A Meta-Analysis of the Effects of Secondhand Smoke Exposure toward the Incidence of Pneumonia in Children Under Five

Abstract

Background: Pneumonia is an acute respira­tory infection in which the alveoli are filled with pus and fluids that cause painful respiration and limit oxygen intake. Pneumonia is the main cause of death among children under five in the world, killing more than 800,000 children under five each year, or about 2,200 per day. One of the risk factors for pneumonia in chil­dren under five is exposure to secondhand smoke. This study aimed to estimate the magni­tude of the effect of exposure to secondhand smoke on the incidence of pneumonia in chil­dren under five. Subjects and Method: This study used a syste­matic review and meta-analysis technique. There were three article search databases in­cluding Google Scholar, Pubmed, and Science Direct with a publication period from 2009-2020. The article search was carried out by con­si­dering the eligibility criteria defined using the PICO model. P: children under five, I: ex­po­sed to secondhand smoke, C: not exposed to second­hand smoke, and O: pneumonia. The key­­words for searching the articles were (risk factors OR passive smoking OR secondhand smoking) AND (pneumonia) AND (children under five). The articles included in this study were full-text articles, articles in English, arti­cles with cross-sectional study design and case-con­trol, articles with adjusted odds ratio re­sults. Articles were collected using PRISMA flow diagrams and analyzed using RevMan 5.3 application. Results: The total of 12 articles were reviewed in this study. A meta-analysis of three cross-sectional studies showed that exposure to second­hand smoke increased the risk of pneu­monia in children under five (aOR= 1.66; 95% CI= 1.38 to 2.01; p <0.001). A meta-ana­lysis of nine case-control studies showed that exposure to secondhand smoke increased the risk of pneumonia in children under five years (aOR= 2.15; 95% CI=1.25 to 3.68; p=0.005). Conclusion: Exposure to secondhand smoke in­­crea­ses the incidence of pneumonia in chil­dren under five. Keyword s : The exposure to secondhand smoke, pneumonia, children under five. Correspondence: Maya Ayu Riestiyowati. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami, Pucangsawit, Jebres, Surakarta 57125, Central Java, Indonesia. Email: maaya.­ayuu.­ma­­­@gmail.com. Journal of Epidemiology and Public Health (2020), 05(04): 410-419 https://doi.org/10.26911/jepublichealth.2020.05.04.03