Abstract
Objective:To determine the efficacy of Vitamin D supplementation in achieving an early sputum conversion in vitamin D deficient smear positive pulmonary tuberculosis patients.Methods:This randomized clinical trial was done at Mayo hospital Lahore from November 2015 to August 2016. One hundred twenty patients with sputum smear positive pulmonary tuberculosis were selected and randomized to Group-A (taking anti-tuberculous therapy (ATT) only) and Group-B (taking ATT with Vitamin D supplementation). Four doses of100,000 IU of Vitamin D injection intramuscularly were given after every 14 days during intensive-phase. Sputum examination was repeated at 2nd, 4th, 6th, 8th, 10th and 12th weeks. Efficacy of treatment in terms of early sputum conversion between both groups was tested using Chi square and independent sample t-test was applied to compare mean values of serum vitamin D before and after treatment. P-value ≤ 0.05 was considered as significant.Results:The mean age of patients was 37.18±6.81 years in Group-A and 39.02±7.56 years in Group-B. There were 63 (52.50%) males and 57 (47.50%) females. The mean serum Vitamin D was 17.07±1.44 in Group-A and 17.23±2.37 in Group-B at baseline and at 12th week, the levels were 21.77±2.23 in Group-A and 29.24±0.72 in Group-B. In Group-A, 7 (11.7%) patients showed positive sputum examination and in Group-B, only one (1.7%) patient had positive sputum examination at 12th week. The difference was statistically significant (p-value= 0.028).Conclusion:Four doses of intramuscular vitamin D given after every 14 days corrected vitamin D deficiency and improved the rate of sputum smear conversion in patients of pulmonary tuberculosis.
Highlights
Tuberculosis (TB) is a major health problem all over the world
An estimated 10.4 million people had Tuberculosis in 2016: 90% were adults, 65% were male, 10% were people living with human immunodeficiency virus (HIV) (74% in Africa) and 56% were in five countries: India, Indonesia, China, the Philippines
TB is one of the most challenging diseases for the developing countries. The spread of this disease is favored by several factors like human immunodeficiency virus (HIV)/Acquired immune deficiency syndrome (AIDS), low socio-economic status, overcrowding and malnutrition.[2,3]
Summary
Tuberculosis (TB) is a major health problem all over the world. It is the ninth major cause of death worldwide and the leading cause from a single infectious agent, ranking above Human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS).[1]. Pak J Med Sci July - August 2018 Vol 34 No 4 www.pjms.com.pk 849 and Pakistan.[1,2] TB is one of the most challenging diseases for the developing countries. The spread of this disease is favored by several factors like human immunodeficiency virus (HIV)/Acquired immune deficiency syndrome (AIDS), low socio-economic status, overcrowding and malnutrition.[2,3]
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