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Table 4 Results of meta-analyses on studies reporting Neisseria gonorrhoeae prevalence in symptomatic populations and patients with confirmed or suspected STIs and related infections in the Middle East and North Africa

From: Epidemiology of gonorrhea in countries of the Middle East and North Africa: systematic review, meta analyses, and meta regressions

Population typea

Stratified prevalence measures

Sample

size

NG prevalence (%)

Pooled mean NG prevalence

Heterogeneity measures

Total

n

Total

N

Range

Median

Mean (%)

(95% CI)

Qb

(p value)

I2c (%)

(95% CI)

Prediction intervald (%)

Symptomatic women

    Current urogenital infection

NAAT/PCR

30

8008

0.0–30.0

3.2

3.4 (2.0–5.2)

227.1 (p<0.001)

87.2 (82.9–90.5)

0.0–16.1

Culture

27

8633

0.0–25.0

3.8

4.3 (2.4–6.7)

466.8 (p<0.001)

94.4 (92.9–95.6)

0.0–21.6

Gram stain

14

2028

0.0–38.1

2.6

3.8 (0.8–8.7)

195.0 (p<0.001)

93.3 (90.4–95.3)

0.0–32.2

Wet mount

5

387

0.0–14.3

5.3

3.1 (0.0–10.0)

9.6 (p=0.048)

58.3 (0.0–84.5)

0.0–31.2

Other/unclear assaye

2

446

0.0–26.0

13.0

2.7 (1.4–4.6)f

–

–

–

Overall

78

19,502

0.0–38.1

3.1

3.9 (2.7–5.3)

965.3 (p<0.001)

92.0 (90.7–93.2)

0.0–20.5

    Current anorectal infection

Culture

1

200

–

–

1.2 (1.1–6.4)

–

–

–

Overall

1

200

–

–

1.2 (1.1–6.4)

–

–

–

    Unspecified/mixed anatomical site

NAAT/PCR

1

441

–

–

0.9 (0.2–2.3)

–

–

–

Culture

1

400

–

–

19.2 (15.5–23.5)

–

–

–

Other/unclear assaye

3

447

1.4–5.0

4.0

3.3 (1.3–6.1)

3.6 (p=0.162)

45.1 (0.0–83.7)

0.0–54.5

Overall

5

1288

1.0–19.2

4.0

4.8 (0.8–11.7)

115.8 (p<0.001)

96.5 (94.2–98.0)

0.0–42.7

Symptomatic men

    Current urogenital infection

NAAT/PCR

7

1130

11.4–63.0

40.0

39.2 (27.1–52.1)

76.1 (p<0.001)

92.4 (86.9–95.6)

4.4–82.3

Culture

26

5109

2.0–94.0

41.5

41.6 (30.9–52.8)

1,648.7 (p<0.001)

98.5 (98.2–98.7)

0.6–93.1

Gram stain

33

11,003

3.5–96.0

46.0

44.6 (34.9–54.4)

2,286.4 (p<0.001)

98.6 (98.4–98.8)

1.7–94.1

Other/unclear assaye

3

460

0.6–28.0

26.8

14.9 (0.7–41.4)

89.6 (p<0.001)

97.8 (95.8–98.8)

0.0–100

Overall

69

17,702

0.6–96.0

43.0

41.4 (34.9–48.1)

4,471.2 (p<0.001)

98.5 (98.3–98.6)

1.6–90.7

    Unspecified/mixed anatomical site

NAAT/PCR

1

422

–

–

41.7 (36.9–46.6)

–

–

–

Gram stain

1

162

–

–

67.3 (59.5–74.4)

–

–

–

Overall

2

584

41.6–67.3

54.5

48.8 (44.7–52.9)f

–

–

–

Symptomatic patients (mixed sexes)

    Current urogenital infection

NAAT/PCR

1

168

–

–

22.6 (16.5–29.7)

–

–

–

Culture

1

95

–

–

26.3 (17.8–36.3)

–

–

–

Overall

2

263

23.0–26.3

24.7

23.9 (18.9–29.5)f

–

–

–

Patients with confirmed or suspected STIs and related infections

    Current urogenital infection

NAAT/PCR

4

335

3.8–96.2

12.5

29.0 (0.0–79.7)

280.5 (p<0.001)

98.9 (98.4–99.3)

0.0–100

Culture

7

1174

4.7–61.3

21.7

26.4 (11.1–45.4)

315.7 (p<0.001)

98.1 (97.3–98.7)

0.0–91.2

Gram stain

2

160

55.0–93.7

74.4

74.4 (66.9–80.9)f

–

–

–

Overall

13

1669

3.8–96.3

21.7

34.8 (16.2–56.2)

835.1 (p<0.001)

98.6 (98.2–98.9)

0.0–100

  1. Abbreviations: CI Confidence interval, NAAT Nucleic acid amplification test, NG Neisseria gonorrhoeae, PCR Polymerase chain reaction, STI Sexually transmitted infection
  2. A minimum of three studies were required to conduct a meta-analysis
  3. Bolded numbers represent overall pooled estimates
  4. aPopulation type classification can be found in Table 1
  5. bQ: The Cochran’s Q statistic is a measure assessing the existence of heterogeneity in pooled outcome measures, here NG prevalence
  6. cI2: A measure that assesses the magnitude of between–study variation that is due to actual differences in NG prevalence across studies rather than chance
  7. dPrediction interval: A measure that estimates the distribution (95% interval) of true NG prevalence around the estimated mean
  8. eOther/unclear assay include enzyme immunoassay, indirect hemagglutination, or mixed/unclear testing technique
  9. fTwo prevalence measures are not sufficient to conduct a random-effects meta-analysis. The pooled measure was calculated as the arithmetic mean of the two measures and their 95% confidence intervals
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BMC Global and Public Health

ISSN: 2731-913X

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