Exposure to indoor smoking, poor household conditions may increase risk of developing pediatric tuberculosis

Manipal: A systematic review and meta-analysis, published in the European Journal of Pediatrics has shed light on the risk factors for the development of tuberculosis (TB) among the pediatric population. 

Pediatric tuberculosis poses a significant health burden, leading to high mortality and morbidity rates among children worldwide. The disease's complexity and resemblance to other respiratory conditions make accurate diagnosis and intervention challenging.

In addition to what is already known, the research has identified exposure to indoor smoking, poor household conditions, and indoor smoking as important risk factors for developing pediatric tuberculosis. 

The findings highlight that children living in poor household conditions and getting exposed to passive indoor smoking demand more attention for preventing pediatric TB in addition to routine contact screening for the pediatric group. 

A systematic review of studies from PubMed, Embase, and Google Scholar was conducted, focusing on risk factors related to pediatric TB. Meta-analysis was performed to assess the strength of the association between specific risk factors and the development of TB in children.

The meta-analysis revealed that out of the eleven analyzed risk factors, four were significantly associated with pediatric TB:

1. Contact with known TB cases: Children who had contact with individuals diagnosed with TB had a 6.42 times higher odds (95% confidence interval [CI]: 3.85, 10.71) of developing TB themselves.

2. Exposure to smoke: Children exposed to indoor smoking were at 2.61 times higher odds (95% CI: 1.24, 5.51) of contracting TB compared to their non-exposed counterparts.

3. Overcrowding in houses: Overcrowded living conditions contributed to a 2.29 times higher odds (95% CI: 1.04, 5.03) of pediatric TB.

4. Poor household conditions: Children living in suboptimal household conditions faced a 2.65 times higher odds (95% CI: 1.38, 5.09) of developing TB.

The study also identified heterogeneity among the included studies, underscoring the need for further research and standardized screening protocols.

The findings of this meta-analysis underscore the importance of screening for specific risk factors in the pediatric population to combat the prevalence of TB. Routine contact screening for children exposed to known TB cases is essential, and clinicians should be vigilant in identifying children living in overcrowded and poorly maintained households. Moreover, passive exposure to indoor smoking emerged as a previously unexplored risk factor, emphasizing the need for public health initiatives to address this issue.

This comprehensive meta-analysis sheds light on key risk factors associated with pediatric TB, providing clinicians and policymakers with valuable insights to strengthen disease prevention and control measures. By identifying and addressing these risk factors, healthcare providers can take proactive steps to reduce the burden of pediatric TB and improve the overall health outcomes of vulnerable children.

Reference:

Siddalingaiah, N., Chawla, K., Nagaraja, S. B., & Hazra, D. (2023). Risk factors for the development of tuberculosis among the pediatric population: a systematic review and meta-analysis. European Journal of Pediatrics, 182(7), 3007–3019. https://doi.org/10.1007/s00431-023-04988-0