Infection with M. tuberculosis and atopy in children

Abstract

The incidence of atopic disease has increased dramatically in countries with a western life-style. Although the exact cause(s) of the increase is still unknown, different hypotheses have been proposed. The hygiene hypothesis ascribes the rising incidence of atopic disease to reduction in incidence of serious infectious diseases, such as mycobacteria. Efforts are being made to investigate the possible protective effects of mycobacterial infection on the development of atopy, as this may be relevant for the production of mycobacterial-based vaccines against the development of atopic disease.

This thesis focuses on the relationship between Mycobacterium tuberculosis (M. tuberculosis) infection and the prevalence of atopic disease manifestations in children. In addition, it evaluates the influence of co-morbidity with intestinal helminthic infection and other possible confounding or disease modifying environmental factors, such as prolonged breastfeeding, maternal smoking, number of siblings and socioeconomic variables, on this relation. A general introduction to the subject is given in Chapter 1, with a short summary of the epidemiology of tuberculosis (TB), particularly describing the diagnostic problems in the pediatric population. In addition, the epidemiology of atopic disease and the hygiene hypothesis in relation to infection with M. tuberculosis, co-infection with intestinal helminth and the influence of prolonged breastfeeding, is also discussed.