.org/10.12688/f1000research.160135.3 ) Revised Amendments from Version 2 We made changes to the abstract, the introduction, the methodology, and the discussion. We replaced the old references, at least those from which we took data on parasites, with new ones. We made changes to the abstract, the introduction, the methodology, and the discussion. We replaced the old references, at least those from which we took data on parasites, with new ones. See the authors' detailed response to the review by Majed H. Wakid See the authors' detailed response to the review by Angela Bracho Mora See the authors' detailed response to the review by Ashok Kumar Sah See the authors' detailed response to the review by Abayeneh Girma READ REVIEWER RESPONSES Introduction Intestinal parasitic infections are serious diseases worldwide. However, doctors working in these regions tend to give them little attention due to the commonality of their occurrence. As a result, they are rarely a reason for regular consultation and are often neglected. 1 , 2 Although they attract little interest today compared to diseases such as AIDS, tuberculosis, malaria, and onchocerciasis, they remain a public health issue in tropical and impoverished areas. 3 Climatic conditions are one of the main factors that contribute greatly to the spread of intestinal parasitic infections, by increasing their transmission and perpetuating the parasitic cycles. 4 According to World Health Organization (WHO) estimates, more than three billion people are affected, with 450 million severely ill; of these, over 50% are school-aged children. 5 The global prevalence is 35.8% in the world population. 6 These diseases have disastrous health, social, and economic consequences for more than one billion people. 6 In Africa, a study conducted in Morocco in 2019 among migrants from sub-Saharan Africa (Equatorial Guinea “30.6%”, Côte d’Ivoire “16.6%”, Senegal “9.29%”, Cameroon “8.01%”, with the remaining patients coming from Niger, Togo, Congo, Burkina Faso, Mali, Gabon, and Benin “35.5%”) showed a prevalence of 43.18% for intestinal parasitic infections. Among these individuals, 63.15% were infested with various digestive parasites simultaneously. 7 A study conducted Algeria showed a highly significant difference of prevalence between symptomatic (82.3%) and asymptomatic subjects (14.9%), with the majority attributable to protozoan infection. The most common species in the symptomatic subjects were Blastocystis spp. (43.8%), Entamoeba histolytica/dispar (25.4%) and Giardia intestinalis (14.6%) and more rarely Enterobius vermicularis (02.1%), Teania spp. (0.6%) and Trichuris trichiura (0.2%), while in asymptomatic population Blastocystis spp. (8%), Entamoeba coli (3.3%) and E. histolytica/dispar (2.5%) were the most common parasites detected with no case of helminth infection. 8 Another study conducted among schoolchildren in the Republic of Congo revealed a prevalence of intestinal parasitosis of 25.7%, with the most frequent parasites being: Entamoeba coli (52.2%), Ascaris lumbricoides (13%), and Endolimax nana (10.9%). 9 In the DRC, data on intestinal parasitosis are poor. The few available data that parasitic infections pose a public health problem due to multiple crises that have led to displacement and a lack of potable water, food hygiene, and sanitary facilities. 10 A study conducted in Bukavu in 2016 on the impact of seasons on intestinal parasitic infections showed a prevalence of 94%. The identified helminths, in decreasing order of frequency, were: S. mansoni (30.6%), S. stercoralis (21.3%), Ancylostoma duodenales (13.6%), A. lumbricoides (12.6%), T. trichiura (9.0%), and T. saginata (6.6%). Identified protozoa included Pentatrichomonas hominis (13.69%), Entamoeba histolytica (6.75%), and Giardia lamblia (4.76%). 11 According to a study conducted in Kinshasa more than half of the diagnosed individuals were infested with A. lumbricoides at 58.3%, followed by 30% of individuals hosting E. histolytica , and A. duodenales was isolated in 11.7% of the diagnosed individuals. 12 The East Kasai region is dominated by a humid tropical climate with two seasons (dry season from 15 th May to 15 th August and rainy season from 15 th August to 15 th May). 13 The population living in the eastern part of its capital, Mbujimayi, and the surrounding villages, served by CHUNDE, is poor and lives in very poor hygienic conditions. We have not identified any study that could inform us about the prevalence of intestinal parasitic infections here. The prevalences of intestinal parasitosis as well as the factors that influence them are poorly documented in East Kasai. The prevalence of intestinal parasitic infections is likely very high at CHUNDE and may be associated with the season. General objective To determine the prevalence of intestinal parasitic infections via stool examination at CHUNDE and to assess the impact of the season on the frequency of intestinal parasitic infections in general and on each specific type. Specific objectives • To determine the specific prevalence of each identified intestinal parasitic infection at CHUNDE. • To determine the prevalence of intestinal helminths and protozoa at CHUNDE. • To determine the association between the season and the prevalence of intestinal parasitic infections. Methods Study population This study included patients who consulted at the Notre Dame de l’Espérance University Hospital Center (CHUNDE) and were requested to have a direct stool examination. This center serves the East Kasai province, particularly the rural-urban areas to the east of Mbujimayi city in the DRC. These areas are characterized by poor sanitary and economic conditions. The study period was from January 1, 2020, to December 31, 2021. Sampling and type of study Thid is a cross-sectional study with recruitment of patients consecutively meeting the inclusion criteria. Inclusion and exclusion criteria The study included all patients who consulted at CHUNDE during the study period and were requested by physicians to have a direct stool examination. Patients who did not provide a sample for this examination were excluded. Sample collection Fresh stool samples of approximately 10-20 grams (5-6 milliliters if liquid) were collected by the patient. For this collection, the laboratory provided each patient with a clean container and rod. The patients were provided with these instructions: avoid touching the inside of the container; if the stools are associated with mucus or blood, preferably collect them; prevent urine and stool from mixing. Direct stool examination The direct stool examination was conducted within 30 minutes of sample collection. Approximately 1 gram of stool were mixed with 1drop of saline solution (0.9%) on a slide. After homogenization, this preparation was covered with a slide and observed under an optical microscope at 10x and 40x objectives. The results were recorded in the laboratory register and entered into an Excel database as follows: Parasitic infection (yes, no), type of parasite (helminths, protozoa), multiple infestation (yes, no), types of combined parasites, E. histolytica (yes, no), G. lamblia (yes, no), P. hominis (yes, no), A. lumbricoides (yes, no), S. mansoni (yes, no), A. duodenales (yes, no), E. vermicularis (yes, no). Cases of E. histolytica also included those of Entamoeba dispar due to the difficulty in distinguishing them microscopically. Other patients information were obtained directly from the laboratory voucher and recorded in the laboratory register. Statistical analysis The prevalence of intestinal parasitic infections was calculated by dividing the number of patients with at least one identified parasite in a direct stool examination by the total number of patients who underwent this examination. The prevalence in each population group was calculated by dividing the number of patients in that group with at least one identified parasite by the total number of patients in that group who underwent this examination. The prevalence of a specific intestinal parasitic infection was calculated by dividing the number of patients with a specific parasite by the total number of patients who underwent the examination. The confidence interval (CI) for each prevalence rate is 95%. The relationship between the prevalence of parasitosis and climate was studied using the Yatt corrected chi-square test and Fisher as appropriate. The test was considered valid if the P value was less than 0.05. Statistical analyses were performed using EPI INFO 7.2.6.0 and R version 4.3.3. Ethical considerations and informed consent This study received approval from the ethics committee of the University of Mbujimayi on N52/CEUM1209 of 11th December 2019. It was conducted in accordance with the requirements of good clinical practices and the principles of the Helsinki Declaration of the World Medical Association, along with any subsequent relevant amendments. All patients who have participated in this study have provided their consent by signing a written Document, the consent form, or their guardian, where applicable. Study results Characteristics of the study population From January 1, 2020, to December 31, 2021, 187 patients were included in our study. Table 1 summarizes the demographic characteristics: Among the 187 patients included in our study, 94 were female and 93 were male. The sex ratio was one woman for one man. A total of 158 patients were adults [≥18 years <70], 20 were children [<18 years], and 9 were elderly [≥70 years]. The mean age was 41.68 ± 17.95 years. The youngest patient was 2 years old, and the oldest was 77 years. Table 1. Demographic characteristics of patients undergoing direct stool examination between 2020 and 2021. Frequency (N=187) % Sex Female 93 49.73 Male 94 50.27 Age groups Children (<18 years old) 20 10.69 Adults (18-70 years old) 158 84.49 Senior adults (˃70 years old) 9 4.81 Mean age 41.68±17.95 Figure 1. Frequency of different types of intestinal protozoa. Frequency of intestinal parasitic infections As shown in Table 2 , a total of 141 patients, or 75.40%, had at least one intestinal parasitic infection. Forty-seven patients (24.13%) had multiple infestations, of which 37 (19.79%) combined at least one helminth and one protozoan, and 10 (5.35%) combined at least two protozoa. The most frequent combination was E. histolytica and A. lumbricoides , with 27 cases (14.44%). Intestinal parasitic infections were more frequent among children (95.00%) and elderly adults (88.89%). They were also more common in women (78.49%) than in men (72.34%). A total of 114 patients (60.96%) had at least one intestinal protozoan, and 66 patients (35.29%) had an intestinal helminth infection. Table 2. Frequency of intestinal parasitic infections, intestinal helminth infections, and intestinal protozoa. Frequency (N=187) % Intestinal parasitic infections 141 75.40 Type of parasitosis Protozoa 114 60.96 Helminths 66 35.29 Multiple infestation Yes 47 24.13 No 94 50.27 Different combinations Protozoa-helminth 37 19.79 E. histolytica/dispar A. lumbricoides 27 14.44 E. histolytica/dispar A. duodenales 1 0.53 E. histolytica/dispar S. mansoni 2 1.07 E. histolytica/dispar A. lumbricoides S. mansoni 1 0.53 E. histolytica/dispar P. homimis A. lumbricoides 1 0.53 G. lamblia P. hominis A. lumbricoides 1 0.53 G. lamblia P. hominis S. mansoni 1 0.53 P. hominis A. lumbricoides 2 1.07 P. hominis S. mansoni 1 0.53 Protozoa2 10 5.35 E. histolytica/dispar P. hominis 2 1.07 E. histolytica/dispar P. hominis G. lamblia 4 2.14 G. lamblia P. hominis 4 2.14 Age group Children 19 (n=20) 95.00 Adults 114 (n=158) 72.15 Senior adults 8 (n=9) 88.89 Sex Male 68 (n=94) 72.34 Female 73 (n=93) 78.49 Frequencies of intestinal protozoa Figure 1 shows that E. histolytica/dispar was the most frequent protozoan, with 103 cases (55.08%), followed by P. hominis , and G. lamblia with respective prevalence rates of 9.09%, and 6.24%. Frequencies of intestinal helminths As shown in Figure 2 , A. lumbricoides/dispar was the most frequent helminth, with 52 cases (27.81%), followed by S. mansoni , with 7 cases (3.74%), A. duodenale , with 3 cases (1.60%), and E. vermicularis , with 2 cases (1.07%). Figure 2. Frequency of different types of intestinal helminth infections. Frequency curves of intestinal parasitic infections Figure 3 shows the evolution of frequency of intestinal parasitosis by year (2020 and 2021). It allows to analyze this evolution in relation to the season (dry season: from 15/5 to 15/8 and rainy season: from 1/1 to 14/5 and from 16/8 to 31/12). Figure 3. Frequency curves of intestinal parasitic infections in 2020 and 2021. In 2020, the frequency of intestinal parasitic infections was high, with peak values during the dry season (83-100% in May, June, and July) and in October. In 2021, the frequency also remained high, particularly with peak values observed during the dry season (87-90% in May and June) and in September. Intestinal parasitosis prevalence and seasonal relationship Table 3 shows that the frequency of intestinal parasitic infections was higher during the dry season (83.33%) compared to the rainy season (72.66%). When considered by year, the frequency was higher during the dry season (87.50%) than during the rainy season (62.69%) in 2020, whereas in 2021, the rainy season recorded a slightly higher frequency than the dry season, with 81.94% and 79.17%, respectively. But the chi-square test showed that there was no association between intestinal parasitic infections and the season. Table 3. Distribution of intestinal parasitic infection cases by year and season. Frequency % Rainy season (2020-1) (n=139) 101 72.66 2020 (n=67) 42 62.69 2021 (n=72) 59 81.94 Dry season (2020-1) (n=48) 40 83.33 2020 (n=24) 21 87.50 2021 (n=24) 19 79.17 Chi-square 1.6531 P Value 0.1985 Frequency curves of intestinal protozoan infections Figure 4 shows that the frequency of intestinal protozoa was high in both 2020 and 2021. In 2020, two peaks of this frequency were observed during the dry season (100% in May and July). In 2021, two high values of this frequency, 80% and 85%, were observed in May and September, respectively. Figure 4. Curve of the frequency of intestinal protozoa in 2020 and 2021. Intestinal protozoan prevalence and season relationship As shown in Table 4 the dry season recorded a higher frequency of intestinal protozoa (64.58%) compared to the rainy season (59.71%). This superiority remained stable in both 2020 and 2021. There is no association between the frequency of intestinal protozoa and the season. The frequencies of E. histolytica/diapar , P. hominis , and G. lamblia are not associated with the season. Table 4. Distribution of cases of protozoa according to year and season, and relation statistical tests. Frequency % Rainy season (2020-1) (n=139) 83 59.71 2020 (n=67) 40 59.70 2021 (n=72) 43 59.72 Dry season (2020-1) (n=48) 31 64.58 2020 (n=24) 19 79.17 2021 (n=24) 12 50.00 Chi-square 0.18049 P Value 0.671 E. histolytica/dispar Chi-square 0.12764 P Value 0.7209 P. hominis Fisher test P Value 0.5666 G. lamblia Fishier test P Value 0.5081 Frequency curves of intestinal helminthiasis infections The frequency of intestinal helminthiasis was higher in 2021 than in 2020. In 2020, three high frequencies were recorded during the dry season (66% and 40% in May and July) and in October (74%). In 2021, three other high frequencies (72%, 56%, and 60%) were recorded in February, June, and October, respectively ( Figure 5 ). Figure 5. Curve of the frequency of intestinal helminthiasis in 2020 and 2021. Intestinal helminthiasis prevalence and season relationship The frequency of intestinal helminthiasis (37.50%) was higher during the dry season than during the rainy season (34.53%). In 2020, the dry season recorded a frequency of 25.00%, higher than that of the rainy season (17.91%). In 2021, both seasons recorded the same frequency (50.00%). There is no association between the frequency of intestinal helminthiasis and the season. The frequencies of A. lumbricoides , S. mansoni , A. duodenales , and E. vermicularis are not associated with the season ( Table 5 ). Table 5. Distribution of cases of helminthiasis according to year and season, and relation statistical test. Frequency % Rainy season (2020-1) (n=139) 48 34.53 2020 (n=67) 12 17.91 2021 (n=72) 36 50.00 Dry season (2020-1) (n=48) 18 37.50 2020 (n=24) 6 25.00 2021 (n=24) 12 50.00 Chi-square 0.038326 P Value 0.8448 A. lumbricoides Chi-square 9.4562 P Value 1 S. Mansoni Fisher test P Value 1 A. duodenales Fisher test P Value 1 E. vermicularis Fisher test P Value 0.4485 Discussion In this study, we estimated the prevalence of intestinal parasitosis in general, as well as the prevalence of different types of intestinal parasitosis, among patients who underwent direct stool examination at CHUNDE in 2020 and 2021. These patients were aged between 2 years and 77 years, with an odds ratio of one woman for every man. In this study, the overall prevalence of intestinal parasitosis was high (75.40%). Intestinal protozoa (60.69%) were more frequent than helminths (35.29%). The most prevalent protozoa were E. histolytica/dispar (55.08%), P. hominis (9.09%), and G. lamblia (6.24%). The most common helminths were A. lumbricoides (27.81%), S. mansoni (3.74%), A. duodenale (1.60%), and E. vermicularis (1.07%). Polyparasitism was observed in 24.13% of patients, with the combination of E. histolytica and A. lumbricoides being the most frequent (14.44%). Intestinal parasitosis were particularly prevalent in children (95.00%) and elderly adults (88.89%), and more frequent among women (78.49%) than men (72.34%). Prevalence was higher, although no statistically significant association was observed between season and parasitosis prevalence. The overall prevalence of intestinal parasitosis was 75.40%. The prevalence of intestinal protozoa and helminths was 60.69% and 35.29%, respectively. The most prevalent intestinal protozoa were E. histolytica/dispar (55.08%), followed by P. hominis (9.09%) and G. lamblia (6.24%). The most prevalent intestinal helminths were Ascaris lumbricoides (27.81%), followed by S. mansoni (3.74%), A. duodenale (1.60%), and E. vermicularis (1.07%). Worldwide, a study in Brazil estimated the prevalence at 10.8% (95% CI: 8.6–13.4). Endolimax nana was the most frequent parasite (4.8%), followed by E. histolytica/dispar (1.7%). In Africa, the prevalence of intestinal parasitosis remains high in many studies. Studies in Ethiopia and Morocco showed high frequencies of intestinal parasitosis but lower than ours, with prevalences of 52.9% and 43.18%, respectively. 7 , 14 , 15 In Guinea the prevalence of intestinal parasitosis is 52% with A. Lumbricoides (Figure 3), hookworm, and S. mansoni being the helminths most frequently found, with a prevalence of 15% (95% CI: 12,18), 6% (95% CI: 5,8), and 5% (95% CI: 3,7), respectively. Among protozoans, E. histolytica was predominant with a prevalence of 4% (95% CI: 3,5). The young children were less infected, with a prevalence of 37 % (95 % CI: 26,50) when compared to adults. The pooled prevalence of soil-transmitted helminth infections was 12%. 16 In the DRC, according to a 2019 study conducted in Kinshasa More than half of the diagnosed individuals were infested with A. lumbricoides at 58.3%, followed by 30% of individuals hosting E. histolytica , and A. duodenales was isolated in 11.7% of the diagnosed individuals. 12 In all these studies, the prevalence of intestinal parasitosis remains high, with intestinal protozoa being more frequent than helminths. We note some differences, that we attribute to the fact that these studies were conducted in different regions with varying hygienic conditions. Specifically, studies in Tunisia provide percentages of intestinal helminths and protozoa relative to the total number of people affected by intestinal parasitosis, while our study shows the actual prevalence of each specific parasite type within the total population studied. 45 patients (24.13%) were infested by multiple intestinal parasites simultaneously, with 19.79% combining at least one helminth and one protozoan. The most frequent combination was E. histolytica and A. lumbricoides , with 27 cases (14.44%). Other studies have noted cases of polyparasitism. A study conducted in Benin between 2005 and 2013 by Sissinto et al. showed a polyparasitism rate of 17.4% (3.09% of the total study population). The most common associations were Blastocystis hominis + E. histolytica/dispar (20.1%), Entamoeba coli + E. histolytica/dispar (17.2%), and B. hominis + Endolimax nana (11.7%). In Morocco, Zouitni reported a polyparasitism rate of 63.15% (27.2% of their study population). In the DRC, Woolf K. et al. reported a polyparasitism prevalence of 23.41%. We note similarities between our polyparasitism rate and those found in the last two studies mentioned. 7 , 10 , 17 Intestinal parasitosis were more frequent among children (95.00%) and elderly adults (88.89%). They were also more frequent among women (78.49%) than men (72.34%). In their study among children under 5 years old in Kivu, DRC, Woolf K. et al. recorded a prevalence of intestinal parasitosis of 94%, very close to the rate recorded in our study for children. In Guinea a meta-analysis showed a high prevalence of intestinal parasitosis among children under (37% of cases). A study in Bangui by Lango Y. et al. showed a higher prevalence of intestinal parasitosis in women (35.10%) compared to men (32.89%). 3 , 10 , 16 , 18 There was no statistically significant association between season and the prevalence of intestinal parasitosis in general, nor with intestinal helminthiasis or protozoan infections. In the DRC, a study conducted in Sake (Kivu) among 504 children under 5 years old showed no association between season and the prevalence of intestinal parasitosis. 10 These results underscore the need to study the behaviors adopted by the population during different seasons to identify factors that directly affect the prevalence of parasitosis. As highlighted in the introduction, this region is known for its poor hygiene conditions, with frequent shortages of drinking water and poor waste management, especially for fecal matter. The strength of this study lies in providing prevalence data for different types of intestinal parasitosis in Kasai Oriental, where such data had not been published until now. The weakness of this study lies in the fact that the direct stools examination differentiate E. histolytica from E. dispar ; The techniques of enrichment of stools specific to certain parasites were not carried out and certain intestinal parasites, such as S. stercoralis and Schistosoma, require serological tests in addition to the examination of stools because they are often not detected by this examination. We believe that the prevalences of certain intestinal parasites could be underestimated. The small sample size and selection bias (hospital-based, symptomatic patients), limiting generalizability. The lack of data on confounding factors (socioeconomic status, water, sanitation). The prevalence of intestinal parasitosis among symptomatic patients at CHUNDE, East Kasai, is considerably higher than reported in other African and international studies. This difference is due to the fact that the study took place in symptomatic patients. The predominance of protozoa over helminths is consistent with other studies, though the distribution of specific species varies by region. Polyparasitism was frequent and underscored the heavy burden of infection in this population. Seasonal variations were noted, but without statistical significance, suggesting that transmission is consistently high year-round. Conclusion This study provides the first published prevalence data on intestinal parasitosis in East Kasai. The prevalence of intestinal parasitosis was higher among symptomatic patients at CHUNDE, with protozoa more frequent than helminths. Polyparasitism was common. There is no statistically valid association between the season and the prevalence of intestinal parasitosis. Author contributions • Conception and implementation: All authors • Financial support: All authors • Administrative support: Lufuluabu M. Alphonse and Tshishimbi Jean Hubert • Provision of study material or patients: All authors • Data collection and assembly: Lufuluabu M. Alphonse and Tshodi B. Arsène • Data analysis and interpretation: All authors • Manuscript writing: All authors • Final manuscript approval: All authors • Responsible for all aspects of the work: All authors Disclosure statement The authors are employees of the University of Mbujimayi, all in training at its medical faculty and assigned to its University Hospital Center Notre-Dame de l’Espérance. Ethics and consent This study received approval from the ethics committee of the University of Mbujimayi on N52/CEUM1209 of 11th December 2019. It was conducted in accordance with the requirements of good clinical practices and the principles of the Helsinki Declaration of the World Medical Association, along with any subsequent relevant amendments. All patients who have participated in this study have provided their written informed consent by signing a written document, the consent form. Context Key findings • The prevalence of intestinal parasitosis was high, at 75.40%. • Intestinal amebiasis had the highest prevalence, at 55.08%. • The prevalence of intestinal parasitosis was higher during the dry season. • The prevalence was higher in children. Additional knowledge • There is no statistically significant association between season and intestinal parasitosis. Global health impact on policies and actions • Intestinal parasitosis are a major global public health problem. • Intestinal amebiasis should be considered part of the Neglected Tropical Diseases (NTDs). • In relation to SDG 6, there is a need to raise awareness and educate the population on hygiene. • Funding longitudinal data collection is necessary to better understand the factors influencing the prevalence of intestinal parasitosis across seasons. Data availability Figshare: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center. [Dataset]. figshare. 2023. https://doi.org/10.6084/m9.figshare.28050665.v1 . 19 This study contains the following underlying data: Data.xls (anonymized results of microscopic examination of stools, yes=positive, no=negative, na=not attributable, p=rainy season, s=dry season, pro=protozoa, hel=helminth, adu=adult, enf=child, vieux=elder, eh=E. hystolytica giar=G. lamblia, tric=P. hominis, al=A. lumbricoides, sm=S. mansoni, ank=A. duodenales, ox=E. vermicularis ). Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0). Acknowledgements We would like to thank the University of Mbujimayi for allowing us to conduct our study at its University Hospital Center Notre-Dame de l’Espérance. Bibliography 1. 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Publisher Full Text Comments on this article Comments (0) Version 3 VERSION 3 PUBLISHED 09 Jan 2025 ADD YOUR COMMENT Comment Author details Author details 1 internal medecine, University of Mbuji-Mayi, Mbuji-mayi, Kasai oriental, Democratic Republic of the Congo 2 pediatrics, University of Mbuji-Mayi, Mbuji-Mayi, Kasai oriental, Democratic Republic of the Congo 3 gynecology obstetric, university of Mbuji-Mayi, Mbuji-Mayi, Kasai oriental, Democratic Republic of the Congo lufuluabu mpemba Alphonse Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Tshishimbi kalala Jean Hubert Roles: Conceptualization, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Tshodi bulanda Arsène Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (3) version 3 Revised Published: 06 Oct 2025, 14:50 https://doi.org/10.12688/f1000research.160135.3 version 2 Revised Published: 09 Sep 2025, 14:50 https://doi.org/10.12688/f1000research.160135.2 version 1 Published: 09 Jan 2025, 14:50 https://doi.org/10.12688/f1000research.160135.1 Copyright © 2025 Alphonse lm et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Alphonse lm, Jean Hubert Tk and Arsène Tb. 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Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 3 VERSION 3 PUBLISHED 06 Oct 2025 Revised Views 0 Cite How to cite this report: Sah AK. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.189165.r420835 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v3#referee-response-420835 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 09 Oct 2025 Ashok Kumar Sah , A’ Sharqiyah University, Ibra, Oman Approved VIEWS 0 https://doi.org/10.5256/f1000research.189165.r420835 Thank you for your message. I have reviewed the revised manuscript and noted the authors’ responses and modifications. The revisions have appropriately addressed the concerns raised in my initial review. I am satisfied with the current version and recommend ... Continue reading READ ALL Thank you for your message. I have reviewed the revised manuscript and noted the authors’ responses and modifications. The revisions have appropriately addressed the concerns raised in my initial review. I am satisfied with the current version and recommend the manuscript for acceptance. Competing Interests: No competing interests were disclosed. Reviewer Expertise: Medical laboratory science- Clinical chemistry, Pathology, diagnostics, carncer diagnostics I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Sah AK. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.189165.r420835 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v3#referee-response-420835 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Wakid MH. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.189165.r420836 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v3#referee-response-420836 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 09 Oct 2025 Majed H. Wakid , Special Infectious Agents Unit, King Fahd Medical Research Center, Jeddah, Makkah Province, Saudi Arabia Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.189165.r420836 I noticed that there are no responses to my comments for Version 2, which included many major issues. The authors did not take any of my comments into consideration in Version 3. Please see my comments in Version ... Continue reading READ ALL I noticed that there are no responses to my comments for Version 2, which included many major issues. The authors did not take any of my comments into consideration in Version 3. Please see my comments in Version 2 and amend the manuscript accordingly. Competing Interests: No competing interests were disclosed. Reviewer Expertise: Professor and consultant with 30 years of experience in Diagnostic Medical Parasitology. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Wakid MH. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.189165.r420836 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v3#referee-response-420836 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Arrieta SNE. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.189165.r413874 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v3#referee-response-413874 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 08 Oct 2025 Sandra Noemi Escobar Arrieta , Public university in Riobamba Canton, Riobamba Canton, Ecuador; FACULTAD DE CIENCIAS, Escuela Superior Politecnica de Chimborazo (Ringgold ID: 27880), Riobamba, Chimborazo Province, Ecuador Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.189165.r413874 An overview of the article Within an environment with limited resources, the manuscript "Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo" tackles a significant ... Continue reading READ ALL An overview of the article Within an environment with limited resources, the manuscript "Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo" tackles a significant public health concern. The study looks into how common intestinal parasite infections are in patients who have symptoms and whether there is any correlation between them and seasonal variation. All things considered, I think the subject is pertinent, and the manuscript offers useful information for the area. However, before the work can be deemed scientifically sound and appropriate for indexing, a number of methodological, analytical, and presentational concerns must be resolved. General remarks and suggestions 1. The literature review, clarity, and presentation are just partially sufficient. I believe that further language correction would improve the paper. Many grammatical errors, inconsistent terminology, and inaccurate scientific names are present. For example, scientific names are not formatted in accordance with taxonomic norms, and terminology such as parasitoses and parasitosis are used interchangeably. In addition, several of the references that are mentioned are out of date—some of them are over 15 years old—and a number of them are either not in English or do not have all necessary citation information. I strongly advise adding recent studies (2020–2025) to the bibliography, such as more recent African studies and recent WHO reports. The article would also benefit from an improved introduction that highlights the knowledge gap in the Kasai Oriental region. 2. The technique and study design are just partially sufficient. Although the study's sample method is advertised as random, it really involved successive sampling of individuals with symptoms who were referred for stool analysis. This limits how far the results may be applied and increases selection bias. This should be made explicit by the authors in the discussion and methods sections. Furthermore, the diagnostic method is restricted because it only uses direct wet mount microscopy. This method is insensitive and probably understates the actual prevalence. There were no molecular, concentration, or serological techniques employed, and it should be made clearer that E. histolytica and E. dispar cannot be distinguished from one another. Significant methodological information is also lacking, including the laboratory that conducted the analyses, the manner in which demographic data were gathered, and if any quality control protocols were adhered to. 3. Reproducibility and availability of data: Only partially sufficient The work is missing a few important features that would enable complete reproducibility, even if the dataset is accessible on Figshare. These consist of details about sample handling, the staff members doing the analysis, quality control, and contextual elements like socioeconomic status or personal hygiene habits. It would be challenging for other researchers to replicate without these specifics. 4. Interpretation and statistical analysis: Only partially sufficient Fisher's exact test and chi-square are suitable statistical techniques for fundamental analysis, but they don't account for potential confounding variables like age, sex, hygiene, or socioeconomic status. Additionally, the data and the interpretation of the results can occasionally be at odds. For instance, despite the fact that the results show no statistically significant correlation (p > 0.05), the discussion highlights that prevalence was higher during the dry season. The abstract, discussion, and conclusions should all be revised to correct this misunderstanding. 5. Conclusions: The findings partially corroborate these conclusions. Other inferences, like the correlation with season, are not statistically justifiable, even though the data supports the conclusion that the prevalence of parasitic illnesses is high. Furthermore, important limitations such the limited sample size, diagnostic difficulties, and selection bias are not adequately acknowledged in the conclusions. It is also crucial to emphasize that the results cannot be directly extrapolated to the broader community because they are based on a sample of symptomatic patients from a hospital. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly References 1. Alphonse L, Jean Hubert T, Arsène T: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo. F1000Research . 2025; 14 . Publisher Full Text Competing Interests: No competing interests were disclosed. Reviewer Expertise: I have expertise in the following areas, which allow me to adequately assess the scientific content of this article: Parasitology, Basic and Clinical Microbiology, Food Microbiology, Cytology, Hematology, and Blood Analysis. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Arrieta SNE. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.189165.r413874 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v3#referee-response-413874 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 2 VERSION 2 PUBLISHED 09 Sep 2025 Revised Views 0 Cite How to cite this report: Sah AK. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.187631.r413877 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v2#referee-response-413877 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 27 Sep 2025 Ashok Kumar Sah , A’ Sharqiyah University, Ibra, Oman Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.187631.r413877 The manuscript is well-written, thoroughly analyzed, and presented in a clear and constructive manner. I would like to commend all the authors for their hard work and contributions. However, I have a few suggestions to enhance the scientific soundness and ... Continue reading READ ALL The manuscript is well-written, thoroughly analyzed, and presented in a clear and constructive manner. I would like to commend all the authors for their hard work and contributions. However, I have a few suggestions to enhance the scientific soundness and overall readability of the paper: Sample Size and Prevalence Rate : The sample size appears to be quite small, yet the reported prevalence is notably high at 75.40%. It would strengthen the manuscript if the authors could discuss this apparent discrepancy—perhaps by providing justification for the sample size, addressing potential sampling bias, or contextualizing the prevalence rate within the broader population. References : Several of the references cited are outdated. Updating the reference list to include more recent studies from the last five years would enhance the scientific rigor and relevance of the manuscript. I believe addressing these points will improve the overall quality and impact of the study. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Medical laboratory science- Clinical chemistry, Pathology, diagnostics, carncer diagnostics I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Sah AK. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.187631.r413877 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v2#referee-response-413877 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 09 Oct 2025 lufuluabu mpemba Alphonse , Médecine interne, université de Mbuji-Mayi, Mbujimayi, Democratic Republic of the Congo 09 Oct 2025 Author Response Thank you very much for your comments. We have added them. Competing Interests: No competing interests were disclosed. Thank you very much for your comments. We have added them. Thank you very much for your comments. We have added them. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 09 Oct 2025 lufuluabu mpemba Alphonse , Médecine interne, université de Mbuji-Mayi, Mbujimayi, Democratic Republic of the Congo 09 Oct 2025 Author Response Thank you very much for your comments. We have added them. Competing Interests: No competing interests were disclosed. Thank you very much for your comments. We have added them. Thank you very much for your comments. We have added them. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Wakid MH. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.187631.r412656 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v2#referee-response-412656 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 25 Sep 2025 Majed H. Wakid , Special Infectious Agents Unit, King Fahd Medical Research Center, Jeddah, Makkah Province, Saudi Arabia Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.187631.r412656 Please send a point-by-point response to each comment. General Comments - The authors didn't take most of my comments into consideration. I will add them again. - The suggested references (my articles) are very ... Continue reading READ ALL Please send a point-by-point response to each comment. General Comments - The authors didn't take most of my comments into consideration. I will add them again. - The suggested references (my articles) are very recent and relevant to the topic, and I have not received any regulations or objections from the journal regarding this. - The title in the “word” file does not match the title in the “pdf” file. - The authors still use “Mbuji-Mayi or “Mbuji-mayi” in their affiliations. - Additional references are still needed. - Some scientific names still need corrections, including the spelling or species presentation. [The genus name should be written in italics and capitalized, while the species name should also be written in italics but in lowercase. After the first mention, the genus name should be abbreviated to its first capital letter, also in italics, followed by a period and a space]. - When et al is applied, only the family name of the author is used in addition to the year of publication. For example, - Most of the references are still written in a language other than English. - There is no “Conclusion” section at the end of the manuscript. - No limitations were added at the end of ‘Discussion’ section. - The author roles on page 2 are not the same as on page 11. Abstract - Some scientific names spelling in the “Result” still need correction. - The conclusion is still not related to the study area. Introduction - Line 3: Reference [2] is old, replace it with the suggested recent study [Al-Refai MF, Wakid MH: Prevalence of intestinal parasites and comparison of detection techniques for soil-transmitted helminths among newly arrived expatriate labors in Jeddah, Saudi Arabia. PeerJ . 2024; 12: e16820]. - Reference 6 is not from the World Health Organization and is old (2008). A recent reference from a WHO publication or report should be added. - Reference 8 is not related to the 2016 Algeria study. - The presentation of some scientific names still needs correction including spelling. Methods - The authors have not yet explained how they obtained the age and sex of the patients. Is there a questionnaire? - Which laboratory department received the samples and who performed the microscopic examination? - Macroscopic examination of the stool is very important to detect its color, consistency, and presence of adult worms or tapeworm segments. Have you performed it? - A direct stool examination alone is not a sufficient laboratory test for detecting intestinal parasites. Furthermore, the steps described above are completely unrelated to a direct smear. One gram of stool can’t be mixed with one milliliter of saline, a microscope slide, (The correct amount is 1 mg of stool and one drop of saline). Use the suggested reference: [Bahwaireth EO, Wakid MH: Molecular, microscopic, and immunochromatographic detection of enteroparasitic infections in hemodialysis patients and related risk factors. Foodborne Path. Dis . 2022; 19: 830-838.] - You can’t name the specific parasites you want to examine, as other parasites may be detected. - Written informed consent could not be obtained from the child. Please amend the sentence to read: "Written informed consent was obtained from the patients or their guardian, where applicable.". Results - Correct “women/ woman” and “men/ man” to “female” and “male”, where applicable in the whole manuscript. - Lines 4-5: Unify the name of each “Age group” in the text, with Tables 1 and 2, and where applicable in the whole manuscript. - Remove the explanation of each age group in Table 1. - Table 1: Correct “Age groups” to “Age group”, and “childreen” to “Children”. - Delete “categories” from the x-axis in Figure 1, and Figure 2. - Table 2, some words were written in non-English letters. - Correct the scientific names ( S. mansoni ) in Table 5. - What are (yes) and (no) used in Figures 1 and 2? Present only positive cases. Discussion - Correct the presentation of several scientific names. - Correct and modify the whole text in paragraph 2. The references (7,14,15) relate to Morocco, Brazil and Tunisia respectively. Add the reference number of the study discussed directly after it, not at the end of the paragraph. - Paragraph 3: correct to “In Tunisia, Cheikhrouhou et al. (2009)….”. - Paragraph 4: correct to “In the DRC, Nimo (2008)….”. - Correct and modify the whole text in paragraph 6. The references (7,10,17) relate to Morocco, DR Congo and Benin respectively. Add the reference number of the study discussed directly after it, not at the end of the paragraph. - Benin study from 2003 to 2015 not from 2005 to 2013. - Correct to “…by Sissinto-savi et al. (2018), showed….”. - Correct Woolf et al. to “Kapiteni et al. (2019),”. - Correct and modify the whole text in paragraph 7. The references (3,10,16,18) relate to Central African Republic, DR Congo, and Tunisia, respectively (3 and 18 for the same refrence). Add the reference number of the study discussed directly after it, not at the end of the paragraph. - Correct Woolf et al. to “Kapiteni et al. (2019),”. - Correct to “In Tunisia, Cheikhrouhou et al. (2009), showed….”. - Correct to “A study in Central African Republic by Lango-Yaya. et al. (2021), showed….”. - The limitations statement for this study has not been added yet. (Our findings are based on routine diagnostic procedures performed in CHUNDE on individuals referred to the study area. Therefore, despite its strategic geographic location and high patient population, these findings may not apply to the entire population. Furthermore, the stool samples in this study were not tested using any of the concentration techniques, which increases the possibility of detecting diagnostic stages of the intestinal parasites. Therefore, a major limitation of this study is the possibility that some intestinal parasite cases may be underreported due to the limitations of the direct wet examination [Reference: Alqarni AS, Wakid MH, Gattan HS. Prevalence, type of infections and comparative analysis of detection techniques of intestinal parasites in the province of Belgarn, Saudi Arabia. PeerJ. 2022; 10: e13889].). Add a “Conclusion” section after the “Discussion” section . Data availability Use suitable abbreviations for the corrected names of the parasites. References - Most of the references are still written in a language other than English. - Reference No. 3 repeated in No. 18. - Data for most references is incomplete. - The references style does not comply with the journal's guidelines. - After adding suggested references/removing duplicate references, renumber in-text citations and references list. References 1. Bahwaireth E, Wakid M: Molecular, Microscopic, and Immunochromatographic Detection of Enteroparasitic Infections in Hemodialysis Patients and Related Risk Factors. Foodborne Pathogens and Disease . 2022; 19 (12): 830-838 Publisher Full Text 2. Alqarni A, Wakid M, Gattan H: Prevalence, type of infections and comparative analysis of detection techniques of intestinal parasites in the province of Belgarn, Saudi Arabia. PeerJ . 2022; 10 . Publisher Full Text 3. Al-Refai M, Wakid M: Prevalence of intestinal parasites and comparison of detection techniques for soil-transmitted helminths among newly arrived expatriate labors in Jeddah, Saudi Arabia. PeerJ . 2024; 12 . Publisher Full Text Competing Interests: No competing interests were disclosed. Reviewer Expertise: Professor and consultant with 30 years of experience in Diagnostic Medical Parasitology. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Wakid MH. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.187631.r412656 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v2#referee-response-412656 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Bracho Mora A. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.187631.r413872 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v2#referee-response-413872 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 23 Sep 2025 Angela Bracho Mora , Universidad Técnica de Manabí, Portoviejo, Ecuador Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.187631.r413872 In the abstract: They must change the language “Intestinal parasitoses” I suggest not writing acronyms in this section. Writing full D.R If they only used conventional techniques, the way of writing is not Entamoeba histolytica. Pentstrichomonas ... Continue reading READ ALL In the abstract: They must change the language “Intestinal parasitoses” I suggest not writing acronyms in this section. Writing full D.R If they only used conventional techniques, the way of writing is not Entamoeba histolytica. Pentstrichomonas hominis is Pentatrichomonas hominis Ascaris lumbrucoide is Ascaris lumbricoides In the introduction: Change Endolimax nanus Change reference number 9 because it is very older. The correct form of Schistosoma M is S. mansoni. This sentence: The prevalence of intestinal parasitic infections is likely very high at CHUNDE and may be associated with the season. It’s isolated In the article it is not recommended to write specifics objectives In the results: Entamoeba histolytica is not recommended to write because no used molecular techniques are used in the study. Leave a single title on the figures In the Discussion There is a need for further discussion of the results since they are only compared with other works that are very old without giving their own interpretation and do not have a conclusion of the work General comments The paper seems to be written in a language other than English, and it is necessary to check the translation as there are words that are not in this language. There are spelling errors that must be corrected and correct use of upper- and lower-case letters It has some old references that should be changed Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? No Competing Interests: No competing interests were disclosed. Reviewer Expertise: Parasitology, Epidemiology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Bracho Mora A. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.187631.r413872 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v2#referee-response-413872 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 26 Sep 2025 lufuluabu mpemba Alphonse , Médecine interne, université de Mbuji-Mayi, Mbujimayi, Democratic Republic of the Congo 26 Sep 2025 Author Response Thank you for the feedback. We Have incorporated it. For the titles of figures, it depends on the Journal. Competing Interests: No competing interests were disclosed. Thank you for the feedback. We Have incorporated it. For the titles of figures, it depends on the Journal. Thank you for the feedback. We Have incorporated it. For the titles of figures, it depends on the Journal. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 26 Sep 2025 lufuluabu mpemba Alphonse , Médecine interne, université de Mbuji-Mayi, Mbujimayi, Democratic Republic of the Congo 26 Sep 2025 Author Response Thank you for the feedback. We Have incorporated it. For the titles of figures, it depends on the Journal. Competing Interests: No competing interests were disclosed. Thank you for the feedback. We Have incorporated it. For the titles of figures, it depends on the Journal. Thank you for the feedback. We Have incorporated it. For the titles of figures, it depends on the Journal. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Girma A. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.187631.r412655 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v2#referee-response-412655 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 18 Sep 2025 Abayeneh Girma , Mekdela Amba University, Tulu Awuliya, Ethiopia Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.187631.r412655 General comments The study addresses a relevant public health issue in a resource-limited setting. It reports a very high prevalence of intestinal parasitosis (75.4%) and investigates an important potential environmental driver: seasonality. However, the manuscript in its current form ... Continue reading READ ALL General comments The study addresses a relevant public health issue in a resource-limited setting. It reports a very high prevalence of intestinal parasitosis (75.4%) and investigates an important potential environmental driver: seasonality. However, the manuscript in its current form has significant methodological flaws, presentation issues, and statistical limitations that substantially weaken its conclusions and impact. Major revisions are required before it can be considered for indexing. 1. Abstract: The conclusion that "prevalence was higher during the dry season" directly contradicts the stated result of "no statistically valid association." This must be corrected to align with the statistical findings. Again, The term "Intestinal amebiasis" should be replaced with " Entamoeba histolytica/dispar complex" to reflect the diagnostic limitation accurately. Moreover, the specific prevalence rates should be formatted correctly (e.g., E. histolytica , P. hominis ). 2. Introduction: The background is generally good and establishes the public health importance of the topic. It could be slightly strengthened by more explicitly stating the knowledge gap for the specific region of Kasai Oriental. 3. Methods, particularly on study design: Labeling it as "random sampling" is incorrect. Consecutive sampling of patients meeting the inclusion criteria is a better description. 4. Discussion: The structure should be improved to flow from key findings -> comparison with literature -> interpretation -> limitations -> conclusion. Again, the discussion fails to adequately acknowledge the study's primary limitation: the diagnostic method. This should be the first point discussed. Additionally, comparisons with studies that used more sensitive diagnostic techniques are of limited validity and should be made with extreme caution. Moreover, the speculation about hygiene conditions is not supported by any data collected in this study. 5. Limitations: The listed limitations in the manuscript are insufficient. The following must be added: The use of direct smear only, leading to an underestimation of prevalence. The inability to differentiate E. histolytica from E. dispar . The small sample size and selection bias (hospital-based, symptomatic patients), limiting generalizability. The lack of data on confounding factors (socioeconomic status, water, sanitation). 6. Conclusion: The conclusions are not fully supported by the data. They should be tempered significantly: Instead of "The prevalence of intestinal parasitosis was higher," state: "A high prevalence of intestinal parasites was observed among symptomatic patients at this hospital, but the true community prevalence is likely different." Again, the conclusion on seasonality should clearly state that no statistically significant association was found, likely due to limited power and other unmeasured confounding factors. 7. References: Some references are quite old (e.g., Faye 1998, and remaining two studies each conducted in 2008 and 2009). It should also be formatted uniformly according to the journal's guidelines. Competing Interests: No competing interests were disclosed. Reviewer Expertise: Microbiology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Girma A. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.187631.r412655 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v2#referee-response-412655 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 26 Sep 2025 lufuluabu mpemba Alphonse , Médecine interne, université de Mbuji-Mayi, Mbujimayi, Democratic Republic of the Congo 26 Sep 2025 Author Response Thank you for the comments. We have integrated them. However, we did not change article number 4 because we only took an idea from it and not statistics on the ... Continue reading Thank you for the comments. We have integrated them. However, we did not change article number 4 because we only took an idea from it and not statistics on the prevalence of parasitoses that can vary. Thank you for the comments. We have integrated them. However, we did not change article number 4 because we only took an idea from it and not statistics on the prevalence of parasitoses that can vary. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 26 Sep 2025 lufuluabu mpemba Alphonse , Médecine interne, université de Mbuji-Mayi, Mbujimayi, Democratic Republic of the Congo 26 Sep 2025 Author Response Thank you for the comments. We have integrated them. However, we did not change article number 4 because we only took an idea from it and not statistics on the ... Continue reading Thank you for the comments. We have integrated them. However, we did not change article number 4 because we only took an idea from it and not statistics on the prevalence of parasitoses that can vary. Thank you for the comments. We have integrated them. However, we did not change article number 4 because we only took an idea from it and not statistics on the prevalence of parasitoses that can vary. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 09 Jan 2025 Views 0 Cite How to cite this report: Abaka-Yawson A. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.175968.r399022 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v1#referee-response-399022 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 27 Aug 2025 Albert Abaka-Yawson , University of Ghana, Legon, Ghana Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.175968.r399022 ABSTRACT i. Authors should remove prevalence figures from background since they would be no opportunity to add reference ii. Methods section fails to talk about the study design and the sampling technique iii. You used "parasitoses" and ... Continue reading READ ALL ABSTRACT i. Authors should remove prevalence figures from background since they would be no opportunity to add reference ii. Methods section fails to talk about the study design and the sampling technique iii. You used "parasitoses" and "parasitosis" interchangeably in background and results section. Streamline that. iv. At the results section, parasites are presented as "Enterobius V., Schistosoma M. etc." consider rewriting them as "E. vermicularis, S. mansoni etc". In other words rather write the species in full and abbreviate the genus. v. Check spelling of various words throughout the manuscript. For instance, "Ancylostoma" not "Ankylostoma" MAIN WORK I. Remove general and specific objectives. Unless it aligns with journal's style ii. The methods section fails to capture the study design and sampling technique ii. Under results section, merge all 5 tables to one iii. Table 1: Remove ratio under sex iv. Authors should consider keeping just one. Either mean or median ages. Use only the best measure of central tendency v. Table 2: Under age, various categories are in French i.e., Enfants, Adultes etc. vi. Discussion should not be bulletins and also reduce the numbers and repetition of results. Focus on discussing the results in the light of other studies as well as its implications on patients and future studies. vii. Also consider adding limitations to the latter part of the discussion GENERAL COMMENTS The manuscript is currently not in a indexing state but holds potential for improvement. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? No Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? I cannot comment. A qualified statistician is required. Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Neglected Tropical Diseases, Parasitology, Infectious Diseases Epidemiology, Laboratory Medicine I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Abaka-Yawson A. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.175968.r399022 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v1#referee-response-399022 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Wakid MH. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.175968.r399028 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v1#referee-response-399028 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 25 Aug 2025 Majed H. Wakid , Special Infectious Agents Unit, King Fahd Medical Research Center, Jeddah, Makkah Province, Saudi Arabia Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.175968.r399028 A- General Comments - Mbuji-Mayi or Mbujimayi? - Additional references are required. - Scientific names need to be corrected throughout the manuscript (including Figures and Tables). The genus name should be written in italics and capitalized, while ... Continue reading READ ALL A- General Comments - Mbuji-Mayi or Mbujimayi? - Additional references are required. - Scientific names need to be corrected throughout the manuscript (including Figures and Tables). The genus name should be written in italics and capitalized, while the species name should also be written in italics but in lowercase. After the first mention, the genus name should be abbreviated to its first capital letter, also in italics, followed by a period and a space. Thus, Entamoeba histolytica becomes E. histolytica . This must be done in both the abstract and the main text. - The name Trichomonas intestinalis is no longer used. - Some words were written in non-English letters. - There is no Conclusion section at the end of the manuscript. - There are some limitations to the study that should be mentioned. - In Author roles, delete “Funding Acquisition”, as there is no fund for this study. - Is it correct that the first letter of some authors name is written in lowercase? - D. R. Congo or DRC? also was abbreviated without the full name at first mention. B- Title - Add the country name to the title. C- Abstract - In the “Background” you mentioned that the prevalence in Africa is 42.18%, but in the Introduction section it is 43.12. - In the “objectives”, you must add the study area. - Correct all scientific names in the “Result”. - Use Ancylostoma , which is the preferred spelling, instead of Ankylostoma . - in the “Conclusion”, relate your conclusion to the study area. D- Introduction - Line 2: correct to “As a result, they are rarely a reason for regular consultation and are often neglected”. - Replace reference [2], with a recent study [Al-Refai MF, Wakid MH: Prevalence of intestinal parasites and comparison of detection techniques for soil-transmitted helminths among newly arrived expatriate labors in Jeddah, Saudi Arabia. PeerJ . 2024; 12: e16820]. - (WHO, 2023), should be given a reference number and added to the reference list. - Correct “ABOU BEKR BELKAID” to “Abou Bekr Belkaid”. - Correct all scientific names. - Include the objectives as a separate paragraph at the end of the Introduction section. E- Methods - The authors didn’t mention the sample collection instructions provided to the patients. - The authors didn’t explain how they obtained the patients' age and sex. A questionnaire? - Which laboratory department received the samples and who performed the microscopic examination? - Macroscopic examination of the stool is very important to detect its color, consistency, and presence of adult worms or tapeworm segments. Have you performed it? - A direct stool examination alone is not a sufficient laboratory test for detecting intestinal parasites. Furthermore, the steps described above are completely unrelated to a direct smear. Two grams of stool equals approximately half a teaspoon, and when mixed with one milliliter of saline, it cannot be mixed on a microscope slide, (The correct amount is 1 mg of stool and one drop of saline). Direct iodine smear and permanent staining are also necessary methods to observe and confirm diagnostic features for identifying protozoan parasites. You can add this reference for these techniques (Macroscopic, Microscopic: direct saline, direct iodine, and permanent staining) [Bahwaireth EO, Wakid MH: Molecular, microscopic, and immunochromatographic detection of enteroparasitic infections in hemodialysis patients and related risk factors. Foodborne Path. Dis . 2022; 19: 830-838.] - There is no need to list the names of the parasites, as other parasites may be detected. - P value statistical significance was not mentioned in the statistical analysis. - Written informed consent could not be obtained from the child. Please amend the sentence to read: "Written informed consent was obtained from the patients or their guardian, where applicable.". F- Results - Unify the name of each age group in the text, tables and figures. - Correct scientific names in the text, figures and tables. - Correct “women” and “men” to “male” and “female”, where applicable in the text, and tables. - The "Frequencies of intestinal protozoa" results section needs correction as in this section you represented results for helminths compared to E. histolytica . - The name “ Trichomonas intestinalis ” is no longer used. Are you referring to Retortamonas intestinalis or Pentatrichomonas hominis ? - Delete Figure 1, which adds no value to the results. - Table 2, some words were written in non-English letters. - Figures 2 and 3, are not in English, also these are not different types. What is yes and no used for? - Represent Figures 4, 5 and 6 in English. G- Discussion - The discussion section should not contain subheadings. - Correct the presentation of the scientific names. - You should mention the limitations of this study, with the suggested reference: (Our findings are based on routine diagnostic procedures performed in CHUNDE on individuals referred to the study area. Therefore, despite its strategic geographic location and high patient population, these findings may not apply to the entire population. Furthermore, the stool samples in this study were not tested using any of the concentration techniques, which increases the possibility of detecting diagnostic stages of the intestinal parasites. Therefore, a major limitation of this study is the possibility that some intestinal parasite cases may be underreported due to the limitations of the direct wet examination [Alqarni AS, Wakid MH, Gattan HS. Prevalence, type of infections and comparative analysis of detection techniques of intestinal parasites in the province of Belgarn, Saudi Arabia. PeerJ. 2022; 10: e13889].). H- Add a Conclusion section. I- References - After adding the three suggested references, the total becomes 21 references. The references should be renumbered in the text citations and the references list. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? No Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly References 1. Al-Refai M, Wakid M: Prevalence of intestinal parasites and comparison of detection techniques for soil-transmitted helminths among newly arrived expatriate labors in Jeddah, Saudi Arabia. PeerJ . 2024; 12 . Publisher Full Text 2. Bahwaireth E, Wakid M: Molecular, Microscopic, and Immunochromatographic Detection of Enteroparasitic Infections in Hemodialysis Patients and Related Risk Factors. Foodborne Pathogens and Disease . 2022; 19 (12): 830-838 Publisher Full Text 3. Alqarni A, Wakid M, Gattan H: Prevalence, type of infections and comparative analysis of detection techniques of intestinal parasites in the province of Belgarn, Saudi Arabia. PeerJ . 2022; 10 . Publisher Full Text Competing Interests: No competing interests were disclosed. Reviewer Expertise: Professor and Consultant in Diagnostic Medical Parasitology. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Wakid MH. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.175968.r399028 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v1#referee-response-399028 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 10 Sep 2025 lufuluabu mpemba Alphonse , Médecine interne, université de Mbuji-Mayi, Mbujimayi, Democratic Republic of the Congo 10 Sep 2025 Author Response Thank you very much for insightful comments. We will integrate them into the new version of our article. But we have a concern regarding the articles you are proposing to ... Continue reading Thank you very much for insightful comments. We will integrate them into the new version of our article. But we have a concern regarding the articles you are proposing to add. they are all your articles. wouldn't that be a matter of interest or is it allowed by the journal ? Thank you very much for insightful comments. We will integrate them into the new version of our article. But we have a concern regarding the articles you are proposing to add. they are all your articles. wouldn't that be a matter of interest or is it allowed by the journal ? Competing Interests: The reviewer is asking us to add three articles to our manuscript. This is a major change. But all three of these articles are his. Is this permissible? Can we say that without these additions, he would have simply approved our manuscript with remaining modifications ? We are confused Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 10 Sep 2025 lufuluabu mpemba Alphonse , Médecine interne, université de Mbuji-Mayi, Mbujimayi, Democratic Republic of the Congo 10 Sep 2025 Author Response Thank you very much for insightful comments. We will integrate them into the new version of our article. But we have a concern regarding the articles you are proposing to ... Continue reading Thank you very much for insightful comments. We will integrate them into the new version of our article. But we have a concern regarding the articles you are proposing to add. they are all your articles. wouldn't that be a matter of interest or is it allowed by the journal ? Thank you very much for insightful comments. We will integrate them into the new version of our article. But we have a concern regarding the articles you are proposing to add. they are all your articles. wouldn't that be a matter of interest or is it allowed by the journal ? Competing Interests: The reviewer is asking us to add three articles to our manuscript. This is a major change. But all three of these articles are his. Is this permissible? Can we say that without these additions, he would have simply approved our manuscript with remaining modifications ? We are confused Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Girma A. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.175968.r399027 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v1#referee-response-399027 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 23 Aug 2025 Abayeneh Girma , Mekdela Amba University, Tulu Awuliya, Ethiopia Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.175968.r399027 General comments This study investigates the prevalence of intestinal parasitosis and its association with seasonal variation among patients at the Notre Dame de l’Espérance University Hospital Center in the Democratic Republic of the Congo (DRC). The authors report a ... Continue reading READ ALL General comments This study investigates the prevalence of intestinal parasitosis and its association with seasonal variation among patients at the Notre Dame de l’Espérance University Hospital Center in the Democratic Republic of the Congo (DRC). The authors report a high overall prevalence (75.40%), with Entamoeba histolytica and Ascaris lumbricoides being the most common parasites. The study also examines demographic and seasonal trends but finds no statistically significant association between parasitosis prevalence and seasons. While the topic is relevant to public health in tropical regions, the manuscript has several methodological and presentation issues that need addressing before it can be considered for publication. Major comments I. Methodology and analysis Sample size and representativeness: The sample size (187 patients) is relatively small for a two-year study, and the inclusion criteria (only patients referred for stool examination) may introduce selection bias. The authors should clarify whether this sample is representative of the general population or specific subgroups (e.g., symptomatic patients). Seasonal analysis: The definition of "dry" and "rainy" seasons is arbitrary (e.g., dry season: 15/5 to 15/8). The authors should justify this classification and consider regional climatic data. Statistical power: The lack of association between season and parasitosis may reflect inadequate statistical power rather than a true absence of association. A power calculation should be included. Confounding factors: The study does not account for potential confounders (e.g., hygiene practices, water sources, socioeconomic status) that could influence parasitosis prevalence independently of season. II. Results and Interpretation Contradictory findings: The abstract states that the prevalence was higher during the dry season, but the results section notes no significant association. This discrepancy should be resolved. Polyparasitism: The high rate of polyparasitism (24.13%) is noteworthy, but the clinical or epidemiological implications are not discussed. Comparative data: The discussion compares findings to studies in Tunisia, Morocco, and Brazil, but differences in study design, population, and diagnostic methods limit the validity of these comparisons. III. Presentation and clarity Tables and figures: Some tables (e.g., Table 2) are fragmented across pages, making them hard to follow. Figures (e.g., frequency curves) lack clarity in labeling and interpretation. Language and grammar: The manuscript has numerous grammatical errors and awkward phrasing, which hinder readability. Professional editing is recommended. Data availability: The dataset is available, but the description (e.g., "yes=positive, no=negative, na=not attributable") is unclear. A codebook or detailed metadata would improve reproducibility. Minor comments Abstract: The conclusion ("prevalence was higher during the dry season") contradicts the results ("no association"). Revise for consistency. Introduction: The background could better highlight gaps in the DRC-specific literature. Discussion: The high prevalence of Entamoeba histolytica should be contextualized with local diagnostic challenges (e.g., differentiation from E. dispar ). Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Microbiology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Girma A. Reviewer Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.175968.r399027 ) The direct URL for this report is: https://f1000research.com/articles/14-50/v1#referee-response-399027 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 10 Sep 2025 lufuluabu mpemba Alphonse , Médecine interne, université de Mbuji-Mayi, Mbujimayi, Democratic Republic of the Congo 10 Sep 2025 Author Response Thank you very much for the comments on our article, impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l'Espérance University Hospital . We will respond ... Continue reading Thank you very much for the comments on our article, impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l'Espérance University Hospital . We will respond to your concerns in the order in which you listed them. We did not conduct this study in the general population of the eastern region of the city of Mbujimayi served by the University Hospital, but rather at the University Hospital. The 187 subjects live in this region and consulted the University Hospital during the study period and they had symptoms that led the doctors to request direct examination of the stool. So it is a prevalence of intestinal parasitosis in symptomatic subjects who have consulted the University Hospital. The definition of the season is not arbitrary but rather very precise. Please see page 17 of this scientific document ( kasai-oriental.pdf ). We will add this article to the revised version. And 4 Our study focused on the effect of climate on the prevalence of intestinal parasitosis. The finding is the lack of association, although on simple glance the data showed an increase in prevalence during the dry season. We plan to conduct a study in the general population including other factors to increase potency. 2.1 There is no contradiction. High prevalence during the dry season does not necessarily mean that there is an association between the dry season and prevalence. If this were the case, statistical analyses to prove an association would be useless. However, this lack of association shows the interest in looking for other factors that would normally influence this prevalence. 2.2 This is an observation at this stage. Our study, which focused on the relationship between climate and the prevalence of intestinal parasitosis, does not have enough evidence to initiate such a discussion. 2.3 Indeed, we even pointed this out in the discussion. These differences still exist but do not totally limit the comparison. 3.1 It is a technical problem that will be fixed by the Journal. Our figures are clear and accepted by the Journal. 3.2 We will reread our manuscript and correct any errors we find. However, please let us know for fear that these errors will still go unnoticed. 3.3 There is indeed a code guide published with the data. Please check carefully. Minor comments As explained in 2.1, there is no contradiction Thanks for advices in 2 and 3. Thank you very much for the comments on our article, impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l'Espérance University Hospital . We will respond to your concerns in the order in which you listed them. We did not conduct this study in the general population of the eastern region of the city of Mbujimayi served by the University Hospital, but rather at the University Hospital. The 187 subjects live in this region and consulted the University Hospital during the study period and they had symptoms that led the doctors to request direct examination of the stool. So it is a prevalence of intestinal parasitosis in symptomatic subjects who have consulted the University Hospital. The definition of the season is not arbitrary but rather very precise. Please see page 17 of this scientific document ( kasai-oriental.pdf ). We will add this article to the revised version. And 4 Our study focused on the effect of climate on the prevalence of intestinal parasitosis. The finding is the lack of association, although on simple glance the data showed an increase in prevalence during the dry season. We plan to conduct a study in the general population including other factors to increase potency. 2.1 There is no contradiction. High prevalence during the dry season does not necessarily mean that there is an association between the dry season and prevalence. If this were the case, statistical analyses to prove an association would be useless. However, this lack of association shows the interest in looking for other factors that would normally influence this prevalence. 2.2 This is an observation at this stage. Our study, which focused on the relationship between climate and the prevalence of intestinal parasitosis, does not have enough evidence to initiate such a discussion. 2.3 Indeed, we even pointed this out in the discussion. These differences still exist but do not totally limit the comparison. 3.1 It is a technical problem that will be fixed by the Journal. Our figures are clear and accepted by the Journal. 3.2 We will reread our manuscript and correct any errors we find. However, please let us know for fear that these errors will still go unnoticed. 3.3 There is indeed a code guide published with the data. Please check carefully. Minor comments As explained in 2.1, there is no contradiction Thanks for advices in 2 and 3. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 10 Sep 2025 lufuluabu mpemba Alphonse , Médecine interne, université de Mbuji-Mayi, Mbujimayi, Democratic Republic of the Congo 10 Sep 2025 Author Response Thank you very much for the comments on our article, impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l'Espérance University Hospital . We will respond ... Continue reading Thank you very much for the comments on our article, impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l'Espérance University Hospital . We will respond to your concerns in the order in which you listed them. We did not conduct this study in the general population of the eastern region of the city of Mbujimayi served by the University Hospital, but rather at the University Hospital. The 187 subjects live in this region and consulted the University Hospital during the study period and they had symptoms that led the doctors to request direct examination of the stool. So it is a prevalence of intestinal parasitosis in symptomatic subjects who have consulted the University Hospital. The definition of the season is not arbitrary but rather very precise. Please see page 17 of this scientific document ( kasai-oriental.pdf ). We will add this article to the revised version. And 4 Our study focused on the effect of climate on the prevalence of intestinal parasitosis. The finding is the lack of association, although on simple glance the data showed an increase in prevalence during the dry season. We plan to conduct a study in the general population including other factors to increase potency. 2.1 There is no contradiction. High prevalence during the dry season does not necessarily mean that there is an association between the dry season and prevalence. If this were the case, statistical analyses to prove an association would be useless. However, this lack of association shows the interest in looking for other factors that would normally influence this prevalence. 2.2 This is an observation at this stage. Our study, which focused on the relationship between climate and the prevalence of intestinal parasitosis, does not have enough evidence to initiate such a discussion. 2.3 Indeed, we even pointed this out in the discussion. These differences still exist but do not totally limit the comparison. 3.1 It is a technical problem that will be fixed by the Journal. Our figures are clear and accepted by the Journal. 3.2 We will reread our manuscript and correct any errors we find. However, please let us know for fear that these errors will still go unnoticed. 3.3 There is indeed a code guide published with the data. Please check carefully. Minor comments As explained in 2.1, there is no contradiction Thanks for advices in 2 and 3. Thank you very much for the comments on our article, impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l'Espérance University Hospital . We will respond to your concerns in the order in which you listed them. We did not conduct this study in the general population of the eastern region of the city of Mbujimayi served by the University Hospital, but rather at the University Hospital. The 187 subjects live in this region and consulted the University Hospital during the study period and they had symptoms that led the doctors to request direct examination of the stool. So it is a prevalence of intestinal parasitosis in symptomatic subjects who have consulted the University Hospital. The definition of the season is not arbitrary but rather very precise. Please see page 17 of this scientific document ( kasai-oriental.pdf ). We will add this article to the revised version. And 4 Our study focused on the effect of climate on the prevalence of intestinal parasitosis. The finding is the lack of association, although on simple glance the data showed an increase in prevalence during the dry season. We plan to conduct a study in the general population including other factors to increase potency. 2.1 There is no contradiction. High prevalence during the dry season does not necessarily mean that there is an association between the dry season and prevalence. If this were the case, statistical analyses to prove an association would be useless. However, this lack of association shows the interest in looking for other factors that would normally influence this prevalence. 2.2 This is an observation at this stage. Our study, which focused on the relationship between climate and the prevalence of intestinal parasitosis, does not have enough evidence to initiate such a discussion. 2.3 Indeed, we even pointed this out in the discussion. These differences still exist but do not totally limit the comparison. 3.1 It is a technical problem that will be fixed by the Journal. Our figures are clear and accepted by the Journal. 3.2 We will reread our manuscript and correct any errors we find. However, please let us know for fear that these errors will still go unnoticed. 3.3 There is indeed a code guide published with the data. Please check carefully. Minor comments As explained in 2.1, there is no contradiction Thanks for advices in 2 and 3. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 3 VERSION 3 PUBLISHED 09 Jan 2025 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 4 5 6 Version 3 (revision) 06 Oct 25 read read read Version 2 (revision) 09 Sep 25 read read read read Version 1 09 Jan 25 read read read Abayeneh Girma , Mekdela Amba University, Tulu Awuliya, Ethiopia Majed H. Wakid , King Fahd Medical Research Center, Jeddah, Saudi Arabia Albert Abaka-Yawson , University of Ghana, Legon, Ghana Angela Bracho Mora , Universidad Técnica de Manabí, Portoviejo, Ecuador Ashok Kumar Sah , A’ Sharqiyah University, Ibra, Oman Sandra Noemi Escobar Arrieta , Public university in Riobamba Canton, Riobamba Canton, Ecuador; Escuela Superior Politecnica de Chimborazo (Ringgold ID: 27880), Riobamba, Ecuador Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Sah A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 09 Oct 2025 | for Version 3 Ashok Kumar Sah , A’ Sharqiyah University, Ibra, Oman 0 Views copyright © 2025 Sah A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thank you for your message. I have reviewed the revised manuscript and noted the authors’ responses and modifications. The revisions have appropriately addressed the concerns raised in my initial review. I am satisfied with the current version and recommend the manuscript for acceptance. Competing Interests No competing interests were disclosed. Reviewer Expertise Medical laboratory science- Clinical chemistry, Pathology, diagnostics, carncer diagnostics I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Sah AK. Peer Review Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.189165.r420835) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-50/v3#referee-response-420835 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Wakid M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 09 Oct 2025 | for Version 3 Majed H. Wakid , Special Infectious Agents Unit, King Fahd Medical Research Center, Jeddah, Makkah Province, Saudi Arabia 0 Views copyright © 2025 Wakid M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions I noticed that there are no responses to my comments for Version 2, which included many major issues. The authors did not take any of my comments into consideration in Version 3. Please see my comments in Version 2 and amend the manuscript accordingly. Competing Interests No competing interests were disclosed. Reviewer Expertise Professor and consultant with 30 years of experience in Diagnostic Medical Parasitology. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Wakid MH. Peer Review Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.189165.r420836) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-50/v3#referee-response-420836 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Arrieta S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 08 Oct 2025 | for Version 3 Sandra Noemi Escobar Arrieta , Public university in Riobamba Canton, Riobamba Canton, Ecuador; FACULTAD DE CIENCIAS, Escuela Superior Politecnica de Chimborazo (Ringgold ID: 27880), Riobamba, Chimborazo Province, Ecuador 0 Views copyright © 2025 Arrieta S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions An overview of the article Within an environment with limited resources, the manuscript "Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo" tackles a significant public health concern. The study looks into how common intestinal parasite infections are in patients who have symptoms and whether there is any correlation between them and seasonal variation. All things considered, I think the subject is pertinent, and the manuscript offers useful information for the area. However, before the work can be deemed scientifically sound and appropriate for indexing, a number of methodological, analytical, and presentational concerns must be resolved. General remarks and suggestions 1. The literature review, clarity, and presentation are just partially sufficient. I believe that further language correction would improve the paper. Many grammatical errors, inconsistent terminology, and inaccurate scientific names are present. For example, scientific names are not formatted in accordance with taxonomic norms, and terminology such as parasitoses and parasitosis are used interchangeably. In addition, several of the references that are mentioned are out of date—some of them are over 15 years old—and a number of them are either not in English or do not have all necessary citation information. I strongly advise adding recent studies (2020–2025) to the bibliography, such as more recent African studies and recent WHO reports. The article would also benefit from an improved introduction that highlights the knowledge gap in the Kasai Oriental region. 2. The technique and study design are just partially sufficient. Although the study's sample method is advertised as random, it really involved successive sampling of individuals with symptoms who were referred for stool analysis. This limits how far the results may be applied and increases selection bias. This should be made explicit by the authors in the discussion and methods sections. Furthermore, the diagnostic method is restricted because it only uses direct wet mount microscopy. This method is insensitive and probably understates the actual prevalence. There were no molecular, concentration, or serological techniques employed, and it should be made clearer that E. histolytica and E. dispar cannot be distinguished from one another. Significant methodological information is also lacking, including the laboratory that conducted the analyses, the manner in which demographic data were gathered, and if any quality control protocols were adhered to. 3. Reproducibility and availability of data: Only partially sufficient The work is missing a few important features that would enable complete reproducibility, even if the dataset is accessible on Figshare. These consist of details about sample handling, the staff members doing the analysis, quality control, and contextual elements like socioeconomic status or personal hygiene habits. It would be challenging for other researchers to replicate without these specifics. 4. Interpretation and statistical analysis: Only partially sufficient Fisher's exact test and chi-square are suitable statistical techniques for fundamental analysis, but they don't account for potential confounding variables like age, sex, hygiene, or socioeconomic status. Additionally, the data and the interpretation of the results can occasionally be at odds. For instance, despite the fact that the results show no statistically significant correlation (p > 0.05), the discussion highlights that prevalence was higher during the dry season. The abstract, discussion, and conclusions should all be revised to correct this misunderstanding. 5. Conclusions: The findings partially corroborate these conclusions. Other inferences, like the correlation with season, are not statistically justifiable, even though the data supports the conclusion that the prevalence of parasitic illnesses is high. Furthermore, important limitations such the limited sample size, diagnostic difficulties, and selection bias are not adequately acknowledged in the conclusions. It is also crucial to emphasize that the results cannot be directly extrapolated to the broader community because they are based on a sample of symptomatic patients from a hospital. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly References 1. Alphonse L, Jean Hubert T, Arsène T: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo. F1000Research . 2025; 14 . Publisher Full Text Competing Interests No competing interests were disclosed. Reviewer Expertise I have expertise in the following areas, which allow me to adequately assess the scientific content of this article: Parasitology, Basic and Clinical Microbiology, Food Microbiology, Cytology, Hematology, and Blood Analysis. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Arrieta SNE. Peer Review Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.189165.r413874) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-50/v3#referee-response-413874 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Sah A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 27 Sep 2025 | for Version 2 Ashok Kumar Sah , A’ Sharqiyah University, Ibra, Oman 0 Views copyright © 2025 Sah A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The manuscript is well-written, thoroughly analyzed, and presented in a clear and constructive manner. I would like to commend all the authors for their hard work and contributions. However, I have a few suggestions to enhance the scientific soundness and overall readability of the paper: Sample Size and Prevalence Rate : The sample size appears to be quite small, yet the reported prevalence is notably high at 75.40%. It would strengthen the manuscript if the authors could discuss this apparent discrepancy—perhaps by providing justification for the sample size, addressing potential sampling bias, or contextualizing the prevalence rate within the broader population. References : Several of the references cited are outdated. Updating the reference list to include more recent studies from the last five years would enhance the scientific rigor and relevance of the manuscript. I believe addressing these points will improve the overall quality and impact of the study. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Medical laboratory science- Clinical chemistry, Pathology, diagnostics, carncer diagnostics I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 09 Oct 2025 lufuluabu mpemba Alphonse, Médecine interne, université de Mbuji-Mayi, Mbujimayi, Democratic Republic of the Congo Thank you very much for your comments. We have added them. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Sah AK. Peer Review Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.187631.r413877) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-50/v2#referee-response-413877 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Wakid M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 25 Sep 2025 | for Version 2 Majed H. Wakid , Special Infectious Agents Unit, King Fahd Medical Research Center, Jeddah, Makkah Province, Saudi Arabia 0 Views copyright © 2025 Wakid M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Please send a point-by-point response to each comment. General Comments - The authors didn't take most of my comments into consideration. I will add them again. - The suggested references (my articles) are very recent and relevant to the topic, and I have not received any regulations or objections from the journal regarding this. - The title in the “word” file does not match the title in the “pdf” file. - The authors still use “Mbuji-Mayi or “Mbuji-mayi” in their affiliations. - Additional references are still needed. - Some scientific names still need corrections, including the spelling or species presentation. [The genus name should be written in italics and capitalized, while the species name should also be written in italics but in lowercase. After the first mention, the genus name should be abbreviated to its first capital letter, also in italics, followed by a period and a space]. - When et al is applied, only the family name of the author is used in addition to the year of publication. For example, - Most of the references are still written in a language other than English. - There is no “Conclusion” section at the end of the manuscript. - No limitations were added at the end of ‘Discussion’ section. - The author roles on page 2 are not the same as on page 11. Abstract - Some scientific names spelling in the “Result” still need correction. - The conclusion is still not related to the study area. Introduction - Line 3: Reference [2] is old, replace it with the suggested recent study [Al-Refai MF, Wakid MH: Prevalence of intestinal parasites and comparison of detection techniques for soil-transmitted helminths among newly arrived expatriate labors in Jeddah, Saudi Arabia. PeerJ . 2024; 12: e16820]. - Reference 6 is not from the World Health Organization and is old (2008). A recent reference from a WHO publication or report should be added. - Reference 8 is not related to the 2016 Algeria study. - The presentation of some scientific names still needs correction including spelling. Methods - The authors have not yet explained how they obtained the age and sex of the patients. Is there a questionnaire? - Which laboratory department received the samples and who performed the microscopic examination? - Macroscopic examination of the stool is very important to detect its color, consistency, and presence of adult worms or tapeworm segments. Have you performed it? - A direct stool examination alone is not a sufficient laboratory test for detecting intestinal parasites. Furthermore, the steps described above are completely unrelated to a direct smear. One gram of stool can’t be mixed with one milliliter of saline, a microscope slide, (The correct amount is 1 mg of stool and one drop of saline). Use the suggested reference: [Bahwaireth EO, Wakid MH: Molecular, microscopic, and immunochromatographic detection of enteroparasitic infections in hemodialysis patients and related risk factors. Foodborne Path. Dis . 2022; 19: 830-838.] - You can’t name the specific parasites you want to examine, as other parasites may be detected. - Written informed consent could not be obtained from the child. Please amend the sentence to read: "Written informed consent was obtained from the patients or their guardian, where applicable.". Results - Correct “women/ woman” and “men/ man” to “female” and “male”, where applicable in the whole manuscript. - Lines 4-5: Unify the name of each “Age group” in the text, with Tables 1 and 2, and where applicable in the whole manuscript. - Remove the explanation of each age group in Table 1. - Table 1: Correct “Age groups” to “Age group”, and “childreen” to “Children”. - Delete “categories” from the x-axis in Figure 1, and Figure 2. - Table 2, some words were written in non-English letters. - Correct the scientific names ( S. mansoni ) in Table 5. - What are (yes) and (no) used in Figures 1 and 2? Present only positive cases. Discussion - Correct the presentation of several scientific names. - Correct and modify the whole text in paragraph 2. The references (7,14,15) relate to Morocco, Brazil and Tunisia respectively. Add the reference number of the study discussed directly after it, not at the end of the paragraph. - Paragraph 3: correct to “In Tunisia, Cheikhrouhou et al. (2009)….”. - Paragraph 4: correct to “In the DRC, Nimo (2008)….”. - Correct and modify the whole text in paragraph 6. The references (7,10,17) relate to Morocco, DR Congo and Benin respectively. Add the reference number of the study discussed directly after it, not at the end of the paragraph. - Benin study from 2003 to 2015 not from 2005 to 2013. - Correct to “…by Sissinto-savi et al. (2018), showed….”. - Correct Woolf et al. to “Kapiteni et al. (2019),”. - Correct and modify the whole text in paragraph 7. The references (3,10,16,18) relate to Central African Republic, DR Congo, and Tunisia, respectively (3 and 18 for the same refrence). Add the reference number of the study discussed directly after it, not at the end of the paragraph. - Correct Woolf et al. to “Kapiteni et al. (2019),”. - Correct to “In Tunisia, Cheikhrouhou et al. (2009), showed….”. - Correct to “A study in Central African Republic by Lango-Yaya. et al. (2021), showed….”. - The limitations statement for this study has not been added yet. (Our findings are based on routine diagnostic procedures performed in CHUNDE on individuals referred to the study area. Therefore, despite its strategic geographic location and high patient population, these findings may not apply to the entire population. Furthermore, the stool samples in this study were not tested using any of the concentration techniques, which increases the possibility of detecting diagnostic stages of the intestinal parasites. Therefore, a major limitation of this study is the possibility that some intestinal parasite cases may be underreported due to the limitations of the direct wet examination [Reference: Alqarni AS, Wakid MH, Gattan HS. Prevalence, type of infections and comparative analysis of detection techniques of intestinal parasites in the province of Belgarn, Saudi Arabia. PeerJ. 2022; 10: e13889].). Add a “Conclusion” section after the “Discussion” section . Data availability Use suitable abbreviations for the corrected names of the parasites. References - Most of the references are still written in a language other than English. - Reference No. 3 repeated in No. 18. - Data for most references is incomplete. - The references style does not comply with the journal's guidelines. - After adding suggested references/removing duplicate references, renumber in-text citations and references list. References 1. Bahwaireth E, Wakid M: Molecular, Microscopic, and Immunochromatographic Detection of Enteroparasitic Infections in Hemodialysis Patients and Related Risk Factors. Foodborne Pathogens and Disease . 2022; 19 (12): 830-838 Publisher Full Text 2. Alqarni A, Wakid M, Gattan H: Prevalence, type of infections and comparative analysis of detection techniques of intestinal parasites in the province of Belgarn, Saudi Arabia. PeerJ . 2022; 10 . Publisher Full Text 3. Al-Refai M, Wakid M: Prevalence of intestinal parasites and comparison of detection techniques for soil-transmitted helminths among newly arrived expatriate labors in Jeddah, Saudi Arabia. PeerJ . 2024; 12 . Publisher Full Text Competing Interests No competing interests were disclosed. Reviewer Expertise Professor and consultant with 30 years of experience in Diagnostic Medical Parasitology. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Wakid MH. Peer Review Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.187631.r412656) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-50/v2#referee-response-412656 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Bracho Mora A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 23 Sep 2025 | for Version 2 Angela Bracho Mora , Universidad Técnica de Manabí, Portoviejo, Ecuador 0 Views copyright © 2025 Bracho Mora A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions In the abstract: They must change the language “Intestinal parasitoses” I suggest not writing acronyms in this section. Writing full D.R If they only used conventional techniques, the way of writing is not Entamoeba histolytica. Pentstrichomonas hominis is Pentatrichomonas hominis Ascaris lumbrucoide is Ascaris lumbricoides In the introduction: Change Endolimax nanus Change reference number 9 because it is very older. The correct form of Schistosoma M is S. mansoni. This sentence: The prevalence of intestinal parasitic infections is likely very high at CHUNDE and may be associated with the season. It’s isolated In the article it is not recommended to write specifics objectives In the results: Entamoeba histolytica is not recommended to write because no used molecular techniques are used in the study. Leave a single title on the figures In the Discussion There is a need for further discussion of the results since they are only compared with other works that are very old without giving their own interpretation and do not have a conclusion of the work General comments The paper seems to be written in a language other than English, and it is necessary to check the translation as there are words that are not in this language. There are spelling errors that must be corrected and correct use of upper- and lower-case letters It has some old references that should be changed Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? No Competing Interests No competing interests were disclosed. Reviewer Expertise Parasitology, Epidemiology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 26 Sep 2025 lufuluabu mpemba Alphonse, Médecine interne, université de Mbuji-Mayi, Mbujimayi, Democratic Republic of the Congo Thank you for the feedback. We Have incorporated it. For the titles of figures, it depends on the Journal. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Bracho Mora A. Peer Review Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.187631.r413872) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-50/v2#referee-response-413872 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Girma A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 18 Sep 2025 | for Version 2 Abayeneh Girma , Mekdela Amba University, Tulu Awuliya, Ethiopia 0 Views copyright © 2025 Girma A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions General comments The study addresses a relevant public health issue in a resource-limited setting. It reports a very high prevalence of intestinal parasitosis (75.4%) and investigates an important potential environmental driver: seasonality. However, the manuscript in its current form has significant methodological flaws, presentation issues, and statistical limitations that substantially weaken its conclusions and impact. Major revisions are required before it can be considered for indexing. 1. Abstract: The conclusion that "prevalence was higher during the dry season" directly contradicts the stated result of "no statistically valid association." This must be corrected to align with the statistical findings. Again, The term "Intestinal amebiasis" should be replaced with " Entamoeba histolytica/dispar complex" to reflect the diagnostic limitation accurately. Moreover, the specific prevalence rates should be formatted correctly (e.g., E. histolytica , P. hominis ). 2. Introduction: The background is generally good and establishes the public health importance of the topic. It could be slightly strengthened by more explicitly stating the knowledge gap for the specific region of Kasai Oriental. 3. Methods, particularly on study design: Labeling it as "random sampling" is incorrect. Consecutive sampling of patients meeting the inclusion criteria is a better description. 4. Discussion: The structure should be improved to flow from key findings -> comparison with literature -> interpretation -> limitations -> conclusion. Again, the discussion fails to adequately acknowledge the study's primary limitation: the diagnostic method. This should be the first point discussed. Additionally, comparisons with studies that used more sensitive diagnostic techniques are of limited validity and should be made with extreme caution. Moreover, the speculation about hygiene conditions is not supported by any data collected in this study. 5. Limitations: The listed limitations in the manuscript are insufficient. The following must be added: The use of direct smear only, leading to an underestimation of prevalence. The inability to differentiate E. histolytica from E. dispar . The small sample size and selection bias (hospital-based, symptomatic patients), limiting generalizability. The lack of data on confounding factors (socioeconomic status, water, sanitation). 6. Conclusion: The conclusions are not fully supported by the data. They should be tempered significantly: Instead of "The prevalence of intestinal parasitosis was higher," state: "A high prevalence of intestinal parasites was observed among symptomatic patients at this hospital, but the true community prevalence is likely different." Again, the conclusion on seasonality should clearly state that no statistically significant association was found, likely due to limited power and other unmeasured confounding factors. 7. References: Some references are quite old (e.g., Faye 1998, and remaining two studies each conducted in 2008 and 2009). It should also be formatted uniformly according to the journal's guidelines. Competing Interests No competing interests were disclosed. Reviewer Expertise Microbiology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 26 Sep 2025 lufuluabu mpemba Alphonse, Médecine interne, université de Mbuji-Mayi, Mbujimayi, Democratic Republic of the Congo Thank you for the comments. We have integrated them. However, we did not change article number 4 because we only took an idea from it and not statistics on the prevalence of parasitoses that can vary. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Girma A. Peer Review Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.187631.r412655) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-50/v2#referee-response-412655 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Abaka-Yawson A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 27 Aug 2025 | for Version 1 Albert Abaka-Yawson , University of Ghana, Legon, Ghana 0 Views copyright © 2025 Abaka-Yawson A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions ABSTRACT i. Authors should remove prevalence figures from background since they would be no opportunity to add reference ii. Methods section fails to talk about the study design and the sampling technique iii. You used "parasitoses" and "parasitosis" interchangeably in background and results section. Streamline that. iv. At the results section, parasites are presented as "Enterobius V., Schistosoma M. etc." consider rewriting them as "E. vermicularis, S. mansoni etc". In other words rather write the species in full and abbreviate the genus. v. Check spelling of various words throughout the manuscript. For instance, "Ancylostoma" not "Ankylostoma" MAIN WORK I. Remove general and specific objectives. Unless it aligns with journal's style ii. The methods section fails to capture the study design and sampling technique ii. Under results section, merge all 5 tables to one iii. Table 1: Remove ratio under sex iv. Authors should consider keeping just one. Either mean or median ages. Use only the best measure of central tendency v. Table 2: Under age, various categories are in French i.e., Enfants, Adultes etc. vi. Discussion should not be bulletins and also reduce the numbers and repetition of results. Focus on discussing the results in the light of other studies as well as its implications on patients and future studies. vii. Also consider adding limitations to the latter part of the discussion GENERAL COMMENTS The manuscript is currently not in a indexing state but holds potential for improvement. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? No Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? I cannot comment. A qualified statistician is required. Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Neglected Tropical Diseases, Parasitology, Infectious Diseases Epidemiology, Laboratory Medicine I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (0) Abaka-Yawson A. Peer Review Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.175968.r399022) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-50/v1#referee-response-399022 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Wakid M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 25 Aug 2025 | for Version 1 Majed H. Wakid , Special Infectious Agents Unit, King Fahd Medical Research Center, Jeddah, Makkah Province, Saudi Arabia 0 Views copyright © 2025 Wakid M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions A- General Comments - Mbuji-Mayi or Mbujimayi? - Additional references are required. - Scientific names need to be corrected throughout the manuscript (including Figures and Tables). The genus name should be written in italics and capitalized, while the species name should also be written in italics but in lowercase. After the first mention, the genus name should be abbreviated to its first capital letter, also in italics, followed by a period and a space. Thus, Entamoeba histolytica becomes E. histolytica . This must be done in both the abstract and the main text. - The name Trichomonas intestinalis is no longer used. - Some words were written in non-English letters. - There is no Conclusion section at the end of the manuscript. - There are some limitations to the study that should be mentioned. - In Author roles, delete “Funding Acquisition”, as there is no fund for this study. - Is it correct that the first letter of some authors name is written in lowercase? - D. R. Congo or DRC? also was abbreviated without the full name at first mention. B- Title - Add the country name to the title. C- Abstract - In the “Background” you mentioned that the prevalence in Africa is 42.18%, but in the Introduction section it is 43.12. - In the “objectives”, you must add the study area. - Correct all scientific names in the “Result”. - Use Ancylostoma , which is the preferred spelling, instead of Ankylostoma . - in the “Conclusion”, relate your conclusion to the study area. D- Introduction - Line 2: correct to “As a result, they are rarely a reason for regular consultation and are often neglected”. - Replace reference [2], with a recent study [Al-Refai MF, Wakid MH: Prevalence of intestinal parasites and comparison of detection techniques for soil-transmitted helminths among newly arrived expatriate labors in Jeddah, Saudi Arabia. PeerJ . 2024; 12: e16820]. - (WHO, 2023), should be given a reference number and added to the reference list. - Correct “ABOU BEKR BELKAID” to “Abou Bekr Belkaid”. - Correct all scientific names. - Include the objectives as a separate paragraph at the end of the Introduction section. E- Methods - The authors didn’t mention the sample collection instructions provided to the patients. - The authors didn’t explain how they obtained the patients' age and sex. A questionnaire? - Which laboratory department received the samples and who performed the microscopic examination? - Macroscopic examination of the stool is very important to detect its color, consistency, and presence of adult worms or tapeworm segments. Have you performed it? - A direct stool examination alone is not a sufficient laboratory test for detecting intestinal parasites. Furthermore, the steps described above are completely unrelated to a direct smear. Two grams of stool equals approximately half a teaspoon, and when mixed with one milliliter of saline, it cannot be mixed on a microscope slide, (The correct amount is 1 mg of stool and one drop of saline). Direct iodine smear and permanent staining are also necessary methods to observe and confirm diagnostic features for identifying protozoan parasites. You can add this reference for these techniques (Macroscopic, Microscopic: direct saline, direct iodine, and permanent staining) [Bahwaireth EO, Wakid MH: Molecular, microscopic, and immunochromatographic detection of enteroparasitic infections in hemodialysis patients and related risk factors. Foodborne Path. Dis . 2022; 19: 830-838.] - There is no need to list the names of the parasites, as other parasites may be detected. - P value statistical significance was not mentioned in the statistical analysis. - Written informed consent could not be obtained from the child. Please amend the sentence to read: "Written informed consent was obtained from the patients or their guardian, where applicable.". F- Results - Unify the name of each age group in the text, tables and figures. - Correct scientific names in the text, figures and tables. - Correct “women” and “men” to “male” and “female”, where applicable in the text, and tables. - The "Frequencies of intestinal protozoa" results section needs correction as in this section you represented results for helminths compared to E. histolytica . - The name “ Trichomonas intestinalis ” is no longer used. Are you referring to Retortamonas intestinalis or Pentatrichomonas hominis ? - Delete Figure 1, which adds no value to the results. - Table 2, some words were written in non-English letters. - Figures 2 and 3, are not in English, also these are not different types. What is yes and no used for? - Represent Figures 4, 5 and 6 in English. G- Discussion - The discussion section should not contain subheadings. - Correct the presentation of the scientific names. - You should mention the limitations of this study, with the suggested reference: (Our findings are based on routine diagnostic procedures performed in CHUNDE on individuals referred to the study area. Therefore, despite its strategic geographic location and high patient population, these findings may not apply to the entire population. Furthermore, the stool samples in this study were not tested using any of the concentration techniques, which increases the possibility of detecting diagnostic stages of the intestinal parasites. Therefore, a major limitation of this study is the possibility that some intestinal parasite cases may be underreported due to the limitations of the direct wet examination [Alqarni AS, Wakid MH, Gattan HS. Prevalence, type of infections and comparative analysis of detection techniques of intestinal parasites in the province of Belgarn, Saudi Arabia. PeerJ. 2022; 10: e13889].). H- Add a Conclusion section. I- References - After adding the three suggested references, the total becomes 21 references. The references should be renumbered in the text citations and the references list. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? No Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly References 1. Al-Refai M, Wakid M: Prevalence of intestinal parasites and comparison of detection techniques for soil-transmitted helminths among newly arrived expatriate labors in Jeddah, Saudi Arabia. PeerJ . 2024; 12 . Publisher Full Text 2. Bahwaireth E, Wakid M: Molecular, Microscopic, and Immunochromatographic Detection of Enteroparasitic Infections in Hemodialysis Patients and Related Risk Factors. Foodborne Pathogens and Disease . 2022; 19 (12): 830-838 Publisher Full Text 3. Alqarni A, Wakid M, Gattan H: Prevalence, type of infections and comparative analysis of detection techniques of intestinal parasites in the province of Belgarn, Saudi Arabia. PeerJ . 2022; 10 . Publisher Full Text Competing Interests No competing interests were disclosed. Reviewer Expertise Professor and Consultant in Diagnostic Medical Parasitology. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 10 Sep 2025 lufuluabu mpemba Alphonse, Médecine interne, université de Mbuji-Mayi, Mbujimayi, Democratic Republic of the Congo Thank you very much for insightful comments. We will integrate them into the new version of our article. But we have a concern regarding the articles you are proposing to add. they are all your articles. wouldn't that be a matter of interest or is it allowed by the journal ? View more View less Competing Interests The reviewer is asking us to add three articles to our manuscript. This is a major change. But all three of these articles are his. Is this permissible? Can we say that without these additions, he would have simply approved our manuscript with remaining modifications ? We are confused reply Respond Report a concern Wakid MH. Peer Review Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.175968.r399028) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-50/v1#referee-response-399028 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Girma A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 23 Aug 2025 | for Version 1 Abayeneh Girma , Mekdela Amba University, Tulu Awuliya, Ethiopia 0 Views copyright © 2025 Girma A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions General comments This study investigates the prevalence of intestinal parasitosis and its association with seasonal variation among patients at the Notre Dame de l’Espérance University Hospital Center in the Democratic Republic of the Congo (DRC). The authors report a high overall prevalence (75.40%), with Entamoeba histolytica and Ascaris lumbricoides being the most common parasites. The study also examines demographic and seasonal trends but finds no statistically significant association between parasitosis prevalence and seasons. While the topic is relevant to public health in tropical regions, the manuscript has several methodological and presentation issues that need addressing before it can be considered for publication. Major comments I. Methodology and analysis Sample size and representativeness: The sample size (187 patients) is relatively small for a two-year study, and the inclusion criteria (only patients referred for stool examination) may introduce selection bias. The authors should clarify whether this sample is representative of the general population or specific subgroups (e.g., symptomatic patients). Seasonal analysis: The definition of "dry" and "rainy" seasons is arbitrary (e.g., dry season: 15/5 to 15/8). The authors should justify this classification and consider regional climatic data. Statistical power: The lack of association between season and parasitosis may reflect inadequate statistical power rather than a true absence of association. A power calculation should be included. Confounding factors: The study does not account for potential confounders (e.g., hygiene practices, water sources, socioeconomic status) that could influence parasitosis prevalence independently of season. II. Results and Interpretation Contradictory findings: The abstract states that the prevalence was higher during the dry season, but the results section notes no significant association. This discrepancy should be resolved. Polyparasitism: The high rate of polyparasitism (24.13%) is noteworthy, but the clinical or epidemiological implications are not discussed. Comparative data: The discussion compares findings to studies in Tunisia, Morocco, and Brazil, but differences in study design, population, and diagnostic methods limit the validity of these comparisons. III. Presentation and clarity Tables and figures: Some tables (e.g., Table 2) are fragmented across pages, making them hard to follow. Figures (e.g., frequency curves) lack clarity in labeling and interpretation. Language and grammar: The manuscript has numerous grammatical errors and awkward phrasing, which hinder readability. Professional editing is recommended. Data availability: The dataset is available, but the description (e.g., "yes=positive, no=negative, na=not attributable") is unclear. A codebook or detailed metadata would improve reproducibility. Minor comments Abstract: The conclusion ("prevalence was higher during the dry season") contradicts the results ("no association"). Revise for consistency. Introduction: The background could better highlight gaps in the DRC-specific literature. Discussion: The high prevalence of Entamoeba histolytica should be contextualized with local diagnostic challenges (e.g., differentiation from E. dispar ). Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Microbiology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 10 Sep 2025 lufuluabu mpemba Alphonse, Médecine interne, université de Mbuji-Mayi, Mbujimayi, Democratic Republic of the Congo Thank you very much for the comments on our article, impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l'Espérance University Hospital . We will respond to your concerns in the order in which you listed them. We did not conduct this study in the general population of the eastern region of the city of Mbujimayi served by the University Hospital, but rather at the University Hospital. The 187 subjects live in this region and consulted the University Hospital during the study period and they had symptoms that led the doctors to request direct examination of the stool. So it is a prevalence of intestinal parasitosis in symptomatic subjects who have consulted the University Hospital. The definition of the season is not arbitrary but rather very precise. Please see page 17 of this scientific document ( kasai-oriental.pdf ). We will add this article to the revised version. And 4 Our study focused on the effect of climate on the prevalence of intestinal parasitosis. The finding is the lack of association, although on simple glance the data showed an increase in prevalence during the dry season. We plan to conduct a study in the general population including other factors to increase potency. 2.1 There is no contradiction. High prevalence during the dry season does not necessarily mean that there is an association between the dry season and prevalence. If this were the case, statistical analyses to prove an association would be useless. However, this lack of association shows the interest in looking for other factors that would normally influence this prevalence. 2.2 This is an observation at this stage. Our study, which focused on the relationship between climate and the prevalence of intestinal parasitosis, does not have enough evidence to initiate such a discussion. 2.3 Indeed, we even pointed this out in the discussion. These differences still exist but do not totally limit the comparison. 3.1 It is a technical problem that will be fixed by the Journal. Our figures are clear and accepted by the Journal. 3.2 We will reread our manuscript and correct any errors we find. However, please let us know for fear that these errors will still go unnoticed. 3.3 There is indeed a code guide published with the data. Please check carefully. Minor comments As explained in 2.1, there is no contradiction Thanks for advices in 2 and 3. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Girma A. Peer Review Report For: Impact of the season and prevalence of intestinal parasitosis at the Notre Dame de l’Espérance University Hospital Center, Democratic Republic of the Congo [version 3; peer review: 1 approved, 4 approved with reservations, 1 not approved] . F1000Research 2025, 14 :50 ( https://doi.org/10.5256/f1000research.175968.r399027) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. 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