<p>The rationale could have been strengthened by a comparison of WHO statistics to show that the rate of secondary infection was high. It is not &nbsp;stated what method was used to determine the factors associated with the spread of the infection. Only secondary data about timeliness seems to have been extracted. The median &nbsp;should have been reported with the IQR. &nbsp;It is not clear how the authors arrived at the conclusion because the methods do not support the results.&nbsp;</p>