Effectiveness of micronutrients supplement in patients with active tuberculosis on treatment: Systematic review/Meta-analysis

Abstract

Background: Multiple researchers have suggested the influence of micronutrients in the cure and survival of tuberculosis.

Objective: To determine the effectiveness of micronutrients in the cure and treatment of pulmonary tuberculosis.

Methods: Systematic search of randomized controlled trials (RCTs) in databases of people under treatment for active pulmonary tuberculosis, that must have received oral micronutrients for at least four weeks compared with placebo. The synthesis of the variables was shown in standardized mean difference (MD) and/or risk difference (RD). The random effects model was used and was reported in forest plot of the estimates of the effect with a 95 % CI.

Results: Sixteen of 246 studies were included, in total 4398 people. Zinc showed (RD, 0.04; 95 % CI, 0.00-0.08) in mortality, increases muscle mass index (MD, 1.20; 95 % CI, 0.04-2.36) and gains weight (MD, 3.10; 95 % CI, 0.66-5.54). Zinc plus vitamin A increases the weight (MD, 3.10; 95 % CI, 2.78-3.42), improving karnofsky scale (MD, 2.50; 95 % CI, 2.22-2.78). Additionally, vitamin D accelerate the sputum conversión time (RD, 0.38; 95 % CI, 0.03-0.73). Hemoglobin (Hb) with vitamin A and zinc achieves statistically significant changes (MD, 0.69; 95 % CI, 0.28-1.09) and (MD, 0.52; 95 % CI, 0.21-0.83) and reduces area of cavitations in chest X-ray (MD, -0.33; 95 % CI, -0.60--0.06).

Conclusions: The consumption of micronutrients could achieve weight gain, hemoglobin, accelerated sputum conversion and improvement in quality of life. There are no changes in mortality that may be attributable to the suboptimal dose, larger studies are suggested with adequate doses.

Keywords: Meta-analysis; Micronutrients; Nutrients; Pulmonary; Systematic review; Trace elements; Tuberculosis; Vitamins.