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

• Published in: Tropical medicine & international health Vol. 10; no. 9; pp. 826 - 832
• Main Authors: Range, Nyagosya, Andersen, Åse B., Magnussen, Pascal, Mugomela, Apolinary, Friis, Henrik
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01-09-2005; Blackwell Science; Blackwell Publishing Ltd
• Subjects: Adult; Antitubercular Agents - therapeutic use; Bacterial diseases; Bacterial diseases of the respiratory system; Biological and medical sciences; Dietary Supplements; Double-Blind Method; Female; HIV; HIV Seropositivity - epidemiology; Human bacterial diseases; Human immunodeficiency virus; Humans; Infectious diseases; Male; Medical sciences; micronutrients; Micronutrients - administration & dosage; Mycobacterium; Nutrition; randomization; Sex Distribution; Sputum - microbiology; Tanzania; Tanzania - epidemiology; Treatment Outcome; Tuberculosis; Tuberculosis, Pulmonary - diet therapy; Tuberculosis, Pulmonary - drug therapy; Tuberculosis, Pulmonary - epidemiology; Weight Gain - physiology; Zinc; Zinc - administration & dosage; Africa; Tanzania; Human; Lung disease; Respiratory disease; Pulmonary tuberculosis; Tanzania; tuberculosis; Retroviridae; Mycobacterial infection; Lentivirus; Infection; Virus; Micronutrient; Randomization; Treatment; Bacteriosis; Clinical trial; Evolution; Tropical medicine; micronutrients; Supplementation; Human immunodeficiency virus
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/j.1365-3156.2005.01463.x

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.