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The Effect of Complementary Vitamin D on Sputum Conversion in Pulmonary TB Patients

Nita Andriani Lubis

Abstract

Background: Pulmonary TB is one of the most important health problems in Indonesia. The number of pulmonary TB patients ranked second after India. Vitamin D has a complex effect in the immune system. One of the effects of vitamin D is to stimulate the production of Cathelicidin which increases macrophage phagocytosis. This study aimed to analyze the effect of complementary vitamin D on sputum conversion in pulmonary tuberculosis patients.

Subjects and Method: This study was a randomized controlled trial conducted at several health centers in Deli Serdang, North Sumatera, from November 2015 to June 2016. A total sample of 80 patients with positive acid-resistant bacilli (BTA) was selected for this study by consecutive sampling. The sample was allocated randomly into two groups: (1) TB drug group + 2.5 mg vitamin D; (2) TB drug group + placebo. The dependent variable was sputum conversion. The independent variable was complementary vitamin D. Pre and post vitamin D levels were examined by ELISA technique. Sputum conversion was examined by TB laboratory worker at the health center where patients received TB drug treatment. Difference in percent of sputum conversion between the two groups was tested by chi-square test. Difference in mean of sputum conversion time between the two groups was tested by t-test.

Results: The mean serum vitamin D level in the intervention group (62.05±22.08) was higher than the control group (28.56±7.48) after the intervention, and it was statistically significant (p<0.001). After 56 days, all subjects in the vitamin D group experienced sputum conversion (100%) with a median sputum conversion time of 28 days, whereas 90% of subjects in the placebo group experienced sputum conversion with a median sputum conversion time of 48 days (p= 0.002).

Conclusion: Adding vitamin D to anti-TB drug treatment effectively improves and accelerates sputum conversion of patients with tuberculosis acid-fast bacilli smear positive.

Keywords: Vitamin D, sputum conversion, pulmonary tuberculosis

Correspondence: Nita Andriani Lubis. Department of Health Analysis, School of Health Polytechnics Medan, North Sumatera. Jl. William Iskandar Pasar V Barat No. 6 Medan 20137, North Sumatera, Indonesia. Email: taufik.abay.mumtaz@gmail.com.

Indonesian Journal of Medicine (2017), 2(3): 169-174
https://doi.org/10.26911/theijmed.2017.02.03.04

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