Table 5. Univariable and multivariable meta-regression analyses for Neisseria gonorrhoeae prevalence in anorectal specimens in World Health Organization European Region countries, 1949–2021.
| Anorectal specimens | Outcome measures | Sample size | Univariable analysis | Multivariable analyses | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Total n | Total n | RR | 95% CI | p value | LT test p value | Adjusted R2 | Model 1a | Model 2b | ||||||
| ARR | 95% CI | p value | ARR | 95% CI | p value | |||||||||
| Population characteristics | ||||||||||||||
| Population type | MSM, MSWs, and transgender peoplec | 15 | 9,893 | 1.00 | NA | < 0.001 | 12.87 | 1.00 | NA | 1.00 | NA | |||
| General populations | 3 | 1,258 | 0.41 | 0.11–1.55 | 0.187 | NA | NA | 1.12 | 0.33–3.85 | 0.854 | 1.23 | 0.35–4.27 | 0.744 | |
| Intermediate-risk populations | 2 | 141 | 4.01 | 0.46–34.70 | 0.207 | NA | NA | 10.10 | 1.43–72.00 | 0.021 | 9.35 | 1.31–66.60 | 0.026 | |
| FSWs | 5 | 2,440 | 0.50 | 0.16–1.61 | 0.244 | NA | NA | 1.18 | 0.39–3.57 | 0.766 | 1.09 | 0.36–3.31 | 0.877 | |
| Symptomatic women | 5 | 3,813 | 0.27 | 0.09–0.81 | 0.020 | NA | NA | 1.33 | 0.39–4.46 | 0.647 | 1.21 | 0.36–4.06 | 0.759 | |
| Symptomatic men | 13 | 8,398 | 1.30 | 0.59–2.85 | 0.512 | NA | NA | 1.13 | 0.56–2.30 | 0.730 | 1.11 | 0.54–2.25 | 0.782 | |
| STI clinic attendees | 137 | 739,542 | 0.86 | 0.49–1.52 | 0.597 | NA | NA | 1.27 | 0.75–2.16 | 0.366 | 1.24 | 0.73–2.09 | 0.427 | |
| HIV-positive individuals and individuals in HIV discordant couples | 21 | 4,672 | 1.05 | 0.51–2.19 | 0.887 | NA | NA | 0.90 | 0.47–1.74 | 0.765 | 0.89 | 0.46–1.72 | 0.731 | |
| Sexual contacts of persons infected with NG/CT | 5 | 467 | 2.97 | 0.98–9.00 | 0.054 | NA | NA | 3.45 | 1.25–9.53 | 0.017 | 3.59 | 1.29–9.95 | 0.014 | |
| Patients with confirmed/suspected STIs and related infections | 16 | 2,605 | 3.13 | 1.44–6.78 | 0.004 | NA | NA | 3.23 | 1.60–6.50 | 0.001 | 3.20 | 1.59–6.47 | 0.001 | |
| Other populationsd | 7 | 1,348 | 1.17 | 0.42–3.25 | 0.762 | NA | NA | 2.21 | 0.86–5.68 | 0.100 | 2.29 | 0.89–5.91 | 0.087 | |
| Age group | ≤ 30 years | 8 | 1,165 | 1.00 | NA | 0.559 | 0.00 | NA | NA | NA | NA | |||
| > 30 years | 6 | 498 | 1.41 | 0.34–5.85 | 0.631 | NA | NA | NA | NA | NA | NA | |||
| Mixed ages | 215 | 772,914 | 0.80 | 0.34–1.89 | 0.615 | NA | NA | NA | NA | NA | NA | |||
| Sex | Women | 52 | 176,849 | 1.00 | NA | < 0.001 | 11.86 | 1.00 | NA | 1.00 | NA | |||
| Men | 167 | 579,396 | 2.62 | 1.83–3.75 | < 0.001 | NA | NA | 2.86 | 1.96–4.19 | < 0.001 | 2.75 | 1.89–4.02 | < 0.001 | |
| Mixed sexes | 10 | 18,332 | 2.05 | 0.99–4.24 | 0.052 | NA | NA | 2.05 | 1.06–3.98 | 0.033 | 2.05 | 1.06–3.97 | 0.034 | |
| European subregions | Eastern Europe | 6 | 2,132 | 1.00 | NA | 0.004 | 5.83 | 1.00 | NA | 1.00 | NA | |||
| Southern Europe | 24 | 11,557 | 3.39 | 1.19–9.64 | 0.023 | NA | NA | 0.71 | 0.24–2.12 | 0.537 | 0.63 | 0.21–1.89 | 0.408 | |
| Western Europe | 120 | 633,385 | 1.58 | 0.61–4.14 | 0.347 | NA | NA | 0.80 | 0.30–2.14 | 0.650 | 0.70 | 0.26–1.88 | 0.473 | |
| Northern Europe | 78 | 127,487 | 2.25 | 0.85–5.97 | 0.101 | NA | NA | 0.94 | 0.34–2.62 | 0.910 | 0.85 | 0.31–2.37 | 0.759 | |
| Israel, Türkiye and mixed regions | 1 | 16 | 12.30 | 1.17–129.80 | 0.037 | NA | NA | 2.10 | 0.24–18.50 | 0.504 | 1.96 | 0.22–17.50 | 0.545 | |
| Country’s income level | UMIC | 4 | 1,342 | 1.00 | NA | 0.784 | 0.00 | NA | NA | NA | NA | |||
| HIC | 225 | 773,235 | 1.18 | 0.37–3.76 | 0.784 | NA | NA | NA | NA | NA | NA | |||
| Study methodology characteristics | ||||||||||||||
| Assay type | NAAT/PCR | 121 | 593,512 | 1.00 | NA | 0.288 | 0.41 | NA | NA | NA | NA | |||
| Culture | 65 | 129,889 | 0.74 | 0.52–1.06 | 0.098 | NA | NA | NA | NA | NA | NA | |||
| Gram staining | 4 | 9,857 | 0.80 | 0.25–2.53 | 0.707 | NA | NA | NA | NA | NA | NA | |||
| Other/unclear | 39 | 41,319 | 1.10 | 0.73–1.65 | 0.661 | NA | NA | NA | NA | NA | NA | |||
| Sample size e | < 200 | 38 | 2,715 | 1.00 | NA | < 0.001 | 11.42 | 1.00 | NA | 1.00 | NA | |||
| ≥ 200 | 191 | 771,862 | 0.38 | 0.26–0.56 | < 0.001 | NA | NA | 0.46 | 0.31–0.67 | < 0.001 | 0.45 | 0.31–0.66 | < 0.001 | |
| Sampling method | Probability based | 4 | 1,154 | 1.00 | NA | 0.927 | 0.00 | NA | NA | NA | NA | |||
| Non-probability based | 225 | 773,423 | 0.95 | 0.32–2.85 | 0.927 | NA | NA | NA | NA | NA | NA | |||
| Response rate | ≥ 80% | 7 | 22,936 | 1.00 | NA | 0.509 | 0.00 | NA | NA | NA | NA | |||
| < 80% | 16 | 5,859 | 0.95 | 0.32–2.78 | 0.925 | NA | NA | NA | NA | NA | NA | |||
| Unclear | 206 | 745,782 | 1.32 | 0.54–3.21 | 0.536 | NA | NA | NA | NA | NA | NA | |||
| Temporal trend | ||||||||||||||
| Year of data collection category | < 2000 | 49 | 130,000 | 1.00 | NA | 0.001 | 6.73 | 1.00 | NA | NA | NA | |||
| 2000–2010 | 60 | 139,618 | 1.41 | 0.93–2.16 | 0.109 | NA | NA | 1.60 | 1.10–2.33 | 0.014 | NA | NA | ||
| > 2010 | 120 | 504,959 | 2.02 | 1.40–2.91 | < 0.001 | NA | NA | 2.07 | 1.45–2.96 | < 0.001 | NA | NA | ||
| Year of data collection | 229 | 774,577 | 1.02 | 1.01–1.03 | 0.001 | 0.001 | 5.60 | NA | NA | 1.02 | 1.01–1.04 | < 0.001 | ||
ARR: adjusted risk ratio; CI: confidence interval; CT: Chlamydia trachomatis; FSWs: female sex workers; HIC: high-income country; MSM: men who have sex with men; MSWs: male sex workers; NA: not applicable; NAAT: nucleic acid amplification test, NG: Neisseria gonorrhoeae; LT test: likelihood ratio test, RR: risk ratio; STI: sexually transmitted infection; UMIC: upper-middle income country.
The main results have been bolded to emphasise them and to align them with the corresponding discussions in the results section.
a Adjusted R2 in the final multivariable model 1 = 35.94%.
b Adjusted R2 in the final multivariable model 2 = 35.20%.
c MSM, MSWs, and transgender people group was used as a reference because of epidemiological relevance and because the general populations group had small number of measures.
d Other populations include populations with an undetermined risk of acquiring Neisseria gonorrhoeae infection such as patients with cervical cancer, victims of sexual assault, specimens from virology/bacteriology laboratory and requesting home-based N. gonorrhoeae or Chlamydia trachomatis testing.
e Sample size denotes the sample size of each study population at the baseline found in the original publication.