Zinc and vitamin A supplementation fails to reduce sputum conversion time in
severely malnourished pulmonary tuberculosis patients in Indonesia.
Author(s): Pakasi TA, Karyadi E, Suratih NM, Salean M, Darmawidjaja N, Bor H, van der Velden
K, Dolmans WM, van der Meer JW.
Affiliation(s): 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
Publication date & source: 2010, Nutr J. , 9:41
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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