Association between passive smoking and Mycobacterium tuberculosis infection in children with household TB contact

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Novaily Zuliartha
Ridwan M. Daulay
Melda Deliana
Wisman Dalimunthe
Rini Savitri Daulay


Background Tuberculosis (TB) and cigarette consumption are relatively high in Indonesia. Passive smoking may increase the risk of infection and disease in adults and children exposed to TB. An association between passive smoking and Mycobacterium tuberculosis infection in children has not been well documented. Objective To assess for an association between passive smoking and M. tuberculosis infection in children who had household contact with a TB patient. Methods This cross-sectional study was conducted in February and March 2011. Children aged 5 to 18 years who had household contact with a TB patient underwent tuberculin testing for M. tuberculosis infection. Subjects were divided into two groups: those exposed to passive smoke and those not exposed to passive smoke. Chi-square test was used to assess for an association between passive smoking and M. tuberculosis infection. Results There were 140 children enrolled in this study, with 70 exposed to passive smoke and 70 not exposed to passive smoke. Prevalence of M. tuberculosis infection was significantly higher in the passive smoking group than in those not exposed to passive smoke [81.4% and 52.9%, respectively, (P= 0.0001)]. In the passive smoking group there were significant associations between nutritional state, paternal and maternal education, and M. tuberculosis infection. But no associations were found between M. tuberculosis infection and familial income or BCG vaccination. Conclusion Among children who had household contact with a TB patient, they who exposed to passive smoke are more likely to have M. tuberculosis infection compared to they who not exposed to passive smoke.

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How to Cite
Zuliartha N, Daulay RM, Deliana M, Dalimunthe W, Daulay RS. Association between passive smoking and Mycobacterium tuberculosis infection in children with household TB contact. PI [Internet]. 1Mar.2015 [cited 23Sep.2021];55(1):29-4. Available from:
Received 2016-07-12
Accepted 2016-07-12
Published 2015-03-01


1. Aditama TY, Kamso S, Basri C, Surya A, editors. Pedoman nasional penanggulangan tuberkulosis. 2nd ed. Jakarta: Departemen Kesehatan Republik Indonesia; 2008.
2. Rahajoe NN, Basir D, MS Makmuri, Kartasasmita CB, editors. Pedoman nasional tuberkulosis anak. 2nd ed. Jakarta: UKK Respirologi PP IDAI; 2007.
3. Varaine F, Henkens M, Grauzard V, editors. Tuberculosis. 5th ed. Med Sans Frontieres. 2010.
4. Ahmed T, Sobhan F, Ahmed AMS, Banu S, Mahmoed AM, Hyder KA, et al. Childhood tuberculosis: a review of epidemiology, diagnosis and management. Infect Dis J Pakistan. 2008;17:52-60.
5. Menzies D, Schwartzman K, Pai M. Immune-based test for tuberculosis. In: Schaaf HS, Zumla AI, editors. Tuberculosis: a comprehensive clinical reference. Europe: Elsevier; 2009. p. 179-92.
6. Janson C. The effect of passive smoking on respiratory health in children and adults. Int J Tuberc Lung Dis. 2004;8:510-6.
7. den Boon S, Verver S, Marais BJ, Enarson DA, Lombard CJ, Bateman ED, et al. Association between passive smoking and infection with mycobacterium tuberculosis in children. Pediatrics. 2007;119:734-9.
8. Zellweger JP. Tobacco and tuberculosis. Monaldi Arch Chest Dis. 2008;69:83-5.
9. Leung CC, Lam TH, Ho KS, Yew WW, Tam CM, Chan WM, et al. Passive smoking and tuberculosis. Arch Intern Med. 2010;170:287-92.
10. Glader P, Möller S, Lilja J, Wieslander E, Löfdahl CG, von Wachenfeldt K. Cigarette smoke extract modulates respiratory defence mechanisms through effects on T-cells and airway epithelial cells. Respir Med. 2006;100:818-27.
11. Altet MN, Alcaide J, Plans P, Taberner JL, Saltó E, Folguera, et al. Passive smoking and risk of pulmonary tuberculosis in children immediately following infection. A case-control study. Tuber Lung Disease. 1996;77:537-44.
12. Gupta KB, Gupta R, Atreja A, Verma M, Vishvkarma S. Tuberculosis and nutrition. Lung India. 2009;26:9-16.
13. Mandalakas AM, Kirchner HL, Iverson S, Chesney M, Spencer MJ, Sidler A, et al. Predictors of Mycobacterium tuberculosis infection in international adoptees. Pediatrics. 2007;120:e610-6.
14. Leung CC, Lam TH, Chan WM, Yew WW, Ho KS, Leung G, et al. Lower risk of tuberculosis in obesity. Arch Intern Med. 2007;167:1297-304.
15. Haq S, Hussain M, Krishin J, Abbasi S. Risk factors of tuberculosis in children. Ann Pak Inst Med Sci. 2010;6:50-4.
16. Leinhardt C, Sillah J, Fielding K, Donkor S, Manneh K, Warndorff D, et al. Risk factors for tuberculosis infection in children in contact with infectious tuberculosis cases in the Gambia, West Africa. Pediatrics. 2003;111:e608-14.
17. Karyadi E, Schultink W, Nelwan RH, Gross R, Amin Z, Dolmans WM, et al. Poor micronutrient status of active pulmonary tuberculosis patients in Indonesia. J Nutr. 2000;130:2953-8.
18. Søborg B, Andersen AB, Melbye M, Wohlfahrt J, Andersson M, Biggar RJ, et al. Risk factors for Mycobacterium tuberculosis infection among children in Greenland. Bull World Health Organ. 2011;89:741-8.
19. Besser RE, Pakiz B, Schulte JM, Alvarado S, Zell ER, Kenyon TA, et al. Risk factors for positive mantoux tuberculin skin tests in children in San Diego, California: evidence for boosting and possible foodborne transmission. Pediatrics. 2001;108:305-10.
20. Bozaykut A, Ipek IO, Ozkars MY, Seren LP, Atay E, Atay Z. Effect of BCG vaccine on tuberculin skin test in 1-6-year-old children. Arch Paediatr. 2002;91:235-8.
21. Mustapha MG, Garba AM, Rabasa AI, Gimba MS. Prevalence of mantoux test positivity among apparently healthy children in Maiduguri, Nigeria. South African J Child Health. 2009;3:80-2.
22. Bierrenbach AL, Cunha SS, Barreto ML, Pereira SM, Dourado I, Ichihara MY, et al. Tuberculin reactivity in a population of schoolchildren with high BCG vaccination coverage. Rev Panam Salud Publica. 2003;13:285-93.
23. Santiago EM, Lawson E, Gillenwater K, Kalangi S, Lescanao AG, Du Quella G, et al. A prospective study of bacillus Calmette-Guerin scar formation and tuberculin skin test reactivity in infants in Lima, Peru. Pediatrics. 2003;112:e298.
24. Garcia-Sancho FMC, Garcia-Garcia L, Jimenez-Corona ME, Palacios-Martinez M, Ferreyra-Reyes LD, Canizales-Quintero S, et al. Is tuberculin skin testing useful to diagnose latent tuberculosis in BCG-vaccinated children? Int J Epidemiol. 2006;35:1447-54.