Passive smoking increases the risk of invasive meningococcal disease in children
A close relationship has been established between passive smoking and the occurrence of invasive meningococcal infections in children.
According to a new systematic review and meta-analysis by scientists at the Harvard School of Public Health and published in the December issue of PLoS Medicine, a close relationship has been established between passive smoking and occurrence of invasive meningococcal infections in children.
Researchers have found that reducing the effects of secondhand smoke on children (for example, by encouraging parents not to smoke at home) could significantly reduce the incidence and mortality of invasive bacterial infections. Such an approach would be particularly appropriate in developing countries with low rates of vaccination against invasive bacterial infections.
Invasive bacterial infections are a major cause of infant mortality in both developing and developed countries. The main agents responsible for invasive bacterial infections in children are Streptococcus pneumoniae, Haemophilus influenzae type B (Hib) and Neisseria meningitidis.
Passive smoking in children largely leads to the occurrence of invasive meningococcal infections. However, at present, it is only assumed that there is a link between the development of invasive pneumococcal and hemophiliac infections with passive smoking. There is also evidence of a relationship between secondhand smoke and the carriage of Streptococcus pneumoniae and Neisseria meningitidis.
To conduct a meta-analysis, two independent experts searched the databases of the American National Medical Library (Medline), EMBASE and other databases. All the selected studies were evaluated for compliance with the inclusion and exclusion criteria. As a result, 30 case-control studies and 12 concurrent studies were identified, which were carried out mainly in high-income countries with wide vaccine coverage. Next, the prevalence of invasive bacterial infections in children exposed to passive smoke exposure with no similar effect was compared.
The researchers calculated the total odds ratio. Compared with children not exposed to second-hand smoke, children who smoke indirectly were 2 times more likely to develop invasive meningococcal infections (OS = 2.02, 95% confidence interval 1.52-2.69). The total odds ratio for invasive pneumococcal and hemophiliac infections was 1.21 (95% confidence interval 0.69-2.14) and 1.22 (95% confidence interval 0.93-1 , 62), respectively.
Thus, a clear relationship has been established between passive smoking in children and the development of invasive meningococcal and hemophiliac infections, regardless of results, age groups, study design and year of publication. evaluated during the study. Younger children (i.e., less than 6 years of age), who are the most vulnerable patient category, are more susceptible to secondhand smoke.
Although the current analysis does not report a global burden of invasive meningococcal and hemophiliac infections, regional data on the prevalence of these diseases range from 0.3 to 4 cases per 100,000 population in North America to 1,000 cases per 100,000 inhabitants in central Africa.
According to the authors of the meta-analysis, focus on the effect of second-hand smoke on the spread of invasive bacterial infections, especially in Asia and developing regions, where there is a steady increase in second-hand smoke, and invasive bacterial infections pose a significant threat to public health.
The review and meta-analysis have limitations, namely a small number of identified studies, a lack of studies in developing countries and significant differences in the measurement of the effects of second-hand smoke and the diagnosis of bacterial infections invasive.
Thus, it is now necessary to conduct well-organized large-scale studies in developing countries to confirm the results.