TY - JOUR
T1 - A double-blind, placebo-controlled study of vitamin A and zinc supplementation in persons with tuberculosis in Indonesia
T2 - Effects on clinical response and nutritional status
AU - Karyadi, Elvina
AU - West, Clive
AU - Schultink, Werner
AU - Nelwan, Ronald H.H.
AU - Gross, Rainer
AU - Amin, Zulkifli
AU - Dolmans, Wil M.V.
AU - Schlebusch, Harald
AU - Van Der Meer, Jos W.M.
PY - 2002
Y1 - 2002
N2 - Background: The results of cross-sectional studies indicate that micronutrient deficiencies are common in patients with tuberculosis. No published data exist on the effect of vitamin A and zinc supplementation on antituberculosis treatment. Objective: Our goal was to investigate whether vitamin A and zinc supplementation increases the efficacy of antituberculosis treatment with respect to clinical response and nutritional status. Design: In this double-blind, placebo-controlled trial, patients with newly diagnosed tuberculosis were divided into 2 groups. One group (n = 40) received 1500 retinol equivalents (5000 IU) vitamin A (as retinyl acetate) and 15 mg Zn (as zinc sulfate) daily for 6 mo (micronutrient group). The second group (n = 40) received a placebo. Both groups received the same antituberculosis treatment recommended by the World Health Organization. Clinical examinations, assessments of micronutrient status, and anthropometric measurements were carried out before and after 2 and 6 mo of antituberculosis treatment. Results: At baseline, 64% of patients had a body mass index (in kg/m2) < 18.5, 32% had plasma retinol concentrations < 0.70 μmol/L, and 30% had plasma zinc concentrations < 10.7 μmol/L. After antituberculosis treatment, plasma zinc concentrations were not significantly different between groups. Plasma retinol concentrations were significantly higher in the micronutrient group than in the placebo group after 6 mo (P < 0.05). Sputum conversion (P < 0.05) and resolution of X-ray lesion area (P < 0.01) occurred earlier in the micronutrient group. Conclusion: Vitamin A and zinc supplementation improves the effect of tuberculosis medication after 2 mo of antituberculosis treatment and results in earlier sputum smear conversion.
AB - Background: The results of cross-sectional studies indicate that micronutrient deficiencies are common in patients with tuberculosis. No published data exist on the effect of vitamin A and zinc supplementation on antituberculosis treatment. Objective: Our goal was to investigate whether vitamin A and zinc supplementation increases the efficacy of antituberculosis treatment with respect to clinical response and nutritional status. Design: In this double-blind, placebo-controlled trial, patients with newly diagnosed tuberculosis were divided into 2 groups. One group (n = 40) received 1500 retinol equivalents (5000 IU) vitamin A (as retinyl acetate) and 15 mg Zn (as zinc sulfate) daily for 6 mo (micronutrient group). The second group (n = 40) received a placebo. Both groups received the same antituberculosis treatment recommended by the World Health Organization. Clinical examinations, assessments of micronutrient status, and anthropometric measurements were carried out before and after 2 and 6 mo of antituberculosis treatment. Results: At baseline, 64% of patients had a body mass index (in kg/m2) < 18.5, 32% had plasma retinol concentrations < 0.70 μmol/L, and 30% had plasma zinc concentrations < 10.7 μmol/L. After antituberculosis treatment, plasma zinc concentrations were not significantly different between groups. Plasma retinol concentrations were significantly higher in the micronutrient group than in the placebo group after 6 mo (P < 0.05). Sputum conversion (P < 0.05) and resolution of X-ray lesion area (P < 0.01) occurred earlier in the micronutrient group. Conclusion: Vitamin A and zinc supplementation improves the effect of tuberculosis medication after 2 mo of antituberculosis treatment and results in earlier sputum smear conversion.
KW - Indonesia
KW - Micronutrient supplementation
KW - Sputum smear conversion
KW - Tuberculosis
KW - Tuberculosis transmission
KW - Vitamin A
KW - X-ray lesion area
KW - Zinc
UR - http://www.scopus.com/inward/record.url?scp=0036193876&partnerID=8YFLogxK
U2 - 10.1093/ajcn/75.4.720
DO - 10.1093/ajcn/75.4.720
M3 - Article
C2 - 11916759
AN - SCOPUS:0036193876
VL - 75
SP - 720
EP - 727
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
SN - 0002-9165
IS - 4
ER -