Reviewer's report
Title:Chronic Fatigue Syndrome 5 years after giardiasis: differential diagnoses,
characteristics and natural course
Version: 2Date:17 July 2012
Reviewer: Eva Libman
Reviewer's report:
1) Goals of the study
The primary objectives of this study were to:
• Describe post infectious fatigue in the form of CFS and ICF in a group of
patients who had self-reported chronic fatigue 3 years after giardiasis
• Identify differential diagnoses
Secondary objectives were to:
• Describe the natural course of fatigue at 3 and 5 years after infection
• Identify factors associated with chronic fatigue
2) Methodology
The methods were appropriate and well-described. However, there was no
comment made on the seemingly very low participation rate (approximately
21%), raising serious questions both about representativeness of the sample and
power of the statistical analyses.
3) Interpretation/Discussion
Minor important revisions:
I would have liked the Discussion section to be related more specifically to the
goals presented in the Introduction.
More than 50% of the sample was diagnosed with CFS/ICF, however there were
also some important co-morbidities identified 3 years and 5 years post infection –
e.g. abdominal problems/IBS, asthma, allergies depression. The prevalence of
asthma and allergy was surprisingly high, but there was no commentary on this
finding. It looks as if there is also a substantial amount of depression among
those participants designated as Giardia- induced CFS/ICF, even though
depression presumably would have designated such participants to the Chronic
Fatigue Other Aetiology category. Probably because of small sample size, if is
not clear what the specific factors are that are associated with chronic fatigue
and where co-morbidities fit into the evolution of post infection fatigue. Since all
participants had the same infectious disease, it would have been interesting to
include the evolution of fatigue in those where SAHS, depression and anxiety
were diagnosed as well, rather than excluding them. These aspects should be
clarified and amplified.
Major important revision:
There is no mention of limitations in this study; the small sample size and
reasons for this should definitely be included.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have no competing interests
(document refused to upload; review was copied and pasted into box)
Reviewer's report
Title:Chronic Fatigue Syndrome 5 years after giardiasis: differential diagnoses,
characteristics and natural course
Version: 2Date:17 July 2012
Reviewer: Eva Libman
Reviewer's report:
1) Goals of the study
The primary objectives of this study were to:
• Describe post infectious fatigue in the form of CFS and ICF in a group of
patients who had self-reported chronic fatigue 3 years after giardiasis
• Identify differential diagnoses
Secondary objectives were to:
• Describe the natural course of fatigue at 3 and 5 years after infection
• Identify factors associated with chronic fatigue
2) Methodology
The methods were appropriate and well-described. However, there was no
comment made on the seemingly very low participation rate (approximately
21%), raising serious questions both about representativeness of the sample and
power of the statistical analyses.
3) Interpretation/Discussion
Minor important revisions:
I would have liked the Discussion section to be related more specifically to the
goals presented in the Introduction.
More than 50% of the sample was diagnosed with CFS/ICF, however there were
also some important co-morbidities identified 3 years and 5 years post infection –
e.g. abdominal problems/IBS, asthma, allergies depression. The prevalence of
asthma and allergy was surprisingly high, but there was no commentary on this
finding. It looks as if there is also a substantial amount of depression among
those participants designated as Giardia- induced CFS/ICF, even though
depression presumably would have designated such participants to the Chronic
Fatigue Other Aetiology category. Probably because of small sample size, if is
not clear what the specific factors are that are associated with chronic fatigue
and where co-morbidities fit into the evolution of post infection fatigue. Since all
participants had the same infectious disease, it would have been interesting to
include the evolution of fatigue in those where SAHS, depression and anxiety
were diagnosed as well, rather than excluding them. These aspects should be
clarified and amplified.
Major important revision:
There is no mention of limitations in this study; the small sample size and
reasons for this should definitely be included.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have no competing interests
(document refused to upload; review was copied and pasted into box)
Please review this paper.
user
Reviewer's report
Title:Chronic Fatigue Syndrome 5 years after giardiasis: differential diagnoses,
characteristics and natural course
Version: 2Date:17 July 2012
Reviewer: Eva Libman
Reviewer's report:
1) Goals of the study
The primary objectives of this study were to:
• Describe post infectious fatigue in the form of CFS and ICF in a group of
patients who had self-reported chronic fatigue 3 years after giardiasis
• Identify differential diagnoses
Secondary objectives were to:
• Describe the natural course of fatigue at 3 and 5 years after infection
• Identify factors associated with chronic fatigue
2) Methodology
The methods were appropriate and well-described. However, there was no
comment made on the seemingly very low participation rate (approximately
21%), raising serious questions both about representativeness of the sample and
power of the statistical analyses.
3) Interpretation/Discussion
Minor important revisions:
I would have liked the Discussion section to be related more specifically to the
goals presented in the Introduction.
More than 50% of the sample was diagnosed with CFS/ICF, however there were
also some important co-morbidities identified 3 years and 5 years post infection –
e.g. abdominal problems/IBS, asthma, allergies depression. The prevalence of
asthma and allergy was surprisingly high, but there was no commentary on this
finding. It looks as if there is also a substantial amount of depression among
those participants designated as Giardia- induced CFS/ICF, even though
depression presumably would have designated such participants to the Chronic
Fatigue Other Aetiology category. Probably because of small sample size, if is
not clear what the specific factors are that are associated with chronic fatigue
and where co-morbidities fit into the evolution of post infection fatigue. Since all
participants had the same infectious disease, it would have been interesting to
include the evolution of fatigue in those where SAHS, depression and anxiety
were diagnosed as well, rather than excluding them. These aspects should be
clarified and amplified.
Major important revision:
There is no mention of limitations in this study; the small sample size and
reasons for this should definitely be included.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have no competing interests
(document refused to upload; review was copied and pasted into box)
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