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Randomized Controlled Trial
. 2010 Sep 28:9:41.
doi: 10.1186/1475-2891-9-41.

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

Trevino A Pakasi  1 , Elvina Karyadi, Ni Made Desy Suratih, Michael Salean, Nining Darmawidjaja, Hans Bor, Koos van der Velden, Wil M V Dolmans, Jos W M van der Meer
Affiliations
Randomized Controlled Trial

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

Trevino A Pakasi et al. Nutr J. .

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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Figures

Figure 1
Figure 1
Trial profile. Including reasons for patients' drop out during the study.
Figure 2
Figure 2
Cumulative percentage of the sputum conversion time. The zinc + vitamin A (n = 50) and vitamin A groups (n = 56) showed less weeks to reach 85% of sputum conversion, followed by the placebo group (n = 62).
See this image and copyright information in PMC

References

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