Reviewer ’s report  
 
Title: The Magnitude and correlates of Esophageal Varices among newly diagnosed Cirrhotic 
Patients Undergoing Screening Upper Gastrointestinal Endosc ope before incident bleeding in 
North -Western Tanzania; a Cross Sectional Study  
 
Version: 0 Date: 15 Apr 2019  
 
Reviewer: Yoshihiro Furuichi  
 
Reviewer's report:  
 
Comment to the authors  
 
This paper was reported to clarify the rate of having esophageal varices in liver cirrhosis patients 
in Tanzania. I think this result is valuable for the patients in Tanzania. However, I can not find 
out the author's opinion for liver cirrho sis patients. Should they have a endoscopic examination 
or not? Please reconsider about some points pointed bellow.  
 
 
[Major points]  
 
1. Unfortunately, the impact is very low in this manuscript. Many readers already know that the 
presence of ascites, decrease of albumin and splenomegaly are the predictor of esophageal 
varices. In present paper, the authors described that 40% of liver cir rhosis patients potentially 
had the esophageal varices and described, "Bleeding is the deadly complication of esophageal 
varices which commonly occurs within the first two years of diagnosis. About the endoscopic 
screening for liver cirrhosis patient, plea se mention the author's opinion. I recommend the BMC 
gastroenterology readers to perform the endoscopic examination for liver cirrhosis patients.  
 
2. In material and method section, the introduction of your hospital is not necessary for many 
readers. Pleas e delete this description. (p4 lines4 -10) 
 
3. The description about the ultrasonographic features of liver cirrhosis is not necessary (p4 lines 
16-20). And the amount of endoscopic examination in your hospital is not necessary either 
(lines23 -24). 
 
4. In t he result section, the authors described thrombocytopenia was the factor associated with 
esophageal varices (p6, line 1). But this this description is not correct. In the table 2, the platelet 
counts more than 100 was the predictor of presence of esophagea l varices. Therefore, 
'thrombocytosis' (not thrombocytopenia) is the predictor.  
 
5. The authors should also mention about the relation between PSDR and esophageal varices in 
the result section.  
 
6. "Being married" was written as the predictive factor of es ophageal varices. However, the 
reason was not described in this paper. Please discuss this factor more in detail.  
 
7. There were many reports that spleen and liver elastography were predictor of esophageal 
varices existence. How about this value in present  study?  
 
Are the methods appropriate and well de scribed?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions dra wn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Unable to assess  
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistica l review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration  of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financially from the publication of this  manuscript, either now or in the 
future?  
 
3.  Do you hold or are you currently applying for any patents  relating to the content 
of the manuscript?  
4.  Have you received reimbursements, fees, funding, or salary from an organization 
that holds or has applied f or patents relating to the content of the manuscript?  
 
5.  Do you have any other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
none  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepte d for publication,  my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.or g/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: The Magnitude and correlates of Esophageal Varices among newly diagnosed Cirrhotic 
Patients Undergoing Screening Upper Gastrointestinal Endosc ope before incident bleeding in 
North -Western Tanzania; a Cross Sectional Study  
 
Version: 0 Date: 15 Apr 2019  
 
Reviewer: Yoshihiro Furuichi  
 
Reviewer's report:  
 
Comment to the authors  
 
This paper was reported to clarify the rate of having esophageal varices in liver cirrhosis patients 
in Tanzania. I think this result is valuable for the patients in Tanzania. However, I can not find 
out the author's opinion for liver cirrho sis patients. Should they have a endoscopic examination 
or not? Please reconsider about some points pointed bellow.  
 
 
[Major points]  
 
1. Unfortunately, the impact is very low in this manuscript. Many readers already know that the 
presence of ascites, decrease of albumin and splenomegaly are the predictor of esophageal 
varices. In present paper, the authors described that 40% of liver cir rhosis patients potentially 
had the esophageal varices and described, "Bleeding is the deadly complication of esophageal 
varices which commonly occurs within the first two years of diagnosis. About the endoscopic 
screening for liver cirrhosis patient, plea se mention the author's opinion. I recommend the BMC 
gastroenterology readers to perform the endoscopic examination for liver cirrhosis patients.  
 
2. In material and method section, the introduction of your hospital is not necessary for many 
readers. Pleas e delete this description. (p4 lines4 -10) 
 
3. The description about the ultrasonographic features of liver cirrhosis is not necessary (p4 lines 
16-20). And the amount of endoscopic examination in your hospital is not necessary either 
(lines23 -24). 
 
4. In t he result section, the authors described thrombocytopenia was the factor associated with 
esophageal varices (p6, line 1). But this this description is not correct. In the table 2, the platelet 
counts more than 100 was the predictor of presence of esophagea l varices. Therefore, 
'thrombocytosis' (not thrombocytopenia) is the predictor.  
 
5. The authors should also mention about the relation between PSDR and esophageal varices in 
the result section.  
 
6. "Being married" was written as the predictive factor of es ophageal varices. However, the 
reason was not described in this paper. Please discuss this factor more in detail.  
 
7. There were many reports that spleen and liver elastography were predictor of esophageal 
varices existence. How about this value in present  study?  
 
Are the methods appropriate and well de scribed?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions dra wn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Unable to assess  
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistica l review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration  of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financially from the publication of this  manuscript, either now or in the 
future?  
 
3.  Do you hold or are you currently applying for any patents  relating to the content 
of the manuscript?  
4.  Have you received reimbursements, fees, funding, or salary from an organization 
that holds or has applied f or patents relating to the content of the manuscript?  
 
5.  Do you have any other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
none  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepte d for publication,  my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.or g/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: The Magnitude and correlates of Esophageal Varices among newly diagnosed Cirrhotic 
Patients Undergoing Screening Upper Gastrointestinal Endosc ope before incident bleeding in 
North -Western Tanzania; a Cross Sectional Study  
 
Version: 0 Date: 15 Apr 2019  
 
Reviewer: Yoshihiro Furuichi  
 
Reviewer's report:  
 
Comment to the authors  
 
This paper was reported to clarify the rate of having esophageal varices in liver cirrhosis patients 
in Tanzania. I think this result is valuable for the patients in Tanzania. However, I can not find 
out the author's opinion for liver cirrho sis patients. Should they have a endoscopic examination 
or not? Please reconsider about some points pointed bellow.  
 
 
[Major points]  
 
1. Unfortunately, the impact is very low in this manuscript. Many readers already know that the 
presence of ascites, decrease of albumin and splenomegaly are the predictor of esophageal 
varices. In present paper, the authors described that 40% of liver cir rhosis patients potentially 
had the esophageal varices and described, "Bleeding is the deadly complication of esophageal 
varices which commonly occurs within the first two years of diagnosis. About the endoscopic 
screening for liver cirrhosis patient, plea se mention the author's opinion. I recommend the BMC 
gastroenterology readers to perform the endoscopic examination for liver cirrhosis patients.  
 
2. In material and method section, the introduction of your hospital is not necessary for many 
readers. Pleas e delete this description. (p4 lines4 -10) 
 
3. The description about the ultrasonographic features of liver cirrhosis is not necessary (p4 lines 
16-20). And the amount of endoscopic examination in your hospital is not necessary either 
(lines23 -24). 
 
4. In t he result section, the authors described thrombocytopenia was the factor associated with 
esophageal varices (p6, line 1). But this this description is not correct. In the table 2, the platelet 
counts more than 100 was the predictor of presence of esophagea l varices. Therefore, 
'thrombocytosis' (not thrombocytopenia) is the predictor.  
 
5. The authors should also mention about the relation between PSDR and esophageal varices in 
the result section.  
 
6. "Being married" was written as the predictive factor of es ophageal varices. However, the 
reason was not described in this paper. Please discuss this factor more in detail.  
 
7. There were many reports that spleen and liver elastography were predictor of esophageal 
varices existence. How about this value in present  study?  
 
Are the methods appropriate and well de scribed?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions dra wn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Unable to assess  
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistica l review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration  of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financially from the publication of this  manuscript, either now or in the 
future?  
 
3.  Do you hold or are you currently applying for any patents  relating to the content 
of the manuscript?  
4.  Have you received reimbursements, fees, funding, or salary from an organization 
that holds or has applied f or patents relating to the content of the manuscript?  
 
5.  Do you have any other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
none  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepte d for publication,  my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.or g/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant