Zinc and vitamin A supplementation fails to reduce sputum conversion time in severely malnourished pulmonary tuberculosis patients in Indonesia

Nutr J. 2010 Sep 28;9:41. doi: 10.1186/1475-2891-9-41.


Background: A previous study showed that combination of zinc and vitamin A reduced sputum conversion time in pulmonary tuberculosis (TB) patients.

Objective: We studied the efficacy of which single micronutrient contributed more to the sputum conversion time.

Methods: In a double-blind randomized community trial, newly sputum smear positive pulmonary TB patients were assigned randomly to receive zinc, vitamin A, zinc + vitamin A or placebo on top of TB treatment. Patients were asked to deliver their sputum on weekly basis to measure positivity of the bacteria. Nutritional status, chest x-ray, hemoglobin, C-reactive protein (CRP), retinol and zinc level were examined prior to, after 2 and 6 months of treatment.

Results: Initially, 300 patients were enrolled, and 255 finished the treatment. Most patients were severely malnourished (mean BMI 16.5 ± 2.2 Kg/m2). Patients in the zinc + vitamin A group showed earlier sputum conversion time (mean 1.9 weeks) compared with that in the other groups; however the difference was not significant. Also, no benefit could be demonstrated of any of the used supplementations on clinical, nutritional, chest x-ray, or laboratory findings.

Conclusions: This study among severely malnourished TB patients, did not confirm that single or combined supplementation of zinc and vitamin A significantly reduced sputum conversion time or had other significant benefit.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antitubercular Agents / therapeutic use
  • Double-Blind Method
  • Female
  • Humans
  • Immune System / drug effects
  • Indonesia
  • Male
  • Malnutrition / complications*
  • Malnutrition / drug therapy
  • Middle Aged
  • Mycobacterium tuberculosis / isolation & purification*
  • Nutritional Status
  • Sputum / microbiology*
  • Treatment Outcome
  • Tuberculosis, Pulmonary / complications
  • Tuberculosis, Pulmonary / drug therapy*
  • Vitamin A / therapeutic use*
  • Vitamins / therapeutic use*
  • Zinc / therapeutic use*


  • Antitubercular Agents
  • Vitamins
  • Vitamin A
  • Zinc