Income level and antibiotic misuse: a systematic review and dose–response meta-analysis

Abstract Objectives To quantify the association between income and antibiotic misuse including unprescribed use, storage of antibiotics and non-adherence. Methods We identified pertinent studies through database search, and manual examination of reference lists of selected articles and review reports. We performed a dose–response meta-analysis of income, both continuous and categorical, in relation to antibiotic misuse. Summary odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated under a random-effects random effects model. Results Fifty-seven studies from 22 countries of different economic class were included. Overall, the data are in agreement with a flat linear association between income standardized to socio-economic indicators and antibiotic misuse (OR per 1 unit increment = 1.00, p-value = 0.954, p-value non-linearity = 0.429). Data were compatible with no association between medium and high income with general antibiotic misuse (OR 1.04; 95% CI 0.89, 1.20 and OR 1.03; 95% CI 0.82, 1.29). Medium income was associated with 19% higher odds of antibiotic storage (OR 1.19; 95% CI 1.07, 1.32) and 18% higher odds of any aspect of antibiotic misuse in African studies (OR 1.18; 95% CI 1.00, 1.39). High income was associated with 51% lower odds of non-adherence to antibiotic treatment (OR 0.49; 95% CI 0.34, 0.60). High income was also associated with 11% higher odds of any antibiotic misuse in upper-middle wealth countries (OR 1.11; 95% CI 1.00, 1.22). Conclusions The association between income and antibiotic misuse varies by type of misuse and country wellness. Understanding the socioeconomic properties of antibiotic misuse should prove useful in developing related intervention programs and health policies.

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The association and dose–response relationship between dietary intake of α-linolenic acid and risk of CHD: a systematic review and meta-analysis of cohort studies

British Journal Of Nutrition ◽

10.1017/s0007114517003294 ◽

2018 ◽

Vol 119 (1) ◽

pp. 83-89 ◽

Cited By ~ 9

Author(s):

Jingkai Wei ◽

Ruixue Hou ◽

Yuzhi Xi ◽

Alysse Kowalski ◽

Tiansheng Wang ◽

...

Keyword(s):

Cohort Studies ◽

Linolenic Acid ◽

Random Effects ◽

Dose Response ◽

Meta Analysis ◽

Geographic Region ◽

Response Relationship ◽

Dose Response Relationship ◽

Chd Risk ◽

Reduced Risk

AbstractPrevious studies show inconsistent associations between α-linolenic acid (ALA) and risk of CHD. We aimed to examine an aggregate association between ALA intake and risk of CHD, and assess for any dose–response relationship. We searched the PubMed, EMBASE and Web of Science databases for prospective cohort studies examining associations between ALA intake and CHD, including composite CHD and fatal CHD. Data were pooled using random-effects meta-analysis models, comparing the highest category of ALA intake with the lowest across studies. Subgroup analysis was conducted based on study design, geographic region, age and sex. For dose–response analyses, we used two-stage random-effects dose–response models. In all, fourteen studies of thirteen cohorts were identified and included in the meta-analysis. The pooled results showed that higher ALA intake was associated with modest reduced risk of composite CHD (risk ratios (RR)=0·91; 95 % CI 0·85, 0·97) and fatal CHD (RR=0·85; 95 % CI 0·75, 0·96). The analysis showed a J-shaped relationship between ALA intake and relative risk of composite CHD (χ2=21·95, P<0·001). Compared with people without ALA intake, only people with ALA intake <1·4 g/d showed reduced risk of composite CHD. ALA intake was linearly associated with fatal CHD – every 1 g/d increase in ALA intake was associated with a 12 % decrease in fatal CHD risk (95 % CI −0·21, −0·04). Though a higher dietary ALA intake was associated with reduced risk of composite and fatal CHD, the excess composite CHD risk at higher ALA intakes warrants further investigation, especially through randomised controlled trials.

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Epidemiology of obesity and overweight in sub-Saharan Africa: a protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2017-017666 ◽

2017 ◽

Vol 7 (11) ◽

pp. e017666 ◽

Cited By ~ 10

Author(s):

Sibhatu Biadgilign ◽

Tennyson Mgutshini ◽

Demewoz Haile ◽

Bereket Gebremichael ◽

Yonatan Moges ◽

...

Keyword(s):

Systematic Review ◽

Random Effects ◽

Systematic Reviews ◽

Reference Lists ◽

Meta Analysis ◽

Overweight And Obesity ◽

Sub Saharan Africa ◽

Obesity And Overweight ◽

Prevalence Of Obesity ◽

Sub Saharan

IntroductionGlobally, overweight and obesity were estimated to cause 3.4 million deaths, 3.9% of years of life lost and 3.8% of disability-adjusted life years in 2010. Despite the fact that obesity and overweight is a problem of high-income countries, low- and middle-income countries (LMICs), in particular urban settings of sub-Saharan African countries, face the challenge of an increasing trend. The aim of this systematic review and meta-analysis will be to determine the prevalence of obesity and overweight individuals in sub-Saharan Africa and to help guide policy planners in the decision-making process for the increase in non-communicable diseases in Africa.Methods and analysesA comprehensive systematic review and meta-analysis of published studies on the prevalence of obesity and overweight in sub-Saharan Africa will be conducted. A computerised internet search using Medline/PubMed, Google Scholar and EMBASE databases and reference lists of previous prevalence studies and detailed search strategy and cross-checking of reference lists of published peer-reviewed articles will be conducted to identify all epidemiological and/or clinical studies published in English and French. We will use the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement for reporting. The overall effect (pooled estimated effect size) of the prevalence of obesity and overweight will be analysed using the Der Simonian–Laird random effects meta-analysis (random effects model) and the obesity proportion (with 95% CI) will be measured.Ethics and disseminationThe underlying work is based on systematic reviews of published data and thus doed not require ethical review approval. The findings of the systematic review will be disseminated in different conferences and seminars and will be published in a reputable and refereed international peer-reviewed journal.PROSPERO registration numberCRD42017064942.

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High admission blood glucose is an independent risk factor of poor prognosis in COVID-19: A systematic review and dose-response meta-analysis

10.1101/2020.09.25.20200774 ◽

2020 ◽

Author(s):

Gilbert Lazarus ◽

Jessica Audrey ◽

Vincent Kharisma Wangsaputra ◽

Alice Tamara ◽

Dicky L. Tahapary

Keyword(s):

Blood Glucose ◽

Random Effects ◽

Dose Response ◽

Poor Prognosis ◽

Prognostic Value ◽

Meta Analysis ◽

Generalized Least Squares ◽

Response Analysis ◽

Non Linear ◽

Quality Evidence

Aims To investigate the prognostic value of admission blood glucose (BG) in predicting COVID-19 outcomes, including poor composite outcomes (mortality/severity), mortality, and severity. Materials and methods Eligible studies evaluating the prognostic value of fasting BG (FBG) and random BG (RBG) levels in predicting COVID-19 outcomes were included and assessed for risk of bias with the Quality in Prognosis Studies tool. Random-effects high-vs-low meta-analysis followed by dose-response analysis using generalized least squares model in a two-stage random-effects meta-analysis were conducted. Potential non-linear association was explored using restricted cubic splines and pooled using restricted maximum likelihood model in a multivariate meta-analysis. Results The search yielded 35 studies involving a total of 14,502 patients. We discovered independent association between admission FBG and poor prognosis in COVID-19 patients. Furthermore, we demonstrated non-linear relationship between admission FBG and severity (Pnon-linearity<0.001), where each 1 mmol/L increase augmented the risk of COVID-19 severity by 33% (risk ratio 1.33 [95% CI: 1.26-1.40]). Albeit exhibiting similar trends, study scarcity limited the strength of evidence on the independent prognostic value of admission RBG. GRADE assessment yielded high-quality evidence for the association between admission FBG and COVID-19 severity, and moderate-quality evidence for its association with mortality and poor outcomes, while the other assessments yielded very low-to-low quality. Conclusion High level of FBG at admission was independently associated with poor prognosis in COVID-19 patients. Further researches to confirm the observed prognostic value of admission RBG and to ascertain the estimated dose-response risk between admission FBG and on COVID-19 severity are required.

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Stereotactic radiosurgery for non-functioning pituitary adenomas: meta-analysis and International Stereotactic Radiosurgery Society practice opinion

Neuro-Oncology ◽

10.1093/neuonc/noz225 ◽

2019 ◽

Vol 22 (3) ◽

pp. 318-332 ◽

Cited By ~ 4

Author(s):

Rupesh Kotecha ◽

Arjun Sahgal ◽

Muni Rubens ◽

Antonio De Salles ◽

Laura Fariselli ◽

...

Keyword(s):

Systematic Review ◽

Stereotactic Radiosurgery ◽

Random Effects ◽

Local Control ◽

Pituitary Adenomas ◽

Meta Analysis ◽

Random Effects Models ◽

Review Reports ◽

Meta Analyses ◽

Non Functioning Pituitary Adenomas

Abstract Background This systematic review reports on outcomes and toxicities following stereotactic radiosurgery (SRS) for non-functioning pituitary adenomas (NFAs) and presents consensus opinions regarding appropriate patient management. Methods Using the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a systematic review was performed from articles of ≥10 patients with NFAs published prior to May 2018 from the Medline database using the key words “radiosurgery” and “pituitary” and/or “adenoma.” Weighted random effects models were used to calculate pooled outcome estimates. Results Of the 678 abstracts reviewed, 35 full-text articles were included describing the outcomes of 2671 patients treated between 1971 and 2017 with either single fraction SRS or hypofractionated stereotactic radiotherapy (HSRT). All studies were retrospective (level IV evidence). SRS was used in 27 studies (median dose: 15 Gy, range: 5–35 Gy) and HSRT in 8 studies (median total dose: 21 Gy, range: 12–25 Gy, delivered in 3–5 fractions). The 5-year random effects local control estimate after SRS was 94% (95% CI: 93.0–96.0%) and 97.0% (95% CI: 93.0–98.0%) after HSRT. The 10-year local control random effects estimate after SRS was 83.0% (95% CI: 77.0–88.0%). Post-SRS hypopituitarism was the most common treatment-related toxicity observed, with a random effects estimate of 21.0% (95% CI: 15.0–27.0%), whereas visual dysfunction or other cranial nerve injuries were uncommon (range: 0–7%). Conclusions SRS is an effective and safe treatment for patients with NFAs. Encouraging short-term data support HSRT for select patients, and mature outcomes are needed before definitive recommendations can be made. Clinical practice opinions were developed on behalf of the International Stereotactic Radiosurgery Society (ISRS).

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National prevalence and associated factors of khat chewing among students in Ethiopia: A protocol for a systematic review and meta-analysis

Journal of Public Health in Africa ◽

10.4081/jphia.2018.830 ◽

2018 ◽

Vol 9 (3) ◽

Author(s):

Wondale Getinet ◽

Tadele Amare ◽

Wubet Worku

Keyword(s):

Systematic Review ◽

Random Effects ◽

Systematic Reviews ◽

Associated Factors ◽

Reference Lists ◽

Meta Analysis ◽

Ethical Review ◽

Published Data ◽

Cross Sectional ◽

Khat Chewing

The existing prevalence of khat chewing among university students ranges from 23.1% to 74.1%. Its impact affected students mentally, physically, economically and their social interaction. The aim of this systematic review and meta-analysis will be to determine the prevalence of khat chewing and associated factors among students in Ethiopia and to help guide policy makers in the decision-making process. A complete systematic review and meta-analysis of published studies on the prevalence of khat chewing and associated factors in Ethiopia will be conducted. A computerized internet search using Medline/PubMed, Google Scholar and EMBASE databases and reference lists of previous prevalence studies and full search strategy and cross-checking of reference lists of published peerreviewed articles will be conducted to identify all cross-sectional and cohort studies published in English. We will use the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement for reporting. Pooled estimated effect of prevalence of khat chewing and associated factors will be analyzed using the random effects meta-analysis (random effects model) and (with 95% CI) will be measured. The underlying work is based on systematic reviews of published data and thus do not require ethical review approval. The results of the systematic review will be disseminated in different conferences, seminars and published in a reputable international reviewed journal. A complete systematic review and meta-analysis of published studies on the prevalence of khat chewing and associated factors in Ethiopia will be conducted. All observational studies of (cross-sectional, cohort, case control) and randomized controlled trials will be included. A widespread range of studies and settings will be included.

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Carotenoid Intake and Circulating Carotenoids Are Inversely Associated with the Risk of Bladder Cancer: A Dose-Response Meta-analysis

Advances in Nutrition ◽

10.1093/advances/nmz120 ◽

2019 ◽

Vol 11 (3) ◽

pp. 630-643 ◽

Cited By ~ 3

Author(s):

Shenghui Wu ◽

Yanning Liu ◽

Joel E Michalek ◽

Ruben A Mesa ◽

Dorothy Long Parma ◽

...

Keyword(s):

Bladder Cancer ◽

Random Effects ◽

Dose Response ◽

Meta Analysis ◽

Epidemiologic Studies ◽

Cochrane Library ◽

Response Analysis ◽

Random Effects Models ◽

The Cochrane Library ◽

Β Carotene

ABSTRACT Some evidence indicates that carotenoids may reduce the risk of bladder cancer (BC), but the association is unclear. We conducted a systematic review and meta-analysis of case-control and cohort studies investigating the relation between carotenoid intake or circulating carotenoid concentrations and BC risk in men and women. All relevant epidemiologic studies were identified by a search of PubMed and Scopus databases, and the Cochrane Library from inception to April 2019 with no restrictions. A random-effects model was used to calculate pooled RRs and their 95% CIs across studies for high compared with low categories of intake or circulating concentrations. We also performed a dose-response meta-analysis using the Greenland and Longnecker method and random-effects models. A total of 22 studies involving 516,740 adults were included in the meta-analysis. The pooled RRs of BC for the highest compared with the lowest category of carotenoid intake and circulating carotenoid concentrations were 0.88 (95% CI: 0.76, 1.03) and 0.36 (95% CI: 0.12, 1.07), respectively. The pooled RR of BC for the highest compared with lowest circulating lutein and zeaxanthin concentrations was 0.53 (95% CI: 0.33, 0.84). Dose-response analysis showed that BC risk decreased by 42% for every 1 mg increase in daily dietary β-cryptoxanthin intake (RR: 0.58; 95% CI: 0.36, 0.94); by 76% for every 1 μmol/L increase in circulating concentration of α-carotene (RR: 0.24; 95% CI: 0.08, 0.67); by 27% for every 1 μmol/L increase in circulating concentration of β-carotene (RR: 0.73; 95% CI: 0.57, 0.94); and by 56% for every 1 μmol/L increase in circulating concentrations of lutein and zeaxanthin (RR: 0.44; 95% CI: 0.28, 0.67). Dietary β-cryptoxanthin intake and circulating concentrations of α-carotene, β-carotene, and lutein and zeaxanthin were inversely associated with BC risk. The protocol was registered at PROSPERO as CRD42019133240.

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RETRACTED: Nut consumption with risk of hypertension and type 2 diabetes mellitus: A meta-analysis of prospective cohort studies

European Journal of Preventive Cardiology ◽

10.1177/2047487313501120 ◽

2013 ◽

Vol 27 (13) ◽

pp. NP6-NP15 ◽

Cited By ~ 1

Author(s):

Kai Guo ◽

Yibo Jiang ◽

Zhiwen Zhou ◽

Yigang Li

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Cohort Studies ◽

Random Effects ◽

Dose Response ◽

Prospective Cohort ◽

Meta Analysis ◽

Prospective Cohort Studies

Background The consumption of nuts was reported to be associated with risk of hypertension and type 2 diabetes mellitus (T2DM), but the results were inconclusive. The aim of this study was to systematically examine longitudinal studies investigating nut intake in relation to risk of hypertension and T2DM. Methods A systematic search of the PubMed and EMBASE databases to 31 March 2013 was performed. Reference lists of retrieved articles were also screened. Summary relative risks (SRRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Q and I2 statistics were used to examine between-study heterogeneity. Results A total of nine prospective cohort studies (three for hypertension and six for T2DM) were identified. Using random effects models, we found that based on the highest vs lowest analysis, nut consumption were inversely associated with risk of hypertension (SRR = 0.84, 95% CI: 0.76–0.93, pheterogeneity = 0.831, I2 = 0%). Dose-response analyses indicated that nut consumption at more than two servings/wk, but not ne serving/wk, had a preventative role in the hypertension. In addition, nut consumption was not associated with risk of T2DM (SRRs = 0.98, 95% CI: 0.84–1.15; pheterogeneity = 0.008, I2 = 67.7%) on the basis of the highest vs lowest analysis. This null association was also shown in the dose-response analysis. Conclusion In our meta-analysis, nut consumption is found to be inversely associated with hypertension risk but is not associated with the risk of T2DM.

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