RESUMO
OBJECTIVE: To investigate the associations between family structure and social vulnerability with TDIs in children and adolescents. METHODS: An electronic search was conducted in seven databases (PubMed, Scopus, LILACS, Embase, Web of Science, ProQuest, and Google Scholar) to retrieve observational studies that evaluated the prevalence of TDIs. The risk of bias was assessed using the JBI Critical Appraisal Tools. Meta-analyses were also conducted using odds ratios (ORs) and 95% confidence intervals (CIs). The certainty of evidence was evaluated using the GRADE approach. RESULTS: Out of 7,424 records, seventeen articles were included (n = 18,806 children and adolescents aged between 0 and 19 years). Only two studies had a low risk of bias. Children and adolescents from nonnuclear families were more likely to suffer from TDIs (OR: 1.39; 95% CI: 1.17; 1.66). On the other hand, the level of social vulnerability did not show a positive association with TDIs (OR - 1.21; 95% CI: 1.00; 1.47). The GRADE approach assessed the certainty of evidence as low. CONCLUSION: Despite the uncertainty of the evidence, children and adolescents from nonnuclear families are more likely to have TDIs than are those from nuclear families. On the other hand, social vulnerability does not seem to be associated with episodes of TDIs in children and adolescents. CLINICAL RELEVANCE: Through knowledge of the risk factors for TDIs, it is possible to develop public policies for their prevention.
