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.

Is the work clearly and accurately presented and does it cite the current literature?

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

Is the study design appropriate and is the work technically sound?

Yes

Are the conclusions drawn adequately supported by the results?

Yes

Are sufficient details of methods and analysis provided to allow replication by others?

Yes

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.

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.

Is the work clearly and accurately presented and does it cite the current literature?

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?

Partly

Is the study design appropriate and is the work technically sound?

No

Are the conclusions drawn adequately supported by the results?

Partly

Are sufficient details of methods and analysis provided to allow replication by others?

No

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.

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

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

Is the study design appropriate and is the work technically sound?

Yes

Are the conclusions drawn adequately supported by the results?

No

Are sufficient details of methods and analysis provided to allow replication by others?

Yes

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.

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.

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.

Is the work clearly and accurately presented and does it cite the current literature?

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

Is the study design appropriate and is the work technically sound?

Partly

Are the conclusions drawn adequately supported by the results?

Partly

Are sufficient details of methods and analysis provided to allow replication by others?

Partly

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.

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

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

Is the study design appropriate and is the work technically sound?

No

Are the conclusions drawn adequately supported by the results?

Partly

Are sufficient details of methods and analysis provided to allow replication by others?

No

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.

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

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

Is the study design appropriate and is the work technically sound?

No

Are the conclusions drawn adequately supported by the results?

Partly

Are sufficient details of methods and analysis provided to allow replication by others?

No

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.

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).

Minor comments

Abstract: The conclusion ("prevalence was higher during the dry season") contradicts the results ("no association"). Revise for consistency.

Is the work clearly and accurately presented and does it cite the current literature?

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

Is the study design appropriate and is the work technically sound?

Partly

Are the conclusions drawn adequately supported by the results?

Partly

Are sufficient details of methods and analysis provided to allow replication by others?

Partly

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.