Prevalence and risk factors for antibiotic utilization in Chinese children

Abstract Background Antibiotic resistance poses a significant threat to public health globally. Irrational utilization of antibiotics being one of the main reasons of antibiotic resistant. Children as a special group, there's more chance of getting infected. Although most of the infection is viral in etiology, antibiotics still are the most frequently prescribed medications for children. Therefore, high use of antibiotics among children raises concern about the appropriateness of antibiotic prescribing. This systematic review aims to measuring prevalence and risk factors for antibiotic utilization in children in China. Methods English and Chinese databases were searched to identify relevant studies evaluating the prevalence and risk factors for antibiotic utilization in Chinese children (0-18 years), which were published between 2010 and July 2020. A Meta-analysis of prevalence was performed using random effect model. The Agency for Healthcare Research and Quality (AHRQ) and modified Jadad score was used to assess risk of bias of studies. In addition, we explored the risk factors of antibiotic utilization in Chinese children using qualitative analysis. Results Of 10,075 studies identified, 98 eligible studies were included after excluded duplicated studies. A total of 79 studies reported prevalence and 42 studies reported risk factors for antibiotic utilization in children. The overall prevalence of antibiotic utilization among outpatients and inpatients were 63.8% (35 studies, 95% confidence interval (CI): 55.1-72.4%), and 81.3% (41 studies, 95% CI: 77.3-85.2%), respectively. In addition, the overall prevalence of caregiver’s self-medicating of antibiotics for children at home was 37.8% (4 studies, 95% CI: 7.9-67.6%). The high prevalence of antibiotics was associated with multiple factors, while lacking of skills and knowledge in both physicians and caregivers was the most recognized risk factor, caregivers put pressure on physicians to get antibiotics and self-medicating with antibiotics at home for children also were the main factors attributed to this issue. Conclusion The prevalence of antibiotic utilization in Chinese children is heavy both in hospitals and home. It is important for government to develop more effective strategies to improve the irrational use of antibiotic, especially in rural setting.

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Prevalence and Risk Factors for Antibiotic Utilization in Chinese Children

10.21203/rs.3.rs-244798/v1 ◽

2021 ◽

Author(s):

Shasha Guo ◽

Qiang Sun ◽

Xinyang Zhao ◽

Liyan Shen ◽

Xuemei Zhen

Keyword(s):

Risk Factors ◽

Large Scale ◽

Random Effect ◽

Random Effect Model ◽

Healthcare Research ◽

Chinese Children ◽

Rural Setting ◽

Antibiotic Prescribing ◽

Antibiotic Utilization ◽

At Home

Abstract Background: Antibiotic resistance poses a significant threat to public health globally. Irrational utilization of antibiotics being one of the main reasons of antibiotic resistant. Children as a special group, there's more chance of getting infected. Although most of the infection is viral in etiology, antibiotics still are the most frequently prescribed medications for children. Therefore, high use of antibiotics among children raises concern about the appropriateness of antibiotic prescribing. This systematic review aims to measuring prevalence and risk factors for antibiotic utilization in children in China. Methods: English and Chinese databases were searched to identify relevant studies evaluating the prevalence and risk factors for antibiotic utilization in Chinese children (0-18 years), which were published between 2010 and July 2020. A Meta-analysis of prevalence was performed using random effect model. The Agency for Healthcare Research and Quality (AHRQ) and modified Jadad score was used to assess risk of bias of studies.Results: Of 10,075 studies identified, 101 eligible studies were included. A total of 82 studies reported prevalence and 43 studies reported risk factors for antibiotic utilization in children. The overall prevalence of antibiotic utilization among outpatients and inpatients were 63.8%, and 81.2%, respectively. In addition, the overall prevalence of caregiver’s self-medicating of antibiotics for children at home was 37.8%. The high prevalence of antibiotics was associated with multiple factors, while lacking of skills and knowledge in both physicians and caregivers was the most recognized risk factor, caregivers put pressure on physicians to get antibiotics and self-medicating with antibiotics at home for children also were the main factors attributed to this issue.Conclusion: The prevalence of antibiotic utilization in Chinese children is heavy both in hospitals and home. It is important for government to develop more effective strategies to improve the irrational use of antibiotic. In addition, there is also great need to carry out more large-scale studies of antibiotic utilization on children, especially in rural setting.

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Stroke in COVID-19: A systematic review and meta-analysis

International Journal of Stroke ◽

10.1177/1747493020972922 ◽

2020 ◽

pp. 174749302097292 ◽

Cited By ~ 1

Author(s):

Stefania Nannoni ◽

Rosa de Groot ◽

Steven Bell ◽

Hugh S Markus

Keyword(s):

Risk Factors ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Cerebrovascular Diseases ◽

Large Vessel ◽

Quality Data ◽

Large Vessel Occlusion ◽

Vessel Occlusion ◽

Median Difference

Background Coronavirus disease 2019 (COVID-19) has become a global pandemic, affecting millions of people. However, the relationship between COVID-19 and acute cerebrovascular diseases is unclear. Aims We aimed to characterize the incidence, risk factors, clinical–radiological manifestations, and outcome of COVID-19-associated stroke. Methods Three medical databases were systematically reviewed for published articles on acute cerebrovascular diseases in COVID-19 (December 2019–September 2020). The review protocol was previously registered (PROSPERO ID = CRD42020185476). Data were extracted from articles reporting ≥5 stroke cases in COVID-19. We complied with the PRISMA guidelines and used the Newcastle–Ottawa Scale to assess data quality. Data were pooled using a random-effect model. Summary of review Of 2277 initially identified articles, 61 (2.7%) were entered in the meta-analysis. Out of 108,571 patients with COVID-19, acute CVD occurred in 1.4% (95%CI: 1.0–1.9). The most common manifestation was acute ischemic stroke (87.4%); intracerebral hemorrhage was less common (11.6%). Patients with COVID-19 developing acute cerebrovascular diseases, compared to those who did not, were older (pooled median difference = 4.8 years; 95%CI: 1.7–22.4), more likely to have hypertension (OR = 7.35; 95%CI: 1.94–27.87), diabetes mellitus (OR = 5.56; 95%CI: 3.34–9.24), coronary artery disease (OR = 3.12; 95%CI: 1.61–6.02), and severe infection (OR = 5.10; 95%CI: 2.72–9.54). Compared to individuals who experienced a stroke without the infection, patients with COVID-19 and stroke were younger (pooled median difference = −6.0 years; 95%CI: −12.3 to −1.4), had higher NIHSS (pooled median difference = 5; 95%CI: 3–9), higher frequency of large vessel occlusion (OR = 2.73; 95%CI: 1.63–4.57), and higher in-hospital mortality rate (OR = 5.21; 95%CI: 3.43–7.90). Conclusions Acute cerebrovascular diseases are not uncommon in patients with COVID-19, especially in those whom are severely infected and have pre-existing vascular risk factors. The pattern of large vessel occlusion and multi-territory infarcts suggests that cerebral thrombosis and/or thromboembolism could be possible causative pathways for the disease.

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Glucose- and glycaemic factor-lowering effects of probiotics on diabetes: a meta-analysis of randomised placebo-controlled trials

British Journal Of Nutrition ◽

10.1017/s0007114516000076 ◽

2016 ◽

Vol 115 (7) ◽

pp. 1167-1177 ◽

Cited By ~ 58

Author(s):

Jing Sun ◽

Nicholas J. Buys

Keyword(s):

Risk Factors ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Mean Difference ◽

Controlled Trials ◽

Model Assessment ◽

Related Factors ◽

Evidence Database ◽

Associated Risk Factors

AbstractThis meta-analysis examined the effect of probiotics on glucose and glycaemic factors in diabetes and its associated risk factors. All randomised-controlled trials published in English in multiple databases from January 2000 to June 2015 were systematically searched. Only studies that addressed glucose- and glycaemic-related factors as outcome variables were included. The main outcomes of interest in trials were mean changes in glucose, HbA1c, insulin and homoeostasis model assessment-estimated insulin resistance (HOMA-IR). Using the Physiotherapy Evidence Database (PEDro) scale to assess the quality of studies, a total of eleven studies with 614 subjects were included. The pooled mean difference and effect size with a 95 % CI were extracted using a random-effect model. It was found that there are statistically significant pooled mean differences between the probiotics and the placebo-controlled groups on the reduction of glucose (−0·52 mmol/l, 95 % CI −0·92, −0·11 mmol/l; P=0·01) and HbA1c (−0·32 %, 95 % CI −0·57, −0·07 %; P=0·01). There was no statistically significant pooled mean difference between the probiotics and the placebo-controlled groups on the reduction of insulin (−0·48 µIU/ml, 95 % CI −1·34, 0·38 µIU/ml; P=0·27) and HOMA-IR (pooled effect of –0·44, 95 % CI −1·57, 0·70; P=0·45). Meta-regression analysis identified that probiotics had significant effects on reduction of glucose, HbA1c, insulin and HOMA-IR in participants with diabetes, but not in participants with other risk factors. The present meta-analysis suggested that probiotics may be used as an important dietary supplement in reducing the glucose metabolic factors associated with diabetes.

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A systematic and meta-analysis study on the prevalence of tuberculosis and relative risk factors for prisoners in Iran

Infectious Disorders - Drug Targets ◽

10.2174/1871526521666210913111612 ◽

2021 ◽

Vol 21 ◽

Author(s):

Sedigheh Taherpour ◽

Mojtaba Mousavi Bazzaz ◽

Hamidreza Naderi ◽

Saeed Samarghandian ◽

Alireza Amirabadizadeh ◽

...

Keyword(s):

Risk Factors ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Random Model ◽

Health Interventions ◽

P Value ◽

Analysis Study ◽

Effect Model ◽

Related Risk

Introduction: This study aimed to evaluate the incidence of Tuberculosis (TB) among prisoners in Iran, by performing a systematic and meta-analysis study on the related articles. Methodology: Scopus, Iran doc, Cochrane, Pubmed, Medline, Embase and Iran Medex, Magiran, SID, Google Scholar, and EBSCO were searched. After quality assessment of the articles, a fixed or random model, as appropriate, was used to pool the results in a meta-analysis. Heterogeneity between the studies was assessed using I-square and Q-test. Results: The overall sample size of included studies was 19562 that 64 of them were with TB. The highest prevalence of tuberculosis was related to the study of Rasht, 517 in 100,000 but the lowest rate was related to the study of Sought Khorasan, 25 in 100,000. The ES of the random effect model is 0.003 (95% CI, 0.001-0.005) and p-value <0.0001. The Higgins’ I2 of all studies is 86.55%, and the p-value of the Cochrane Q statistics is <0.001, indicating that there is heterogeneity. Based on the Egger regression plot (t=2.18, p = 0.08, CI 95%: -0.001, 0.005) no publication bias existed. Conclusion: The frequency of TB among the prisoners in Iran was low. Due to important limitations in this study, it is not possible to indicate the exact prevalence of TB among prisoners in Iran and compare this with the general population. More studies are needed to assess the related risk factor for designing health interventions plan to decrease the incidence rate of TB among prisoners.

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The factors of non-specific chronic low back pain in nurses: A meta-analysis

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-200161 ◽

2021 ◽

pp. 1-11

Author(s):

Weige Sun ◽

Haijiao Zhang ◽

Limei Tang ◽

Ying He ◽

Suzhai Tian

Keyword(s):

Risk Factors ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

College Education ◽

Low Back ◽

Night Shifts

BACKGROUND: Numerous studies have investigated factors for non-specific chronic low back pain (NSCLBP) in nurses, and have reached different conclusions. Evidence-based recommendations are required for the prevention and treatment of NSCLBP in nurses. OBJECTIVE: This meta-analysis aimed to systematically review and quantify the factors of NSCLBP in nurses. METHODS: Eleven databases were searched. The odds ratios (OR) with 95% confidence intervals (CIs) were pooled using meta-analysis, and either a fixed-effect or random-effect model was used based on heterogeneity across included studies. RESULTS: Eighteen publications including 11,752 nursing staff were included. Being female (pooled estimate [95% CI], 1.56 [1.24–1.96]; P< 0.001), married (1.89 [1.38–2.60]; P< 0.001), overweight (0.63 [0.43–0.93]; P= 0.02), working at least 10 years (0.65 [0.48–0.89]; P= 0.007), and working night shifts (2.19 [1.16–4.21]; P= 0.02) were positively related to NSCLBP. Junior college education (0.60 [0.47–0.77]; P< 0.001) and job satisfaction (0.58 [0.47–0.73]; P< 0.001) were negatively related. Age (0.80 [0.50–1.27]; P= 0.34) and physical exercise (0.99 [0.39–2.49]; P= 0.98) were not related. CONCLUSIONS: This is the first meta-analysis to quantify the risk factors for NSCLBP in nurses. Being female, married, working night shifts, overweight, working at least 10 years and dissatisfied with work are risk factors. High-quality prospective studies are required to validate the findings of this study.

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Environmental Iodine Content, Female Sex and Age Are Associated with New-Onset Amiodarone-Induced Hypothyroidism: A Systematic Review and Meta-Analysis of Adverse Reactions of Amiodarone on the Thyroid

Cardiology ◽

10.1159/000444578 ◽

2016 ◽

Vol 134 (3) ◽

pp. 366-371 ◽

Cited By ~ 7

Author(s):

Bin Zhong ◽

Yazhu Wang ◽

Guo Zhang ◽

Zhe Wang

Keyword(s):

Risk Factors ◽

Adverse Reactions ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Iodine Content ◽

Cochrane Library ◽

Meta Regression Analysis ◽

Associated Risk Factors ◽

New Onset

Objectives: To investigate the incidence of new-onset amiodarone-induced hypothyroidism (AIH) and the associated risk factors. Methods: We performed a systematic search in MEDLINE, Embase, the Cochrane Library and the Chinese database from 1995 to 2015. Studies that investigated amiodarone-related adverse reactions on the thyroid were included. A random-effect model was used for the meta-analysis to investigate the incidence rate of AIH and associated risk factors. Results: We identified 465 studies, of which data from 9 studies were included, comprising 1,972 patients. The incidence of AIH was 14.0% (95% confidence interval, CI, 8.7-21.7%) as a whole; it was higher in areas with a high than a low iodine content in the environment (20.3 vs. 8.7%, p < 0.001); subgroup analysis showed that AIH occurred in 19.2% (95% CI 10.2-33.1%) of women and 13.3% (95% CI 7.9-21.7%) of men (p < 0.001). Meta-regression analysis indicated a positive correlation with the mean age and percentage of women. Conclusions: The occurrence of AIH is a relatively frequent complication of amiodarone, and older women are more likely to develop AIH, especially in areas with a high iodine content in the environment, and restriction of total exposure to iodine might decrease the incidence of AIH.

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Mortality associated with Blastomyces dermatitidis infection: A systematic review of the literature and meta-analysis

Medical Mycology ◽

10.1093/mmy/myz048 ◽

2019 ◽

Vol 58 (1) ◽

pp. 1-10

Author(s):

Alex Carignan ◽

Mélina Denis ◽

Claire Nour Abou Chakra

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Case Series ◽

Case Fatality ◽

Attributable Mortality ◽

Blastomyces Dermatitidis ◽

Immunocompromised Patients

Abstract Published case fatality in blastomycosis patients ranges between 4% and 78%. This study aimed to assess mortality associated with blastomycosis and identify its associated risk factors. We conducted a systematic review of publications related to Blastomyces dermatitidis available in PubMed and Scopus databases. Studies that reported data on blastomycosis mortality and that were published from inception through February 2018 were assessed and included in the analysis. Using the R meta package, a random-effect model meta-analysis was used to calculate pooled and stratified estimates of case-fatality proportions and risk ratios. Of 1553 publications, we included 20 studies reporting on a total of 2820 cases of blastomycosis between 1970 and 2014 and three case series reports with 10, 21, and 36 patients. The mean or median ages ranged from 28 to 59 years. Mortality was defined as attributable mortality caused by blastomycosis in 13 studies. Among 14 studies with a standard error ≤0.05, the overall pooled mortality was 6.6% (95% confidence interval [CI], 4.9–8.2) with 57% heterogeneity. The mortality rate was 37% (95% CI, 23–51) in immunocompromised patients and 75% (95% CI, 53–96) in patients who developed an acute respiratory distress syndrome (ARDS) (n = 3 studies each). ARDS was the only identified risk factor in general patients (risk ratio = 10.2). The overall mortality was significantly higher in studies involving immunocompromised patients and ARDS patients. Our analysis showed considerable heterogeneity among studies. Inconsistent mortality definitions may have contributed to the observed heterogeneity. Further research is needed to assess potential risk factors for mortality.

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The epidemiology of intransient TB-induced hyperglycaemia in previously undiagnosed diabetes mellitus 2 individuals: a protocol for a systematic review and meta-analysis

Systematic Reviews ◽

10.1186/s13643-019-1143-0 ◽

2019 ◽

Vol 8 (1) ◽

Cited By ~ 1

Author(s):

Sonia Menon ◽

Joel Francis ◽

Natasha Zdraveska ◽

Alfred Dusabimana ◽

Samit Bhattacharyya

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

World Health ◽

Flow Diagram ◽

Undiagnosed Diabetes ◽

Selective Reporting

Abstract Background Diabetes mellitus (DM) is burgeoning as a global chronic health condition. Some studies suggest that tuberculosis (TB) can even cause diabetes in those not previously known to be diabetic, which as a corollary can add to the already heavy global DM burden. The World Health Organization (WHO) recommends screening for DM at the start of TB treatment; however, it remains to be elucidated which patients with TB-induced hyperglycaemia are at risk for developing DM and who would benefit from a more regular follow-up. This systematic review will aim to firstly synthesise literature on the irreversibility of TB-induced hyperglycaemia in individuals with previously undiagnosed type 2 diabetes mellitus and secondly to synthesise literature on risk factors for progression from TB-induced hyperglycaemia to overt DM in previously undiagnosed. Methods We will search for relevant studies in electronic databases such as PubMed, EMBASE, PROQUEST, and SCOPUS. Furthermore, references will be hand searched to identify other studies. A flow diagram will be drawn to identify the studies retrieved from each database. We will review all publications that include studies containing data on impaired glucose metabolism upon TB diagnosis, and the quality of all eligible studies will be assessed using the Newcastle-Ottawa Scale. We will further conduct a meta-analysis to pool estimates on the risk of progression of persistent hyperglycaemia to overt DM within this population group, as well as the risk factors for this progression. We will use a random effect model to assess heterogeneity, will carry out sensitivity analysis to explore the influence of a single study on the overall estimate, and will report our findings from our systematic review and meta-analysis according to PRISMA guidelines. Egger’s test will be performed to explore the presence of selective reporting bias. If data allow, we will perform a subgroup/meta-regression analysis. Summary effects will be reported using odds ratio, hazard ratio, and relative risk ratios. Furthermore, any clinical, epidemiological, and public health research gaps we identify will be described in a research proposal.

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Gestational Diabetes in Malaysia: A Systematic Review of Prevalence, Risk Factors and Outcomes

Sains Malaysiana ◽

10.17576/jsm-2021-5008-19 ◽

2021 ◽

Vol 50 (8) ◽

pp. 2367-2377

Author(s):

Lieng Teng Cheong ◽

Ken Yong Foo ◽

Mun Lum Ka ◽

Yung Toh Shen ◽

Xuan Hii Chan ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Systematic Review ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Effect Model ◽

International Data

Gestational diabetes mellitus (GDM) is glucose intolerance first diagnosed during pregnancy. In Malaysia, the prevalence, risk factors, and maternal/foetal outcomes vary somewhat among the local studies. In this systematic review of Malaysian studies, we synthesise relevant data from 13 journal articles (including 10,285 women with gestational diabetes). A meta-analysis of twelve datasets showed a prevalence of 21.5% (95% CI 17.3 to 25.9%, random effect model). Clinical factors in the mother found to increase her risk of GDM were consistent with international data. A meta-analysis of complications showed statistically significant increase for macrosomia (OR 3.08, 95% CI 1.77 to 5.36) but not for pre-eclampsia (OR 1.44, 95% CI 0.52 to 4.00) and caesarean delivery (OR 1.31, 95% CI 0.98 to 1.75). The high prevalence of gestational diabetes mellitus and documented adverse consequences support the need for universal screening of this condition in all pregnant women in Malaysia.

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Direct and Indirect Therapeutic Effect of Traditional Chinese Medicine as an Additional Drug on Non-proliferative Diabetic Retinopathy: A systematic review and meta-analysis of high-quality studies

10.21203/rs.3.rs-51831/v1 ◽

2020 ◽

Author(s):

Xuedong an ◽

de jin ◽

liyun duan ◽

shenghui zhao ◽

rongrong zhou ◽

...

Keyword(s):

Risk Factors ◽

Diabetic Retinopathy ◽

Chinese Medicine ◽

Traditional Chinese Medicine ◽

Fixed Effects ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Cochrane Library ◽

Number Of Patients

Abstract Background Diabetic retinopathy (DR) is the leading cause of blindness in many countries. The current treatment of non-proliferative DR (NPDR) with Western medicine (WM) alone are still insufficient. At present, the treatment of NPDR with the combination of traditional Chinese medicine (TCM) and WM is universally applied, and we would evaluate the effectiveness and safety of TCM as an additional drug for NPDR with systematic reviews and meta-analysis. Method Data before July 6, 2019 were searched as randomized controlled trials (RCTs) of TCM for the treatment of NPDR with WM, which were collected from China National Knowledge Infrastructure , Wanfang Database , China Biomedical Database , Pubmed , Embase and Cochrane Library . Relevant data was extracted by two reviewers respectively. I 2 statistics was adopted to appraise the heterogeneity, if I 2 <50% then the fixed-effects model would be employed, otherwise the random-effect model would be employed. (PROSPERO: CRD42019134947) Result 18 RCTs (1522 patients) were included according to the inclusion criteria. The results showed that compared with WM, TCM (including Compound Xueshuantong Capsule, Qiming Granule, and others)+ WM for NPDR could improve overall efficiency [n=1686,RR1.24(1.18,1.30), P <0.00001, I 2 =0%], and reduce the level of risk factors related to NPDR, such as glycated hemoglobin level [n=360, MD -0.85(-1.28, -0.41), P =0.0001, I 2 =72%], triglyceride and total cholesterol, but not Qiming Granule. Moreover, no serious adverse events were reported. Conclusion Compared with WM alone, TCM+WM could significantly improve NPDR, and also reduced the correlation levels of risk factors, considering the sample size and the number of patients included in the study, there might be publication bias, so the corresponding results should be treated with caution.

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