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The authors addressed all the Reviewers' concerns.
Three Reviewers assessed your manuscript and are positive about its publication in this journal. One has no comments to address, while the other two have minor points.
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The paper is well laid out with clear description of the overall methodolgy
No issues. My only thought is whether formal statistical analysis is really adding much here compared to the very nice chlorapleth maps? I dont feel strongly but I personally found the visual display of information more useful than the fishers-exact results!
As noted there are some limitation due to the underlying population the study data is drawn from but this is well described.
If a patient had impetigo in 3 locations in the original trial am I correct that only 2 would have been recorded? Do you have any sense of how common this would be? It seems a potential limitation.
This is really a very nice article and my comments are minor. It could probably be accepted as is or after minor changes only.
No comment
No comment
No comment
A well written article, covering an important clinical condition. I commend the authors for pursuing an area of research that is under-explored.
Overall, the research is a good addition to the literature given it brought a novel approach to demonstrate body distribution of impetigo. But the work and its overall relevance can be substantiated using more references etc.
Methods
• Given ~60% of children had co-infection by S. Pyogenes and S. aureus, I wonder if there was any consideration of this on the analyses? Because it appears based on your results the individual pathogens are identified only in 30% of the overall sores in the analysis, leaving the majority of sores not considered for the mapping?
Results
• S1 fig is stratification by age group but reported for gender on line 179 of the manuscript.
• Also, double check S2 Fig with what you have referred in the manuscript.
• Overall, check all your references to the figures. Seems like most of them are not referring to the right figures or appendixes.
• Line 161 put a full stop after 13 years.
Discussion
• The discussion only has 4 or 5 new references – I feel like this can be substantiated further citing a few more works in this area.
• The body distribution with respect to the implicated pathogen, particularly the different pattern of GAS only sores, is barely discussed. Does this difference have any clinical relevance? Or any reason why this difference could exist?
• Headlice should be modified as head lice throughout.
• What is the overall implication of the varied distributions of impetigo for treatments and treatment outcomes?
• Given head lice was identified as a co-infection only in 10 cases, I wouldn’t say the scalp distribution is common.
No comment
Overall, the findings are usefull for clinicians and researchers to understand the disease distribution and its implication.
None.
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