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

Roland Diel1,2, Albert Nienhaus3,4

  • 1Institute for Epidemiology, University Medical Hospital Schleswig-Holstein, 24105 Kiel, Germany.

International Journal of Environmental Research and Public Health
|February 11, 2023
PubMed

Insights

Young children rarely transmit tuberculosis (TB) to others, confirmed by molecular-epidemiological studies. While adult-to-child transmission is common, children under 10 are seldom TB sources.

Area of Science:

  • Microbiology
  • Epidemiology
  • Public Health

Background:

  • The common belief that young children do not transmit Mycobacterium tuberculosis complex (Mtbc) lacks robust genotypic evidence.
  • Investigating child-to-contact transmission is crucial for understanding tuberculosis (TB) epidemiology.

Approach:

  • Systematic review of molecular-epidemiological studies published before August 2022.
  • Searched PubMed, Cochrane, and Google Scholar databases, adhering to PRISMA guidelines.
  • Analyzed 39 studies involving children under 15 with documented TB transmission links.

Key Points:

  • Out of 225 child cluster members across 39 studies, most were infected by adults.
  • Only 3 children, including 2 under 10, were confirmed as TB sources for 11 other children and 1 adult.
  • Molecular-epidemiological data on child-driven TB transmission remains limited.

Conclusions:

  • Findings support the paradigm that children under 10 seldom transmit Mtbc.
  • The actual role of children in TB transmission might be underestimated in current literature.

Keywords:
childrenclustergenotypingmolecular epidemiologytransmissiontuberculosis

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