title: Childhood tuberculosis and exposure to indoor air pollution: a systematic review and meta-analysis.
abstract: 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.
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  Exposure to ETS increases the risk of childhood TB disease or tuberculous infection.
authors: Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
authors: N
authors: N
authors: Jafta
authors: Discipline of Paediatrics and Child Health, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
authors: P M
authors: PM
authors: Jeena
authors: Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden.
authors: L
authors: L
authors: Barregard
authors: Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
authors: R N
authors: RN
authors: Naidoo
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects*; D016022:Case-Control Studies; D002648:Child; D000067576:Child Health; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004784:Environmental Monitoring / Q000379:methods; D005260:Female; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D008297:Male; D020380:Needs Assessment; D010372:Pediatrics; D018570:Risk Assessment; D013548:Sweden; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology
chemical_list: D014028:Tobacco Smoke Pollution