Vitamin A deficiency and other factors associated with severe tuberculosis in timor and Rote Islands, East Nusa Tenggara Province, Indonesia

Trevino Aristarkus Pakasi, E. Karyadi, Y. Wibowo, Y. Simanjuntak, N. M D Suratih, M. Salean, N. Darmawidjaja, J. W M van der Meer, K. van der Velden, W. M V Dolmans

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21 Citations (Scopus)

Abstract

Background: Plasma zinc and vitamin A concentrations have been reported to be low in tuberculosis (TB) patients in some studies, although it is not clear whether this constitutes a risk for a more severe clinical presentation among TB patients. The acute phase reaction may also deplete zinc and vitamin A in the plasma. Therefore, we further studied these associations. Methods: We carried out a cross-sectional study among newly diagnosed sputum smear-positive TB patients in East Nusa Tenggara. The patients were categorized as either mild TB when Karnofsky Score (KS) ≥80 or severe TB (KS <80). Body mass index (BMI), mid upper arm circumference (MUAC), chest radiograph, and the results of hemoglobin, erythrocyte sedimentation rate, albumin, C-reactive protein (CRP), zinc and vitamin A in plasma were correlated with TB category. Results: A total of 300 TB patients participated in the study (63% male and 37% female), and were categorized as mild TB (53%) or severe TB (47%). Vitamin A, hemoglobin and plasma albumin were significantly lower, and CRP was significantly higher, in severe TB than in mild TB, and the active lesion area on the chest radiograph was greater among severe TB patients. In a multiple regression analysis, after adjustment for CRP, low vitamin A (β = 3.2, 95%CI (confidence interval) 1.6-4.9, P = 0.000) but not zinc, correlated with the severity of TB. MUAC was better than BMI as a predictor of TB severity (β = 1.3, 95%CI 0.6-6.2, P = 0.000). Conclusions: Severe TB was associated with vitamin A deficiency. MUAC can be applied as a measure of TB severity.

Original languageEnglish
Pages (from-to)1130-1135
Number of pages6
JournalEuropean Journal of Clinical Nutrition
Volume63
Issue number9
DOIs
Publication statusPublished - 4 Jun 2009

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