Vitamin D level and it is association with the severity of pulmonary tuberculosis in patients attended to Kosti Teaching Hospital, Sudan

Samah Sidahmed M S Elsafi; Bakri Mohammed Nour; Adam Dawoud Abakar; Izzedeen Haroun Omer; Babiker Saad Almugadam

doi:10.3934/microbiol.2020004

Vitamin D level and it is association with the severity of pulmonary tuberculosis in patients attended to Kosti Teaching Hospital, Sudan

AIMS Microbiol. 2020 Mar 13;6(1):65-74. doi: 10.3934/microbiol.2020004. eCollection 2020.

Authors

Samah Sidahmed M S Elsafi¹, Bakri Mohammed Nour², Adam Dawoud Abakar^{2

3}, Izzedeen Haroun Omer⁴, Babiker Saad Almugadam⁵

Affiliations

¹ Department of Medical Microbiology, Kosti Teaching Hospital, Kosti, Sudan.
² Department of Medical Parasitology, Faculty of Medical Laboratory Sciences, University of Gezira, Wad Medani, Sudan.
³ Department of Parasitology, Blue Nile National Institute for Communicable Diseases, University of Gezira, Sudan.
⁴ Department of Medicine, Faculty of Medicine, University of El Imam El Mahdi, Kosti, Sudan.
⁵ Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, University of El Imam El Mahdi, Kosti, Sudan.

Abstract

Globally, tuberculosis is one of the major causes of morbidity and mortality in many countries. Previous studies suggest that the incidence and severity of tuberculosis are associated with low levels of vitamin D (Vit D). Therefore, this study aimed to determine the occurrence and associated factors of vitamin D3 deficiency in pulmonary tuberculosis patients at White Nile State, Sudan. 101 individuals of diagnosed pulmonary tuberculosis patients (71 males and 30 females) and 100 non-TB controls (58 males and 42 females) were included in this study. Sputum samples were obtained from TB patients and subjected to examination for acid-fast bacilli (AFB) using Ziehl-Neelsen (ZN) stain and Gene Xpert analysis. Blood samples were collected from both groups and Serum 25(OH)-vitamin D3 was determined by an Enzyme-Linked Immunosorbent Assay. HIV infection in Tuberculosis (TB) group was also investigated using the immunochromatographic test. In our study, the majority of TB patients were suffered from TB relapse (36.6%); non-HIV infected individuals (99.1%) or showed a positive result for AFB (61.4%) in Gene Xpert analysis. Moreover, there is a significant difference in microscopy findings and bacillary levels of AFB, and Rifampicin (RIF) susceptibility pattern of M. tuberculosis strain among sputum samples of TB patients, P-values less 0.0001. Furthermore, we found that TB patients were suffered from vitamin D deficiency. In particular, the mean of vitamin D level was significantly much lower in TB patients (26.7 ± 1.6) compared to non-TB controls (117.3 ± 3.2), P-value equal 0.0001. Likewise, it's much lower in females, individuals of 21-40 years old, and patients with high bacillary levels or those infected by Rifampicin resistance strain. Accordingly, our study was highlighted the TB and Vit D deficiency relationship and showed the need for further studies to a better understanding of the impact of TB on Vit D level and investigate whether vitamin D supplementation can have a role in the prevention and treatment of tuberculosis.

Keywords: HIV; Mycobacterium tuberculosis; Rifampicin; tuberculosis; vitamin D deficiency.