Childhood tuberculosis and exposure to indoor air pollution: a systematic review and meta-analysis
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.
Keywords: cooking fuel; indoor air pollution; passive smoke; pulmonary tuberculosis; risk factors
Document Type: Research Article
Affiliations: 1: *Discipline of Occupational and Environmental Health, School of Nursing and Public Health, and 2: †Discipline of Paediatrics and Child Health, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; 3: ‡Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden
Publication date: 01 May 2015
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