Role of combined zinc, vitamin A, and fish oil supplementation in childhood tuberculosis

Southeast Asian J Trop Med Public Health. 2013 Sep;44(5):854-61.


This objective of this study was to determine benefit of one month combined supplementation (zinc, vitamin A, fish oil) along with anti-tuberculosis drugs (ATD) on increasing serum leptin levels and decreasing tumor necrosis factor-alpha (TNF-alpha) in children with tuberculosis (TB). A quasi experimental study was conducted on 22 children (aged 5-14 years) with a positive acid-fast bacilli (AFB) smear. The children were divided into 2 groups. A history, physical examination, anthropometric measurements, serum leptin levels, TNF-alpha levels, retinol and zinc levels were examined in all subjects before and after treatment. Nutritional supplementation and ATD were given to group I while ATD only were given to group II. The change in leptin, TNF-alpha, retinol and zinc levels were analyzed with the Mann-Whitney test, while a t-test was used to determine changes in body mass index (BMI). Group I had a higher significant increase in serum leptin levels than group II (p=0.034). Group I had a significantly greater decrease in TNF-a levels than group II (p=0.032). No significant differences in retinol or zinc levels were seen between the two, but both groups had an increase after treatment. Both groups had a significant increase in BMI (p=<0.001) post-treatment compared to pre-treatment. Supplementation with zinc, vitamin A and fish oil is associated with a significant increase in leptin levels and a significant decrease in TNF-alpha levels among children treated for TB. No significant benefit was seen in BMI among children receiving supplementation compared to those without it, although ATD resulted in a significant increase in BMI in both groups.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Antitubercular Agents / administration & dosage
  • Antitubercular Agents / therapeutic use*
  • Body Weights and Measures
  • Child
  • Child Nutrition Disorders / drug therapy
  • Child Nutrition Disorders / immunology
  • Child, Preschool
  • Dietary Supplements*
  • Drug Therapy, Combination
  • Female
  • Fish Oils / administration & dosage
  • Fish Oils / blood
  • Fish Oils / therapeutic use*
  • Humans
  • Leptin / biosynthesis
  • Male
  • Tuberculosis / drug therapy*
  • Tumor Necrosis Factor-alpha / metabolism
  • Vitamin A / administration & dosage
  • Vitamin A / blood
  • Vitamin A / therapeutic use*
  • Zinc / administration & dosage
  • Zinc / blood
  • Zinc / therapeutic use*


  • Antitubercular Agents
  • Fish Oils
  • Leptin
  • Tumor Necrosis Factor-alpha
  • Vitamin A
  • Zinc