Association between passive smoking and infection with Mycobacterium tuberculosis in children
Association between passive smoking and infection with Mycobacterium tuberculosis in children
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DOI：
10.1542/peds.2006-1796
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发表时间：
2007-04-01
期刊：
影响因子：
8
通讯作者：
Beyers, Nulda
中科院分区：
文献类型：
--
作者：
den Boon, Saskia;Verver, Suzanne;Beyers, Nulda
OBJECTIVE.肺结核和吸烟都是严重的公共卫生问题。被动吸烟和结核分枝杆菌感染之间的关系没有很好的记录。本研究旨在探讨被动吸烟对儿童结核分枝杆菌感染的影响。在南非开普敦两个相邻的低收入郊区的15%的地址进行了社区调查。居住在这些地址的所有儿童（< 15岁）及其成年家庭成员都被纳入研究。儿童接受结核菌素皮肤试验。硬结>= 10 mm被认为是结核分枝杆菌感染。被动吸烟被定义为与至少1名成年人一起生活至少1年。进行了随机效应logistic回归分析，并根据年龄、家庭中是否存在结核病患者、平均家庭收入和家庭水平的聚集性调整了比值比。在1344名儿童中，432名（32%）结核菌素皮肤试验阳性。被动吸烟与结核分枝杆菌感染在未校正的分析中有显著相关性，但在校正的分析中没有。在172户有结核病患者的家庭中，被动吸烟与结核菌素皮肤试验阳性显著相关（但在492户无结核病患者的家庭中则无相关性。被动吸烟与结核病患者家庭中儿童结核分枝杆菌感染有关。需要更多的研究来证实这一观察结果，但考虑到大多数发展中国家吸烟和结核病的高流行率，这种可能的联系令人极为关切。
OBJECTIVE. Tuberculosis and smoking are both significant public health problems. The association between passive smoking and Mycobacterium tuberculosis infection is not well documented. The objective of this study was to examine the influence of passive smoking on M tuberculosis infection in children.METHODS. A community survey was conducted in 15% of addresses in 2 adjacent low-income suburbs in Cape Town, South Africa. All children (< 15 years of age) and their adult household members residing at these addresses were included in the study. Children underwent tuberculin skin testing. An induration of >= 10 mm was considered to define M tuberculosis infection. Passive smoking was defined as living in the household with at least 1 adult who smoked for at least 1 year. Random-effects logistic regression analysis was performed, and odds ratios were adjusted for age, presence of a patient with tuberculosis in the household, average household income, and clustering at the household level.RESULTS. Of 1344 children, 432 (32%) had a positive tuberculin skin test. Passive smoking was significantly associated with M tuberculosis infection in the unadjusted analyses but not in the adjusted analyses. In the 172 households with a patient with tuberculosis, passive smoking was significantly associated with a positive tuberculin skin test (but not in the 492 households without a patient with tuberculosis.CONCLUSIONS. Passive smoking is associated with M tuberculosis infection in children living in a household with a patient with tuberculosis. More studies are needed to confirm this observation, but the possible association is a cause of great concern, considering the high prevalence of smoking and tuberculosis in most developing countries.