Assessment of Vitamin A, Vitamin B 12 and Iron levels Among Tuberculosis Patients and Co-infected with HIV before and after TB treatment. Longitudinal Cohort study
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Date
2016-10
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Addis Ababa University
Abstract
Background: Tuberculosis (Tb) is major cause of morbidity and mortality, for millions of
peoples worldwide. Of the different risk factors associated with Tb development and progress,
deficiency of micronutrients (vitamins and minerals), mentioned one. In this regards association
of micronutrients during development of Tb and then after Tb treatments scarcely found in
Ethiopia. Objective: To assess the level of micronutrients (Vitamin A, Vitamin B12 and Iron)
among M. tuberculosis patients with and without HIV confection at baseline and after anti TB
treatment. Material and method: This study was conduct on serum samples, collected from
M.TB patients with and without HIV infection, attending at different health centers in Addis
Ababa. The collected samples were stored at EPHI at - 80 0 C, for about 10 years. Convenient
sampling method used to select TB only (87), TB-HIV confection (57), latent TB (25) and
healthy controls (21). Socio-demographic data was collected from the previously collected log
book. The concentration of Iron and Vitamin B12 was measured by using chemiluminesense
method; whereas concentration of retinol measured by using HPLC method. The collected data
enter and analyzed by using SPSS statistical software version 20. P-values less than 0.05
considered as statistical significant. Result: of the total 190 participants, about 57 had both TB-
HIV (HIV+TB+), 87 had TB only (HIV-TB+), 25 had latent TB (HIV-TST+) and 21 healthy
controls (TB-HIV-) were are included in the study. The median age of study participants in each
study groups with inter quartile range, 30(28-38) years in TB-HIV, 27 (21-32) years in TB only,
23(20-31) years in latent and 24(20-27) years were in healthy controls. Female study participants
had major proportions in all cases, except in TB-HIV cases where males were dominant. The
concentration of vitamin A, Vitamin B 12 and Iron had significant difference before and after Tb
treatments both in Tb patients with and without HIV-co-infections. But these differences was not
seen when Tb only patients (at 0 and after 6 month therapy) micronutrient concentrations
compared with Tb with HIV co infected patients (at 0 and 6 months after treatments. On the
other hand there was statistical significant different between M0 Tb patients with and without
HIV co-infections compared with latent Tb and healthy controls on Iron, Vitamin A and Vitamin
B12 concentration, while theses difference becomes non-significant after 6 months of Tb therap
Conclusion and recommendation: The present study demonstrated that micronutrient
deficiencies may related with development of Tb diseases. Measurement of Micronutrients for
those latent Tb patients might indicate the progress of overt Tb developments. Thus,
micronutrient supplements during Tb treatment might help to enhance Tb cure rates for those Tb
patients. But still large scale active longitudinal studies need to undertake to consolidates the
present findings.
Key word: Tuberculosis, Vitamin B 12, Retinol, Iron, Micronutrients
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Keywords
Tuberculosis, Vitamin B 12, Retinol, Iron