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Zinc and vitamin A supplementation fails to reduce sputum conversion time in severely malnourished pulmonary tuberculosis patients in Indonesia.

Pakasi TA, Karyadi E, Suratih NM, Salean M, Darmawidjaja N, Bor H, van der Velden K, Dolmans WM, van der Meer JW - Nutr J (2010)

Bottom Line: Patients in the zinc + vitamin A group showed earlier sputum conversion time (mean 1.9 weeks) compared with that in the other groups; however the difference was not significant.Also, no benefit could be demonstrated of any of the used supplementations on clinical, nutritional, chest x-ray, or laboratory findings.This study among severely malnourished TB patients, did not confirm that single or combined supplementation of zinc and vitamin A significantly reduced sputum conversion time or had other significant benefit.

View Article: PubMed Central - HTML - PubMed

Affiliation: South East Asia Minister of Education Organization Tropical Medicine, Regional Center for Community Nutrition, University of Indonesia, Jl, Salemba Raya no 6, Jakarta Pusat 10420, Indonesia. tpakasi_commed@fk.ui.ac.id

ABSTRACT

Background: A previous study showed that combination of zinc and vitamin A reduced sputum conversion time in pulmonary tuberculosis (TB) patients.

Objective: We studied the efficacy of which single micronutrient contributed more to the sputum conversion time.

Methods: In a double-blind randomized community trial, newly sputum smear positive pulmonary TB patients were assigned randomly to receive zinc, vitamin A, zinc + vitamin A or placebo on top of TB treatment. Patients were asked to deliver their sputum on weekly basis to measure positivity of the bacteria. Nutritional status, chest x-ray, hemoglobin, C-reactive protein (CRP), retinol and zinc level were examined prior to, after 2 and 6 months of treatment.

Results: Initially, 300 patients were enrolled, and 255 finished the treatment. Most patients were severely malnourished (mean BMI 16.5 ± 2.2 Kg/m2). Patients in the zinc + vitamin A group showed earlier sputum conversion time (mean 1.9 weeks) compared with that in the other groups; however the difference was not significant. Also, no benefit could be demonstrated of any of the used supplementations on clinical, nutritional, chest x-ray, or laboratory findings.

Conclusions: This study among severely malnourished TB patients, did not confirm that single or combined supplementation of zinc and vitamin A significantly reduced sputum conversion time or had other significant benefit.

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Trial profile. Including reasons for patients' drop out during the study.
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Figure 1: Trial profile. Including reasons for patients' drop out during the study.

Mentions: A total of 300 patients were enrolled into the study and randomly grouped into 4 categories of intervention, i.e. supplementation of zinc (n = 76), vitamin A (n = 72), combined zinc + vitamin A (n = 66) and placebo (n = 86). After two months 274 patients were still in the study and analyzed, while 255 patients completed the study after 6 months and were analyzed. (Figure 1). Of all subjects, we received report from the treatment-partners that 22 patients (of total 255 patients who completed TB treatment) were not compliance to the study procedure.


Zinc and vitamin A supplementation fails to reduce sputum conversion time in severely malnourished pulmonary tuberculosis patients in Indonesia.

Pakasi TA, Karyadi E, Suratih NM, Salean M, Darmawidjaja N, Bor H, van der Velden K, Dolmans WM, van der Meer JW - Nutr J (2010)

Trial profile. Including reasons for patients' drop out during the study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2957385&req=5

Figure 1: Trial profile. Including reasons for patients' drop out during the study.
Mentions: A total of 300 patients were enrolled into the study and randomly grouped into 4 categories of intervention, i.e. supplementation of zinc (n = 76), vitamin A (n = 72), combined zinc + vitamin A (n = 66) and placebo (n = 86). After two months 274 patients were still in the study and analyzed, while 255 patients completed the study after 6 months and were analyzed. (Figure 1). Of all subjects, we received report from the treatment-partners that 22 patients (of total 255 patients who completed TB treatment) were not compliance to the study procedure.

Bottom Line: Patients in the zinc + vitamin A group showed earlier sputum conversion time (mean 1.9 weeks) compared with that in the other groups; however the difference was not significant.Also, no benefit could be demonstrated of any of the used supplementations on clinical, nutritional, chest x-ray, or laboratory findings.This study among severely malnourished TB patients, did not confirm that single or combined supplementation of zinc and vitamin A significantly reduced sputum conversion time or had other significant benefit.

View Article: PubMed Central - HTML - PubMed

Affiliation: South East Asia Minister of Education Organization Tropical Medicine, Regional Center for Community Nutrition, University of Indonesia, Jl, Salemba Raya no 6, Jakarta Pusat 10420, Indonesia. tpakasi_commed@fk.ui.ac.id

ABSTRACT

Background: A previous study showed that combination of zinc and vitamin A reduced sputum conversion time in pulmonary tuberculosis (TB) patients.

Objective: We studied the efficacy of which single micronutrient contributed more to the sputum conversion time.

Methods: In a double-blind randomized community trial, newly sputum smear positive pulmonary TB patients were assigned randomly to receive zinc, vitamin A, zinc + vitamin A or placebo on top of TB treatment. Patients were asked to deliver their sputum on weekly basis to measure positivity of the bacteria. Nutritional status, chest x-ray, hemoglobin, C-reactive protein (CRP), retinol and zinc level were examined prior to, after 2 and 6 months of treatment.

Results: Initially, 300 patients were enrolled, and 255 finished the treatment. Most patients were severely malnourished (mean BMI 16.5 ± 2.2 Kg/m2). Patients in the zinc + vitamin A group showed earlier sputum conversion time (mean 1.9 weeks) compared with that in the other groups; however the difference was not significant. Also, no benefit could be demonstrated of any of the used supplementations on clinical, nutritional, chest x-ray, or laboratory findings.

Conclusions: This study among severely malnourished TB patients, did not confirm that single or combined supplementation of zinc and vitamin A significantly reduced sputum conversion time or had other significant benefit.

Show MeSH
Related in: MedlinePlus