Environmental tobacco smoke exposure increases <i> Mycobacterium tuberculosis</i> infection risk in children

Preez, Karen Du; Mandalakas, Anna M.; Kirchner, H. Lester; Grewal, Harleen M. S.; Schaaf, H. Simon; Wyk, S S Van; Hesseling, A C

doi:10.5588/ijtld.10.0759

Cited by 33 publications

(29 citation statements)

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“…3–7 It is known that exposure to IAP increases the risk of respiratory infection and asthma-related illnesses in children, with few studies assessing the role IAP plays in TB disease. 22,29–31 Two studies have found an association between tuberculin skin test positivity and passive tobacco exposure; 30,31 however, this is one of the first studies to demonstrate a strong epidemiological link between exposure to IAP and pediatric TB disease. While this study was not powered to assess passive tobacco smoke exposure or biomass fuel exposure individually, tobacco exposure approached statistical significance, while biomass fuel exposure was highly independently associated with TB using the more stringent research definition of TB.…”

Section: Discussionmentioning

confidence: 92%

Modifiable risk factors associated with tuberculosis disease in children in Pune, India

Jubulis

Kinikar

Ithape³

et al. 2014

int j tuberc lung dis

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SUMMARY SETTING India accounts for the largest burden of tuberculosis (TB) worldwide, with 26% of the world’s cases. OBJECTIVE To assess the association between novel modifiable risk factors and TB in Indian children. DESIGN Cases were children aged ≤5 years with confirmed/probable TB based on World Health Organization definitions (definition 1). Controls were healthy children aged ≤5 years. Logistic regression was performed to estimate the adjusted odds ratio (aOR) of being a TB case given exposure, including indoor air pollution (IAP; exposure to tobacco smoke and/or biomass fuels) and vitamin D deficiency. Cases were re-analyzed according to a new consensus research definition of pediatric TB (definition 2). RESULTS Sixty cases and 118 controls were enrolled. Both groups had high levels of vitamin D deficiency (55% vs. 50%, P = 0.53). In multivariable analysis, TB was associated with household TB exposure (aOR 25.41, 95%CI 7.03–91.81), household food insecurity (aOR 11.55, 95%CI 3.33–40.15) and IAP exposure (aOR 2.67, 95%CI 1.02–6.97), but not vitamin D deficiency (aOR 1.00, 95%CI 0.38–2.66). Use of definition 2 reduced the number of cases to 25. In multivariate analysis, TB exposure, household food insecurity and IAP remained associated with TB. CONCLUSIONS Household TB exposure, exposure to IAP and household food insecurity were independently associated with pediatric TB.

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Section: Discussionmentioning

confidence: 92%

Modifiable risk factors associated with tuberculosis disease in children in Pune, India

Jubulis

Kinikar

Ithape³

et al. 2014

int j tuberc lung dis

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“…Studies from high burden TB regions demonstrate an association between ETS exposure and development of TB disease in adults [52,53]. While the effects of tobacco smoking and exposure on TB have been well described in adults, there are fewer studies focusing on children.…”

Section: Resultsmentioning

confidence: 99%

The association between environmental tobacco smoke exposure and childhood respiratory disease: a review

Vanker

Gie

Zar

2017

Expert Review of Respiratory Medicine

145

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Introduction: Childhood respiratory illness is a major cause of morbidity and mortality particularly in low and middle-income countries. Environmental tobacco smoke (ETS) exposure is a recognised risk factor for both acute and chronic respiratory illness.Areas covered: The aim of this paper was to review the epidemiology of ETS exposure and impact on respiratory health in children. We conducted a search of 3 electronic databases of publications on ETS and childhood respiratory illness from 1990–2015. Key findings were that up to 70% of children are exposed to ETS globally, but under-reporting may mask the true prevalence. Maternal smoking and ETS exposure influence infant lung development and are associated with childhood upper and lower respiratory tract infection, wheezing or asthma. Further, exposure to ETS is associated with more severe respiratory disease. ETS exposure reduces lung function early in life, establishing an increased lifelong risk of poor lung health.Expert commentary: Urgent and effective strategies are needed to decrease ETS exposure in young children to improve child and long-term lung health in adults especially in low and middle income countries where ETS exposure is increasing.

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“…Numerous studies have found individuals with latent TB infection (LTBI) are more likely to be smokers or exposed to second-hand smoke (SHS) ( Table 1). [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] The strength of the associations between LTBI and SHS 15,17,18,21 or direct CS 8,9,11,12,14,16,22,23 exposure is summarized in Figure 1a. There also appears to be an association between the degree of cigarette smoking-as measured by duration or intensity of smoking-and LTBI (Fig.…”

Section: Tb Infection With Cs Exposurementioning

confidence: 99%

“…Having ≥two smokers in a household is associated with positive TST. 18 Tijuana, Mexico (2012) Longitudinal study of 129 intravenous drug users.…”

Section: Shsmentioning

confidence: 99%

Epidemiologic link between tuberculosis and cigarette/biomass smoke exposure: Limitations despite the vast literature

et al. 2015

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The geographic overlap between the prevalence of cigarette smoke (CS) exposure and tuberculosis (TB) in the world is striking. In recent years, relatively large number of studies has linked cigarette or biomass fuel smoke exposure and various aspects of TB. Our goals are to summarize the significance of the known published studies, graphically represent reports that quantified the association and discuss their potential limitations. PubMed searches were performed using the key words 'tuberculosis' with 'cigarette', 'tobacco', 'smoke' or 'biomass fuel smoke.' The references of relevant articles were examined for additional pertinent papers. A large number of mostly case-control and cross-sectional studies significantly associate both direct and second-hand smoke exposure with tuberculous infection, active TB, and/or more severe and lethal TB. Fewer link biomass fuel smoke exposure and TB. While a number of studies interpreted the association with multivariate analysis, other confounders are often not accounted for in these analyses. It is also important to emphasize that these retrospective studies can only show an association and not any causal link.We further explored the possibility that even if CS exposure is a risk factor for TB, several mechanisms may be responsible. Numerous studies associate cigarette and biomass smoke exposure with TB but the mechanism(s) remains largely unknown. While the associative link of these two health maladies is well established, more definitive, mechanistic studies are needed to cement the effect of smoke exposure on TB pathogenesis and to utilize this knowledge in empowering public health policies.

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Environmental tobacco smoke exposure increases Mycobacterium tuberculosis infection risk in children

Cited by 33 publications

References 0 publications

Modifiable risk factors associated with tuberculosis disease in children in Pune, India

Modifiable risk factors associated with tuberculosis disease in children in Pune, India

The association between environmental tobacco smoke exposure and childhood respiratory disease: a review

Epidemiologic link between tuberculosis and cigarette/biomass smoke exposure: Limitations despite the vast literature

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