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Childhood tuberculosis and exposure to indoor air pollution: a systematic review and meta-analysis

Journal article
Authors N. Jafta
P. M. Jeena
Lars Barregård
R. N. Naidoo
Published in International Journal of Tuberculosis and Lung Disease
Volume 19
Issue 5
Pages 596-602
ISSN 1027-3719
Publication year 2015
Published at Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine
Pages 596-602
Language en
Keywords pulmonary tuberculosis, cooking fuel, passive smoke, risk factors, indoor air pollution, PULMONARY TUBERCULOSIS, PASSIVE SMOKING, RISK-FACTORS, MYCOBACTERIUM-TUBERCULOSIS, CLINICAL-TRIALS, SOLID-FUEL, CHILDREN, INFECTION, CANCER, CHINA, Infectious Diseases, Respiratory System
Subject categories Clinical Medicine


BACKGROUND: Indoor air pollution (IAP) from environmental tobacco smoke (ETS) and biomass fuel smoke (BMS) poses respiratory health risks, with children and women bearing the major burden. OBJECTIVES: We used a systematic review and meta-analysis to investigate the relation between childhood tuberculosis (TB) and exposure to ETS and BMS. METHODS: We searched three databases for epidemiological studies that investigated the association of childhood TB with exposure to ETS and BMS. We calculated pooled estimates and heterogeneity for studies eligible for inclusion in the meta-analysis and stratified studies on ETS by outcome. RESULTS: Five case-control and three cross-sectional studies were eligible for inclusion in the meta-analysis and quality assessment. Pooled effect estimates showed that exposure to ETS is associated with tuberculous infection and TB disease (OR 1.9, 95%CI 1.4-2.9) among exposed compared to non-exposed children. TB disease in ETS studies produced a pooled OR of 2.8 (95%CI 0.9-4.8), which was higher than the OR for tuberculous infection (OR 1.9, 95%CI 0.9-2.9) for children exposed to ETS compared to non-exposed children. Studies on BMS exposure were too few and too small to permit a conclusion. CONCLUSION: Exposure to ETS increases the risk of childhood TB disease or tuberculous infection.

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