BACKGROUND
Numerous studies have identified multiple risk factors for tuberculosis (TB). We conducted an umbrella review of meta-analyses to consolidate the available epidemiologic evidence and evaluate its credibility.
OBJECTIVE
The main objective of our study was to systematically consolidate the available risk factors of TB and thus provide a reference for future TB prevention and control.
METHODS
We searched PubMed, Web of Science and the Cochrane Database of Systematic Reviews for meta-analyses on factors influencing TB published between database inception and October 17, 2021. The summary effect, 95% confidence interval (CI) and heterogeneity were obtained. A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR2) was applied to assess the methodological quality.
RESULTS
A total of 17 eligible articles were included in this umbrella review. A total of 24 risk factors, including lifestyle and hygiene, basic personal characteristics, nutrients, vaccinations and other disease factors, were identified. Among these, moderate-quality evidence suggested that indoor air pollution (relative risk [RR], 1.26; 95% CI: 1.08, 1.48), underweight (RR, 4.96; 95% CI: 4.87, 5.05), vitamin D deficiency (odds ratio [OR], 1.48; 95% CI: 1.04, 2.10) and diabetes (OR, 2.3; 95% CI: 2.0, 2.7) increase the risk of TB. Another 17 factors associated with increased risk and 2 factors associated with reduced risk with weak credibility were identified.
CONCLUSIONS
The findings of our study can provide a reference for future TB prevention and control and for clinicians to make medical decisions. Nonetheless, large, multicenter, and multicountry prospective studies are warranted to confirm the results of this umbrella analysis.
CLINICALTRIAL
PROSPERO CRD42021255786; https://tinyurl.com/54d9pxy8