Evidence map›Paper›PMID 33765350›Full record

ArticlePediatric pulmonology2021

The child ecosystem and childhood pulmonary tuberculosis: A South African perspective.

Teresa DeAtley, Lesley Workman, Grant Theron, Sabine Bélard, Margaretha Prins, Lindy Bateman, Martin P Grobusch, Keertan Dheda, Mark P Nicol, Katherine Sorsdahl and 3 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric pulmonology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.1field-weighted citation impact, top 53% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 6 institutions in 6 countries.

Teresa DeAtleyDepartment of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA.ORCID 0000-0002-2234-1629
Lesley WorkmanDepartment of Paediatrics and Child Health, Red Cross Childrens Hospital and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, Western Cape, South Africa.ORCID 0000-0002-3433-6106
Grant TheronDivision of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, SA-MRC Centre for Tuberculosis Research, Stellenbosch University, Stellenbosch, Western Cape, South Africa.ORCID 0000-0002-9216-2415
Sabine BélardDepartment of Paediatrics and Child Health, Red Cross Childrens Hospital and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, Western Cape, South Africa.
Margaretha PrinsDepartment of Paediatrics and Child Health, Red Cross Childrens Hospital and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, Western Cape, South Africa.
Lindy BatemanDepartment of Paediatrics and Child Health, Red Cross Childrens Hospital and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, Western Cape, South Africa.
Martin P GrobuschCenter of Tropical Medicine and Travel Medicine, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Amsterdam, The Netherlands.ORCID 0000-0002-0046-1099
Keertan DhedaCentre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine and UCT Lung Institute & South African MRC/UCT Centre for the Study of Antimicrobial Resistance, University of Cape Town, Cape Town, Western Cape, South Africa.
Mark P NicolDivision of Infection and Immunity, Division of Medical Microbiology, School of Biomedical Sciences, University of Western Australia, Perth, Australia.
Katherine SorsdahlDepartment of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, Western Cape, South Africa.
Caroline KuoDepartment of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA.
Dan J SteinDepartment of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, Western Cape, South Africa.ORCID 0000-0001-7218-7810
Heather J ZarDepartment of Paediatrics and Child Health, Red Cross Childrens Hospital and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, Western Cape, South Africa.ORCID 0000-0002-9046-759X
University of Cape Town · ZAAfrican Institute for Mathematical Sciences · ZABrown University · USNational Health Laboratory Service · ZASouth African Medical Research Council · ZAWestern Cape Department of Health · ZA

Funding

The nasopharyngeal microbiota of African children and lower respiratory tract infectionU54HG009824 · NHGRI · UNIVERSITY OF CAPE TOWN · PI NICOL, MARK PATRICK · 2017 to 2021
$2.9M
Diagnosis of Tuberculosis in HIV-infected children & development of microbiologicR01HD058971 · NICHD · UNIVERSITY OF CAPE TOWN · PI ZAR, HEATHER JOY · 2008 to 2012
$2.2M
Biopsychosocial Factors Associated with Cigarette and E-cigarette Use in Smokers with Affective DisordersF31DA049460 · NIDA · BROWN UNIVERSITY · PI DEATLEY, TERESA E · 2019 to 2021
$115k
Medical Research Council MR/S027777/1Medical Research Council MR/S03563X/1NHGRI NIH HHS U54 HG009824NICHD NIH HHS R01 HD058971NIDA NIH HHS F31 DA049460Wellcome Trust
6 · The paper itself

Abstract

introductionThis study investigates drivers of childhood pulmonary tuberculosis (PTB) using a childhood ecosystem approach in South Africa. An ecosystem approach toward identifying risk factors for PTB may identify targeted interventions.

methodsData were collected as part of a prospective cohort study of children presenting at a primary care facility or tertiary hospital with possible TB. Characterization of the childhood ecosystem included proximal, medial, and distal determinants. Proximal determinants included child characteristics that could impact PTB outcomes. Medial determinants included relational factors, such as caregiver health, which might impact interactions with the child. Distal determinants included macro-level determinants of disease, such as socioeconomic status and food insecurity. Children who started on TB treatment were followed for up to 6 months. Multivariate regression models tested independent associations between factors associated with PTB in children.

resultsOf 1202 children enrolled, 242 (20%) of children had confirmed PTB, 756 (63%) were started on TB treatment, and 444 (37%) had respiratory conditions other than TB. In univariate analyses, childhood malnutrition and caregiver smoking were associated with treated or confirmed PTB. In multivariate analyses, proximal factors, such as male gender and hospitalization, as well as low socioeconomic status as a distal factor, were associated with PTB.

conclusionsInterventions may need to target subgroups of children and families with elevated proximal, medial, and distal risk factors for PTB. Screening for risk factors, such as caregiver's health, may guide targeting. The provision of social protection programs to bolster economic security may be an important intervention for attenuating childhood exposure to risk factors.

Indexed as

EcosystemTuberculosis, PulmonaryChildHospitalizationHumansMaleProspective StudiesRisk Factorsconceptual hierarchical frameworksTB determinants

Identifiers

PMID33765350
PMCPMC8477372
OpenAlexW3139329096

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.