Indoor air pollution from solid fuel on children pneumonia in low- and middle-income countries: a systematic review and meta-analysis.

An updated systematic review was conducted to assessing on the association between indoor air pollution caused by household energy consumption and childhood pneumonia in low- and middle-income countries. We performed a meta-analysis from the electronic databases of PubMed, Cochrane library, Web of Science, EMBASE. Studies were selected when they reported childhood pneumonia or ALRI in relation to indoor air pollution resulted from solid fuel. Studies must provide results on exposure prevalence of children aged below 5 years from Asia or Africa. We devoted ourselves to identifying randomized controlled experiments and observational epidemiological researches, which revealed the relation between household usage of solid fuel and childhood pneumonia. Among 1954 articles, 276 were reviewed thoroughly and 16 conduced to such a meta-analysis. It was found that there is a significant relationship between the solid fuel combustion and increasing risk of childhood pneumonia (OR = 1.66, 95%CI 1.36-2.02). The summary odds ratios from biomass use and mixed fuel use were, respectively, 1.86 (95%CI 1.15-3.02) and 1.58 (95%CI 1.38-1.81), with substantial between study heterogeneity (I2 = 87.2% and 29.2%, respectively). According to the subgroup analysis along with the meta-regression analysis, the risk of using solid fuel in Asian regions is higher than that in African regions. Studies based on non-hospital participates (I2 = 49.5%) may also a source of heterogeneity. We found that indoor air pollution generated by the usage of solid fuel might be a significant risk factor for pneumonia in children and suggested improving the indoor air quality by promoting cleaner fuel will be important in undeveloped countries.

Delayed diagnosis and comprehensive treatment of cutaneous tuberculosis: A case report.

BACKGROUND: Tuberculosis (TB) is a widespread infectious disease, with an incidence that is increasing worldwide. Cutaneous TB (CTB) occurs rarely, accounting for less than 1% of all TB cases. Due to the clinical presentation and diagnostic difficulties, CTB is often clinically neglected and misdiagnosed. CASE SUMMARY: A 32-year-old man underwent several debridement surgeries and skin flap transplantation after trauma. The wound remained unhealed, accompanied by sinus formation. According to empirical judgment, T-cell spot of TB test, and bacterial culture of pyogenic fluids, he was diagnosed with CTB due to infection with exogenous Mycobacterium tuberculosis. A comprehensive anti-TB regimen that included isoniazid, rifampicin, ethambutol, and pyrazinamide was applied. The sinus was filled with a hydrophilic fiber-containing silver dressing, and wound-protecting sponges were applied to part of the wound. The wound healed after 40 d. No ulceration was found within 2 mo after discharge; further follow-up will be conducted. CONCLUSION: A non-healing wound may be caused by TB infection. Comprehensive treatment of CTB is effective.