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Table 2 Summary odds ratios (OR) and their 95% confidence interval (CI) estimated by categorical and continuous approaches of dose–response meta-analysis

From: Education level and misuse of antibiotics in the general population: a systematic review and dose–response meta-analysis

Group of studies Number of studies Medium versus low education level
OR (95% CI)
High versus low education level
OR (95% CI)
1-year increase in education
OR (95% CI)
All studies 94 0.94 (0.83, 1.06) 0.86 (0.72, 1.03) 0.99 (0.97, 1.00)
Study design     
Cohort 2 0.93 (0.89, 0.97)
Cross-sectional 92 0.95 (0.84, 1.07) 0.88 (0.73, 1.05) 0.99 (0.97, 1.00)
Type of antibiotic misuse     
 Use without prescription 70 0.94 (0.82, 1.08) 0.85 (0.68, 1.06) 0.99 (0.97, 1.00)
 Storage of antibiotics 10 1.17 (0.93, 1.48) 1.41 (1.22, 1.64) 1.03 (1.01, 1.06)
 Non-adherence 9 0.98 (0.65, 1.49) 0.98 (0.71, 1.35) 0.99 (0.96, 1.03)
 Several concomitant types of misuse 5 0.91 (0.87, 0.95)
Country economy     
 Low 14 0.84 (0.54, 1.32) 0.69 (0.37, 1.28) 0.97 (0.92, 1.02)
 Lower-middle 24 0.94 (0.74, 1.19) 0.70 (0.44, 1.13) 0.97 (0.93, 1.01)
 Upper-middle 30 1.02 (0.89, 1.17) 0.95 (0.78, 1.16) 1.00 (0.98, 1.02)
 High 25 0.80 (0.66, 0.97) 0.97 (0.74, 1.27) 1.00 (0.97, 1.03)
WHO Region     
 Africa 18 0.93 (0.75, 1.16) 0.84 (0.59, 1.21) 0.98 (0.95, 1.01)
 Eastern Mediterranean 27 0.91 (0.68, 1.22) 0.64 (0.42, 1.00) 0.96 (0.93, 1.00)
 European 18 1.02 (0.81, 1.28) 1.25 (1.00, 1.58) 1.02 (1.00, 1.04)
 Region of the Americas 6 1.06 (0.82, 1.38) 0.98 (0.69, 1.38) 1.00 (0.97, 1.03)
 South-East Asia 8 0.61 (0.30, 1.23) 0.45 (0.14, 1.41) 0.93 (0.81, 1.06)
Western Pacific 17 0.94 (0.77, 1.14) 1.11 (0.94, 1.31) 1.01 (0.99, 1.03)
Publication year     
 Until 2015 42 0.99 (0.81, 1.21) 0.95 (0.74, 1.22) 1.00 (0.97, 1.02)
 After 2015 52 0.92 (0.81, 1.05) 0.81 (0.64, 1.02) 0.98 (0.96, 1.00)
Pre-tested or validated questionnaire     
 No 26 0.75 (0.59, 0.95) 0.65 (0.41, 1.02) 0.97 (0.94, 1.01)
 Yes 68 1.01 (0.89, 1.15) 0.95 (0.80, 1.13) 0.99 (0.98, 1.01)
Restriction, matching or adjustment for age and gender     
 No 47 0.86 (0.72, 1.02) 0.70 (0.53, 0.94) 0.97 (0.93, 1.01)
 Yes 47 1.00 (0.85, 1.19) 1.05 (0.87, 1.28) 1.00 (0.99, 1.02)
Quality Score     
 Lower quality (≤ 3 points) 34 0.84 (0.67, 1.04) 0.76 (0.52, 1.10) 0.98 (0.95, 1.01)
 Higher quality (> 3 points) 60 1.00 (0.87, 1.15) 0.93 (0.77, 1.11) 0.99 (0.98, 1.01)