Comparative Effect of ATT Alone and in Combination with Vitamin D on Physiological and Laboratory Parameters in Pulmonary TB

Authors

  • Fahad Azam Department of Pharmacology and Therapeutics, Shifa College of Medicine, Islamabad, Pakistan.
  • Abida Shaheen Department of Pharmacology and Therapeutics, Shifa College of Medicine, Islamabad, Pakistan.
  • Faisal Faiyaz Zuberi Department of Pulmonology, Ojha Institute of Chest Diseases, Dow University of Health Sciences, Karachi, Pakistan.

Abstract

Objectives: To evaluate the role of adjuvant Vitamin D therapy on pulmonary tuberculosis with respect to disease severity. Objectives of this study were to assess and compare the levels of Vitamin D, C -reactive protein and ESR within and between both groups before and after therapy and time taken for sputum microscopy conversion. We also compared the effect of therapy on the severity of the disease within and between both groups after therapy.
Study Design & Methods: 86 tuberculosis patients were enrolled after obtaining a written informed consent. They were divided into two groups; namely Group D (Patients with ATT and adjuvant Vitamin D) and Group P (Placebo group receiving normal saline injection). Two doses of Vitamin D I/M (0.6 million units) at baseline and at week 6 of the study along with standard ATT were given to the patients in D group. Normal saline injection along with standard therapy was given to the patients in Group P. Laboratory investigations were conducted at baseline and at Day 75 of the therapy and sputum microscopy examination fortnightly till sputum conversion.

Downloads

Download data is not yet available.

References

WHO. 2004. TB/HIV: A Clinical Manual. Second Edition, WHO/HTM/TB/2004; 329.

Dye C. Global epidemiology of tuberculosis. Lancet. 2006; 367: 938-40.

Migliori GB, Besozzi G, Girardi E, Kliiman K, Lange C, Toungoussovae OS, Ferrara G, et al. Clinical and operational value of the extensively drug-resistant tuberculosis definition. Eur Respir J 2007; 30:623-6.

Shah NS, Wright A, Bai GH, Barrera L, Boulahbal F, Martín-Casabona N, et al. Worldwide Emergence of Extensively Drug-resistant Tuberculosis. Emerging Infectious Dis 2007; 13:380-7.

Zhang Y, Yew WW. Mechanisms of drug resistance in Mycobacterium tuberculosis. Int J Tuberc Lung Dis

; 13:1320-30.

Espinal, MA, Laszlo A, Simonsen L, Boulahbal F, Kim SJ. Global Trends in Resistance to Antituberculosis Drugs. N Engl J Med 2001; 344:1294-1303.

Migliori GB, Hopewell PC, Blasi F, Spanevello A, Raviglione MC. Improving the TB case management: the International Standards for Tuberculosis care. Eur Respir J 2006; 28:687–90.

Raviglione MC. The new Stop TB Strategy and the Global Plan to Stop TB, 2006–2015. Bulletin of the World Health Organization 2007; 85:327.

Kaufmann SH. Is the development of a new tuberculosis vaccine possible? Nature Med 2000; 6:955-60.

Fabri1 M, Stenger S, Shin DM, Yuk JM, Liu PT, Realegeno S, et al. Vitamin D isRequired for IFNã–Mediated Antimicrobial Activity of Human Macrophages Sci Transl Med 2011; 3.

Talat N, Perry S, Parsonnet J, Dawood G, Hussain R. Vitamin D Deficiency and Tuberculosis Progression. Emerging Infectious Dis 2010; 16:853-5.

Wejse C, Olesen R, Rabna P, Kaestel P, Gustafson P, Aaby P, et al. Serum 25-hydroxyvitamin D in a West African population of tuberculosis patients and unmatched healthy controls. Am J Clin Nutr 2007; 86:1376–83.

Nursyam EW, Amin Z, Rumende CM. The Effect of Vitamin D as Supplementary Treatment in Patients with Moderately Advanced Pulmonary Tuberculous Lesion. Acta Med Indones-Indones J Intern Med 2006; 38:3-5.

Martineau AR, Timms PM, Bothamley GH, Hanifa Y, Islam K. High-dose vitamin D3 during intensive-phase antimicrobial treatment of pulmonary tuberculosis: a double-blind randomised controlled trial. The Lancet. 2011; 377:242-50.

Baker M, Das D, Venugopal K. Tuberculosis associated with household crowding in a developed country. J Epidemiol Community Health 2008; 62:715-21.

Hargreaves JR, Boccia D, Evans CA, Adato M, Petticrew M, Porter JD. The social determinants of tuberculosis: from evidence to action. Am J Public Health 2011; 101:654–62.

Akhtar S, White F, Hasan R, Rozi S, Younus M, Ahmed F, et al. Hyperendemic pulmonary tuberculosis in peri-

urban areas of Karachi, Pakistan. BMC Pub Health 2007.

Karyadi E, Schultink JW, Nelwan RH, et al. Poor micronutrient status of active pulmonary tuberculosis

patients in Indonesia. J Nutr 2000; 130:2953-8.

Bassili A, Seita A, Baghdadi S, Alabsi A, Abdilai I, Agboatwalla M, et al. Diagnostic and treatment delay

in tuberculosis in 7 countries of the Eastern Mediterranean Region. Infect Dis Clin Pract 2008; 16:23-35.

Hasan Z, Tanveer M, Kanji A, Hasan Q, Ghebremichael S. Spoligotyping of Mycobacterium tuberculosis isolates

from Pakistan reveals predominance of Central Asian Strain 1 and Beijing isolates. J Clin.Microbiol 2006;

:1763-8.

Baumann H, Gauldie J. The acute phase response. Immunol Today. 1994; 15:74–80.

Wolfe F. Comparative usefulness of C-reactive protein and erythrocyte sedimentation rate in patients with rheumatoid arthritis. J Rheumatol 1997; 24:1477-85.

Osei-Bimpong A, Meek JH. ESR or CRP ?A comparsion of their clinical utility. Hematol 2007; 12:353-7.

Ustianowski A, Shaffer R, Collin S, Wilkinson RJ, Davidson RN. Prevalence and associations of vitamin

D deficiency in foreign-born persons with tuberculosis in London. J Infect 2005; 50:432-7.

Ho-Pham LT, Nguyen ND, Nguyen TT, Nguyen DH, Bui PK, Nguyen VN, et al. Association between vitamin D insufficiency and tuberculosis in a vietnamese population. BMC Infectious Dis 2010; 10:306.

Mehta S, Mugusi FM, Bosch RJ, Aboud S, Urassa W, Villamor E, et al. Vitamin D status and TB treatment

outcomes in adult patients in Tanzania: a cohort study. BMJ Open 2013; 3:e003703.

Sato S, Tanino Y, Saito J, Nikaido T, Inokoshi Y, Fukuhara A, et al. Relationship between 25-hydroxy vitamin D levels and treatment course of pulmonary tuberculosis. Respir Investig 2012; 50:40-5.

Brodie MJ. Effect of rifampicin and isoniazid on vitamin D metabolism.Clin Pharmacol Ther 1982; 32:525-30.

Wejse C, Gomes VF, Rabna P, Gustafson P, Aaby P, Lisse IM, et al. Vitamin D as supplementary treatment

for tuberculosis: a double-blind, randomized, placebo-controlled trial. Am J Respir Crit Care Med 2009;

:843-50.

Baig MA, Islam NU, Islam UU. Low Serum Vitamin D Associated with Tuberculosis. J Pak Orthoped Assoc

; 21:27-32.

Cannell JJ, Hollis BW. Use of vitamin D in clinical practice. Altern Med Rev 2008; 13:6-20.

Salahuddin N, Ali F, Hasan Z, Rao N, Aqeel M, Mahmood F. Vitamin D accelerates clinical recovery from tuberculosis: results of the SUCCINCT Study [Supplementary Cholecalciferol in recovery from tuberculosis]. A randomized, placebo-controlled, clinical

trial of vitamin D supplementation in patients with pulmonary tuberculosis. BMC Inf Dis 2013; 13:22.

Downloads

Published

2015-12-28

How to Cite

Azam, F., Shaheen, A., & Zuberi, F. F. (2015). Comparative Effect of ATT Alone and in Combination with Vitamin D on Physiological and Laboratory Parameters in Pulmonary TB. Journal of the Dow University of Health Sciences (JDUHS), 9(3), 92–98. Retrieved from https://jduhs.com/index.php/jduhs/article/view/1431

Issue

Section

Original Articles