Risk factors for the development of tuberculosis among the pediatric population: a systematic review and meta-analysis

Abstract

Pediatric tuberculosis is a major cause of mortality and morbidity in children due to high transmission, poor diagnostic tools, and various respiratory diseases mimicking TB. Identifying risk factors will provide evidence for clinicians to strongly relate their diagnosis to the associated pathology. Studies were retrieved from PubMed, Embase, and Google Scholar, systematically reviewed, and meta-analyzed for various risk factors and their association with pediatric TB. Meta-analysis depicted that four out of eleven risk factors were significant—contact with known TB cases (OR 6.42 [3.85,10.71]), exposure to smoke (OR 2.61 [1.24, 5.51]), overcrowding in the houses (OR 2.29 [1.04, 5.03]), and, poor household conditions (OR 2.65 [1.38, 5.09]). Although significant odds ratio estimates were obtained, we observed heterogeneity in the studies included. Conclusion: The study findings demand the constant screening of risk factors such as contact with known TB cases, exposure to smoke, overcrowding, and, poor household conditions for the development of pediatric TB. What is Known:• Knowledge of the risk factors of a disease is of utmost importance in the planning and institution of its control measures. Well-established risk factors in the occurrence of TB in the pediatric group are HIV positivity, older age and close contact with a known case of TB. What is New:• In addition to what is already known; this review and meta-analysis has identified exposure to indoor smoking, overcrowding and poor household conditions as important risk factors for developing pediatric TB.• Implications of the study: The findings highlight that in addition to routine contact screening for the pediatric group, the children living in poor household conditions and getting exposed to passive indoor smoking demand more attention to prevent the development of pediatric TB.

Undernutrition as a risk factor for tuberculosis disease

“…These five aspects have been identified as risk factors in previous systematic reviews informing the programme [ 6 , 7 , 8 , 9 ]. Moreover, socioeconomic status, sex, and age have been reported as important effect modifiers for the risk of TB disease ( 10 ).…”

Patterns of childhood tuberculosis diagnosis in Ethiopia: A multicenter cross-sectional study

“…Globally in 2022, 16% of the HIV-negative and 18% of HIV-positive people who died from TB were children aged < 15 years [ 1 ]. Available data on children suggests limited access to diagnosis and treatment and a higher risk of developing TB among exposed infants and young children [ 1 , 5 , 6 ]. Worldwide, There is a large gap in case detection among children.…”