scholarly journals Non-prescription dispensing of antibiotic agents among community drug retail outlets in Sub-Saharan African countries: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Sewunet Admasu Belachew ◽  
Lisa Hall ◽  
Linda A. Selvey
Keyword(s):  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Acute Diarrhoea ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Retail Outlets ◽  
Sub Saharan ◽  
Tract Infections ◽  
Ssa Countries

Abstract Background The development of antimicrobial resistance, which is partially attributable to the overuse and/or misuse of antibiotics in health care, is one of the greatest global public health challenges. In Sub-Saharan African (SSA) countries, non-prescribed dispensing of antibiotics in community drug retail outlets (CDROs) has been flagged as one of the contributing factors for the widespread misuse of antibiotics in the community. Objective The current review aimed to estimate the proportion of non-prescription antibiotics requests or consultations that resulted in provision of antibiotics without a valid prescription among CDROs in SSA region, and describe the type of antibiotics dispensed. Methods A literature search was conducted using PubMed, CINAHL, Scopus and Google Scholar. We also searched reference lists of relevant articles. Random effect model meta-analysis was employed to determine the pooled proportion of over the counter sale of antibiotics. Subgroup and meta-regression was undertaken to explore the potential cause of heterogeneity in effect size across studies. Results Of 671 total citations retrieved, 23 met the inclusion criteria (seven cross-sectional questionnaire-based surveys and 16 cross-sectional client-based studies). The overall pooled proportion of non-prescription antibiotics requests or consultations that resulted in supply of antibiotics without prescription was 69% (95% CI 58–80). Upper respiratory tract infections and/or acute diarrhoea were the most frequently presented case scenarios, and amoxicillin and co-trimoxazole were the most frequently dispensed antibiotics to treat those symptoms. Conclusions Non-prescribed dispensing of antibiotics was found to be a common practice among CDROs in several SSA countries. Ease of access to and overuse of antibiotics can potentially accelerate the emergence of resistance to antibiotics available in the region. Our review highlights the need for a stringent enforcement of existing policies and/or enacting new regulatory frameworks that would regulate antibiotic supply, and training and educational support for pharmacy personnel (e.g. pharmacists, pharmacy assistants) regarding judicious use of antibiotics and the importance of antimicrobial stewardship.

Association Between Prediabetes and Retinopathy: A Meta-Analysis

2021 ◽  
Vol 53 (12) ◽  
pp. 801-809
Author(s):  
Ji Jin ◽  
Peirong Lu
Keyword(s):  
Meta Analysis ◽  
Microvascular Complications ◽  
Random Effect ◽  
Random Effect Model ◽  
Community Dwelling ◽  
Current Evidence ◽  
Cross Sectional ◽  
Increased Risk ◽  
Study Heterogeneity ◽  
Study Characteristics

AbstractDiabetes confers an increased risk of microvascular complications, including retinopathy. However, whether prediabetes is also related to retinopathy has not been comprehensively examined. We performed a meta-analysis to evaluate the relationship between prediabetes and retinopathy. This meta-analysis included relevant observational studies from Medline, Embase, and Web of Science databases. A random-effect model after incorporation of the intra-study heterogeneity was selected to pool the results. Subgroup analyses were applied to evaluate the influences of study characteristics on relationship. Nine cross-sectional studies including 14 751 community dwelling adult participants were included; 3847 (26.1%) of them were prediabetic. Results showed that prediabetes was associated with a higher prevalence of retinopathy compared to normoglycemia [odds ratio (OR): 1.55, 95% confidence interval (CI): 1.10–2.20, p=0.01, I2=34%]. Sensitivity analysis by excluding one study at a time showed consistent result (OR: 1.35 to 1.73, p all<0.05). Subgroup analysis showed study characteristics such as definition of prediabetes, country of study, sample size, mean age of participants, or univariate or multivariate analyses may not significantly affect the association (p for subgroup difference all>0.05). Current evidence suggests that patients with prediabetes may be associated with higher prevalence of retinopathy as compared to those with normoglycemia. Although prospective cohort studies are needed to validate these findings, results of our meta-analysis highlighted the importance of early prevention of retinopathy in patients with prediabetes.

scholarly journals Effect of HIV Infection on Mortality in Patients with Tuberculosis in Asia: A Meta-Analysis

2020 ◽  
Author(s):  
Liza Laela Abida ◽  
◽  
Bhisma Murti ◽  
Hanung Prasetya ◽  
◽  
...  
Keyword(s):  
Hiv Infection ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Risk Of Mortality ◽  
Hiv Mortality ◽  
Keywords Hiv

ABSTRACT Background: TB/HIV coinfectioned remains the leading cause of mortality among people living with HIV (PLHIV). The purpose of this study was to explore the effect of HIV infection on mortality in patients with tuberculosis in Asia. Subjects and Method: This was meta-analysis and systematic review. The study was conducted by collecting published studies from Google Scholar, PubMed, Springer Link, Hindawi, Clinical Key, and ProQuest databases, from 2010 to 2020. Keywords used “HIV” AND “mortality” OR “HIV Mortality” OR “Tuberculosis Mortality” AND “cross sectional” AND “adjusted odd ratio”. The inclusion criteria were full text, using English or Indonesian language, using cross-sectional study design, and reporting adjusted odds ratio. The articles were selected by PRISMA flow chart. The quantitative data were analyzed using random effect model run on Review Manager 5.3. Results: 5 studies in Asia (Thailand, China, Malaysia, and Oman) were included for this study. Meta analysis study reported that HIV elevated the risk of mortality in patients with tuberculosis (aOR= 3.45; 95% CI= 1.14 to 10.45; p = 0.030). Conclusion: HIV elevates the risk of mortality in patients with tuberculosis. Keywords: HIV, mortality, Tuberculosis Correspondence: Liza Laela Abida. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 085640115633. DOI: https://doi.org/10.26911/the7thicph.01.52

scholarly journals Effect of Secondary Education on Exclusive Breastfeeding: Meta-Analysis

2020 ◽  
Author(s):  
Ferda Fibi Tyas Nurkholifa ◽  
◽  
Eti Poncorini Pamungkasari ◽  
Hanung Prasetya ◽  
◽  
...  
Keyword(s):  
Secondary Education ◽  
Exclusive Breastfeeding ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
South Australia ◽  
Inclusion Criteria ◽  
Or Education ◽  
Cross Sectional ◽  
Central Java

ABSTRACT Background: Many studies reported the importance of exclusive breastfeeding for infants. However, there are many obstacles faced by lactating mothers to provide exclusive breastfeeding for their children. This study aimed to investigate the effect of secondary education on exclusive breastfeeding using a meta-analysis. Subjects and Method: Meta-analysis and systematic review were conducted by collecting articles from PubMed, Science Direct, and Google Scholar databases. Keywords used exclusive breastfeeding” AND “secondary education” OR “education for breastfeeding” AND “cross sectional” AND “adjusted odd ratio”. The study population was postpartum mothers. Intervention was secondary education with comparison primary education. The study outcome was exclusive breastfeeding. The inclusion criteria were full text, using English or Indonesian language, and reporting adjusted odds ratio. The articles were selected by PRISMA flow chart. The quantitative data were analyzed using random effect model run on Revman 5.3. Results: 7 studies from Peru, China, Nigeria, Korea, Ireland, Sub-Sahara, and South Australia were met the inclusion criteria. There was high heterogeneity between groups (I2= 94%; p<0.001). This study reported that secondary education reduced exclusive breastfeeding, but it was statistically non-significant (aOR= 0.86; 95% CI= 0.60 to 1.24; p= 0.430). Conclusion: Secondary education reduced exclusive breastfeeding, but it was statistically non-significant. Keywords: exclusive breastfeeding, secondary education, postpartum Correspondence: Ferda Fibi Tyas Nurkholifa. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6285655778863. DOI: https://doi.org/10.26911/the7thicph.03.131

Obesity and Gastroesophageal Reflux Disease: A Meta-Analysis Study in Asia and America

2020 ◽  
Author(s):  
Alfiani Vivi Sutanto ◽  
◽  
Hanung Prasetya ◽  
◽  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
The United States ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Central Java

ABSTRACT Background: Gastroesophageal reflux disease (GERD) is a common disorder with a prevalence of 20% in the United States and less than 5% in Asia. Untreated, GERD can result in a symptomatic burden to the patient, poor health-related quality of life, complications, such as esophageal stricture, Barrett’s esophagus, and esophageal adenocarcinoma, and a high direct and indirect cost to the healthcare system. Various pathophysiological mechanisms have been identified to explain the relationship between obesity and GERD, including a high prevalence of hiatal hernia and increased gastroesophageal pressure gradient. This study aimed to examine the association between obesity and GERD in Asia and America. Subjects and Method: This was meta-analysis and systematic review. The study was conducted by collecting articles from PubMed, Google Scholar, BMC Journals, Science Direct, Mendeley, and clinical key databases. Keywords used “Obesity” OR “HMI” AND “Gastroesophageal reflux disease” OR “GERD” AND “Effect obesity for GERD” AND “aOR”. The inclusion criteria were full text, using cross-sectional study design, and reporting adjusted odds ratio. The study population was adults who experienced GERD. Intervention was obesity. The study outcome was gastroesophageal reflux disease (GERD). The articles were selected using PRISMA flow chart. The quantitative data were analyzed using random effect model run on Revman 5.3. Results: 5 studies were analyzed and reviewed for this study. Current study reported that obesity increased the risk of gastroesophageal reflux disease (GERD) (aOR= 2.04; 95% CI=1.42 to 2.92; p= 0.001). Conclusion: Obesity increases the risk of gastroesophageal reflux disease. Keywords: obesity, gastroesophageal reflux disease Correspondence: Alfiani Vivi Sutanto. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 085799253568. DOI: https://doi.org/10.26911/the7thicph.05.50

scholarly journals A meta-analysis of copper level and risk of preeclampsia: evidence from 12 publications

2016 ◽  
Vol 36 (4) ◽  
Author(s):  
Yuqin Fan ◽  
Yan Kang ◽  
Min Zhang
Keyword(s):  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Asian Population ◽  
Epidemiological Studies ◽  
Copper Level ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Healthy Pregnancy ◽  
Risk Of Preeclampsia

The association between copper level and risk of preeclampsia (PE) has produced inconsistent results. Thus, a meta-analysis was conducted to summarize the evidence from epidemiological studies for copper level and PE risk. Pertinent studies were identified by a search of PubMed and Web of Knowledge up to April 2016. Standardized mean difference (SMD) was performed to combine the results. Random-effect model (REM) was used. Publication bias was estimated using Egger's regression asymmetry test. Twelve articles (10 case–control studies and 2 cross-sectional studies) involving 442 PE cases and 463 health controls were included in this meta-analysis. Our pooled results suggested that PE patients had a higher copper level compared with healthy pregnancy controls [summary SMD=0.69, 95% CI: 0.54–0.84, I2=96.7%; P<0.001]. The association was also significant in Asian population [SMD=0.73, 95% CI=0.57–0.90, I2=97.3%] and European populations [SMD=0.50, 95% CI=0.14–0.86, I2=58.9%]. After conducting the subgroup analysis and sensitive analysis, the results showed consistent significant association with the one based on all studies. No publication biases were found. Our analysis indicated that plasma or serum copper level in PE patients was significantly higher than that in healthy pregnancy women.

Association between Toxoplasma gondii infection and headache: a systematic review and meta-analysis

2020 ◽  
Vol 20 ◽  
Author(s):  
Tooran Nayeri ◽  
Shahabeddin Sarvi ◽  
Mahmood Moosazadeh ◽  
Zahra Hosseininejad ◽  
Afsaneh Amouei ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Forest Plot ◽  
Cross Sectional ◽  
Effect Model ◽  
Toxoplasma Gondii Infection ◽  
And Control ◽  
The Impact

Background: The impact of infectious agents, such as Toxoplasma gondii (T. gondii), on human behavior and mental disorders has recently attracted the attention of researchers. T. gondii has emerged as a suitable candidate for such disorders due to its neural nature. Therefore, the current study aimed at investigating the possible relationship between T. gondii infection and headache. Methods: Five databases were thoroughly searched (up to October 4, 2019) for articles on the prevalence of T. gondii in headache sufferer. In this study, the odds ratio (OR) and corresponding 95% confidence interval (CI) were estimated using a random effect model and forest plot to gauge effect size and effect of each study. Results: A total number of four articles, including three case-controls and one cross-sectional studies with 2517 participants entered the meta-analysis out of whom 1205 subjects were afflicted with headache or migraine (17.67% positive for toxoplasmosis) and 1312 participants were not (18.29% for toxoplasmosis). The results of the meta-analysis indicated a common OR of 1.59 (95% CI: 1.03-2.47) by the random effect model. Conclusion: The obtained results of several studies have linked toxoplasmosis and headache. Therefore, more quality studies with larger sample sizes are needed to determine the detailed association between headache and T. gondii infection for the prevention and control of toxoplasmosis among headache sufferers.

scholarly journals Association between body size, weight change and depression: systematic review and meta-analysis

2017 ◽  
Vol 211 (1) ◽  
pp. 14-21 ◽  
Author(s):  
Sun Jae Jung ◽  
Hyung-taek Woo ◽  
Sooyoung Cho ◽  
Kyounghoon Park ◽  
Seokhun Jeong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Body Size ◽  
Weight Change ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Cross Sectional ◽  
Hazard Ratios ◽  
Effect Model ◽  
Subgroup Analyses

BackgroundThe association between body size, weight change and depression has not been systematically summarised, especially for individuals who are underweight.AimsTo conduct a systematic review and a meta-analysis to examine the association between indices of body size, weight change and depression.MethodA total of 183 studies were selected. Fully adjusted hazard ratios (HRs) or odds ratios (ORs) were extracted. A total of 76 studies contributed to data synthesis with a random-effect model, and subgroup analyses were conducted to evaluate the effect of potential moderators.ResultsIn cohort studies, underweight at baseline increased the risk of subsequent depression (OR = 1.16, 95% CI 1.08–1.24). Overweight (BMI 25–29.9 kg/m2) showed no statistically significant relationship with depression overall; however, the subgroup analyses found different results according to gender (men: OR = 0.84, 95% CI 0.72–0.97, women: OR = 1.16, 95% CI 1.07–1.25). In cross-sectional designs, obesity with BMI >40kg/m2 showed a greater pooled odds ratio than obesity with BMI >30kg/m2.ConclusionsBoth underweight and obesity increase the risk of depression. The association between overweight and depression differs by gender.

scholarly journals Prevalence of Malaria and Chikungunya Co-Infection in Febrile Patients: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 6 (3) ◽  
pp. 119
Author(s):  
Wanida Mala ◽  
Polrat Wilairatana ◽  
Kwuntida Uthaisar Kotepui ◽  
Manas Kotepui
Keyword(s):  
Real Time ◽  
Diagnostic Tests ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Rt Pcr ◽  
Chikv Infection ◽  
Cross Sectional ◽  
Effect Model ◽  
Pooled Prevalence

Co-infection with malaria and chikungunya (CHIKV) could exert a significant public health impact with infection misdiagnosis. Therefore, this study aimed to collect qualitative and quantitative evidence of malaria and CHIKV co-infection among febrile patients. Methods: Potentially relevant studies were identified using PubMed, Web of Science, and Scopus. The bias risk of the included studies was assessed using the checklist for analytical cross-sectional studies developed by the Joanna Briggs Institute. The pooled prevalence of malaria and CHIKV co-infection among febrile patients and the pooled prevalence of CHIKV infection among malaria patients were estimated with the random effect model. The odds of malaria and CHIKV co-infection among febrile patients were also estimated using a random effect model that presumed the heterogeneity of the outcomes of the included studies. The heterogeneity among the included studies was assessed using the Cochran Q test and I2 statistics. Publication bias was assessed using the funnel plot and Egger’s test. Results: Of the 1924 studies that were identified from the three databases, 10 fulfilled the eligibility criteria and were included in our study. The pooled prevalence of malaria and CHIKV co-infection (182 cases) among febrile patients (16,787 cases), stratified by diagnostic tests for CHIKV, was 10% (95% confidence interval (CI): 8–11%, I2: 99.5%) using RDT (IgM), 7% (95% CI: 4–10%) using the plaque reduction neutralization test (PRNT), 1% (95% CI: 0–2%, I2: 41.5%) using IgM and IgG ELISA, and 4% (95% CI: 2–6%) using real-time RT-PCR. When the prevalence was stratified by country, the prevalence of co-infection was 7% (95% CI: 5–10%, I2: 99.5%) in Nigeria, 1% (95% CI: 0–2%, I2: 99.5%) in Tanzania, 10% (95% CI: 8–11%) in Sierra Leone, 1% (95% CI: 0–4%) in Mozambique, and 4% (95% CI: 2–6%) in Kenya. The pooled prevalence of CHIKV infection (182 cases) among malaria patients (8317 cases), stratified by diagnostic tests for CHIKV, was 39% (95% CI: 34–44%, I2: 99.7%) using RDT (IgM), 43% (95% CI: 30–57%) using PRNT, 5% (95% CI: 3–7%, I2: 5.18%) using IgM and IgG ELISA, and 9% (95% CI: 6–15%) using real-time RT-PCR. The meta-analysis showed that malaria and CHIKV co-infection occurred by chance (p: 0.59, OR: 0.32, 95% CI: 0.6–1.07, I2: 78.5%). Conclusions: The prevalence of malaria and CHIKV co-infection varied from 0% to 10% as per the diagnostic test for CHIKV infection or the country where the co-infection was reported. Hence, the clinicians who diagnose patients with malaria infections in areas where two diseases are endemic should further investigate for CHIKV co-infection to prevent misdiagnosis or delayed treatment of concurrent infection.

scholarly journals Microbleeds in Alzheimer’s Disease: A Neuropsychological Overview and Meta-Analysis

2016 ◽  
Vol 43 (6) ◽  
pp. 753-759 ◽  
Author(s):  
Amir A. Sepehry ◽  
Alexander Rauscher ◽  
Ging-Yuek Hsiung ◽  
Donna J. Lang
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Degrees Of Freedom ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
High Sensitivity ◽  
P Value ◽  
Cross Sectional ◽  
Small Effect Size

AbstractThe current literature on the role of brain microbleeds (MB) on the neuropsychological outcomes of Alzheimer’s disease (AD) is heterogeneous. We therefore meta-analytically examined the neuropsychological literature pertaining to MBs in AD. Using a priori selected criteria, studies with cross-sectional neuropsychological assessment on MBs and AD were reviewed. Six of 122 studies met selection criteria and provided neuropsychological data on either AD with MB and without MB, or in contrast to healthy controls. The global neuropsychological difference between AD with MB and AD without MB based on random effect model was nonsignificant, heterogeneous, and small (Effect Size =−0.155; 95% confidence interval =−0.465 to 0.155; p value =0.326; Heterogenity: Q-value =12.744; degrees of freedom =5; p =0.026; I2 =61%). The contribution of MBs to cognitive deficits in AD remains unclear. Future studies of MB in AD should strive to use standardized neuroimaging techniques with high sensitivity for MB, a common standard for MB definition, and neuropsychological tests sensitive for detecting subtle cognitive impairment.

scholarly journals Awareness, Knowledge, Attitude, and Practice of Teledentistry among Dental Practitioners during COVID-19: A Systematic Review and Meta-Analysis

Medicina ◽  
2022 ◽  
Vol 58 (1) ◽  
pp. 130
Author(s):  
Galvin Sim Siang Lin ◽  
Sze Hui Koh ◽  
Karyn Zuhuan Ter ◽  
Chia Wei Lim ◽  
Sharmin Sultana ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Systemic Review ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Attitude And Practice ◽  
Dental Practitioners ◽  
Knowledge Attitude And Practice ◽  
Poor Practice

Background and Objectives: This systemic review aims to appraise and analyse the awareness, knowledge, attitude, and practice of teledentistry among dental practitioners during COVID-19. Materials and Methods: This review was registered in the PROSPERO database (CRD42021283404). Cross-sectional articles on dental practitioners’ perceptions towards teledentistry published between March 2020 and September 2021 were searched in ten online databases (PubMed, Google Scholar, Web of Science, ScienceDirect, Cochrane, EMBASE, SIGLE, EBSCO, LILACS, and Open Grey). The Joanna Briggs Institute critical appraisal tool was employed to analyse the risk of bias (RoB) of each article, whereas the Oxford Centre for Evidence-Based Medicine recommendation tool was used to evaluate the level of evidence. Data were analysed using the DerSimonian–Laird random effect model based on a single-arm approach. Results: Six studies were included and demonstrated Level 3 evidence. A single-arm meta-analysis revealed that dental practitioners had a high level of awareness (70.4%) and attitude (72.5%) towards teledentistry during the COVID-19 pandemic, but their knowledge level (57.9%) was moderate with a poor practice level (35.8%). A substantial heterogeneity was observed with the overall I2 ranging from 90.78% to 98.21%. Furthermore, meta-regression indicated that the sample size of each study had a significant (p < 0.05) impact on the degree of data heterogeneity. Conclusions: Despite their high degree of awareness and attitude, dental practitioners demonstrated moderate knowledge and relatively poor practice of teledentistry during the COVID-19 pandemic. More well-designed studies are warranted to investigate the alternatives for enhancing dental practitioners’ knowledge and practice of teledentistry interventions.

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