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Pathways of TB Transmission in Children—A Systematic Review of Molecular Epidemiological Studies

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  • Roland Diel

    (Institute for Epidemiology, University Medical Hospital Schleswig-Holstein, 24105 Kiel, Germany
    LungClinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research (DZL), 22927 Großhansdorf, Germany)

  • Albert Nienhaus

    (Competence Center for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
    Department for Occupational Medicine, Hazardous Substances and Health Sciences (AGG), Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 22089 Hamburg, Germany)

Abstract

The widespread paradigm that younger children usually do not transmit M. tuberculosis complex (Mtbc) to their contacts has not yet been proven by genotypically confirmed transmissions. Therefore, we undertook a systematic review of molecular-epidemiological studies to investigate documented source and secondary TB (tuberculosis) cases among children. We searched the literature published before August 2022 using PubMed , Cochrane , and Google Scholar databases. PRISMA statement was used for systematic review. Of 312 records retrieved, 39 studies including children aged below 15 years offered epidemiological links between cluster members. In the 39 studies from 16 countries, 225 children were reported as cluster members of whom the overwhelming majority were infected by adults. Only 3 children—of those were 2 children aged below 10—were reported to be the definite source cases of 11 other children and 1 adult with genotypically matched Mtbc isolates. To date, molecular-epidemiological studies involving children with verified transmission links are scarce. As far as the heterogeneity of the studies we identified allows, we could conclude that the results confirm the paradigm that children aged below 10 hardly ever transmit Mtbc to others. The true extent of TB transmission through children may, however, be underestimated by those selected studies.

Suggested Citation

  • Roland Diel & Albert Nienhaus, 2023. "Pathways of TB Transmission in Children—A Systematic Review of Molecular Epidemiological Studies," IJERPH, MDPI, vol. 20(3), pages 1-10, January.
  • Handle: RePEc:gam:jijerp:v:20:y:2023:i:3:p:1737-:d:1039409
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    References listed on IDEAS

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    1. Andre, M. & Ijaz, K. & Tillinghast, J.D. & Krebs, V.E. & Diem, L.A. & Metchock, B. & Crisp, T. & McElroy, P.D., 2007. "Transmission network analysis to complement routine tuberculosis contact investigations," American Journal of Public Health, American Public Health Association, vol. 97(3), pages 470-477.
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