The effect of micronutrient supplementation on treatment outcome in patients with pulmonary tuberculosis: a randomized controlled trial in Mwanza, Tanzania

Authors


Authors
Nyagosya Range, National Institute for Medical Research (NIMR), Muhimbili Medical Research Station, P. O. Box 3436, Dar es Salaam, Tanzania. Tel.: +255 744 311952; Fax: +255 22 2124500; E-mail: hn_range@yahoo.co.uk (corresponding author).
Åse B. Andersen, Department of Infectious Diseases M5132, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark. Tel.: +45 3545 8555; Fax: +45 3545 6648; E-mail: bengaard@dadlnet.dk
Pascal Magnussen, DBL-Institute for Health Research and Development, Jægersborg Allé 1 D, 2920 Charlottenlund, Denmark. Tel.: +45 7732 7732; Fax: +45 7732 7733; E-mail: pmagnussen@dblnet.dk
Apolinary Mugomela, Zonal TB Reference Laboratory, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania. Tel: +255 744 895278; E-mail: almugomela@yahoo.com
Henrik Friis, Department of Epidemiology, Institute of Public Health, University of Copenhagen, Øster Farimagsgade 5B, 1014 Copenhagen K, Denmark. Tel.: +45 3532 7669, Fax: +45 3532 7383; E-mail: h.friis@pubhealth.ku.dk

Summary

Objective  The aim of the study was to assess the effects of micronutrient supplementation on culture conversion in tuberculosis (TB) patients.

Design  The study was a randomized, double-blind placebo-controlled 2 × 2 trial of zinc and multi-micronutrient (MMN) supplementation in pulmonary TB patients in Tanzania.

Results  A total of 499 pulmonary TB patients were included in the trial after being confirmed sputum-positive by microscopy or culture. At 8 weeks, 25% were sputum-smear positive but only 11% were culture-positive (P < 0.0001). No significant differences were observed in culture conversion rate among those allocated to MMN or placebo (89.5 vs. 86.2%, P = 0.29) at 8 weeks, although at week 4 those allocated to MMN had a slightly reduced culture conversion rate (42.8 vs. 52.8%, P = 0.058). Zinc had no effects on culture conversion. MMN increased weight gain by 0.78 kg [95% confidence interval (CI): 0.12–1.43] at week 8, while zinc supplementation had no effect. The effects of MMN and zinc did not interact and neither MMN nor zinc interacted with human immunodeficiency virus status, sex and culture-intensity at baseline.

Conclusion  Neither zinc nor MMN supplementation had significant effects on culture conversion, but MMN supplementation increased weight gain in TB patients.

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