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Vitamin D as Supportive Treatment Improve The Sputum Conversion and Radiographic Finding in Tuberculosis Patients
Tuberculosis remains as a major health problem in South East Asia as well as Indonesia. The failure of tuberculosis treatment is mostly due to drop-out and multiple drugs resistant. Previous study showed that vitamin D increase the intracellular cathelicidin which has potency to kill the Mycobacterium tubeculosis. This research was aimed to identify the effect of vitamin D as supportive treatment on the imporvement of sputum corversion, radiographic finding and TNF-α serum concentration. A Double-blind randomized control trial was used in two random allocated patient group with standard tuberculosis treatment. The first group was treated with vitamin D (800 iu/day) while the other was not. Subjects were evaluated using three parameter i.a. sputrum conversion, radiographic finding and TNF-α serum concentration. Compared to the group without vitamin D supllementation, group with vitamin D has higher proportion of sputum conversion in the first month (67% vs. 34%, p=0,04) and second month (95% vs 77%, p=0.18). Improvement in radiographic findingsin the group with vitamin D is also hegher in the first month (67% vs. 18%, p=0.02) and second month (76% vs.45%, p=0.06). There is a significant difference in the level of 25-dihidroxyvitamin D between two groups (p==0.00). However, there is no significant difference in the level of TNF-α between two groups (p=0.75) after two months. Vitamin D has suportive effects in pulmonary tuberculosis by improving healing processas indicated by faster improvement in sputum conversion and radiographic finding but it did not improve the decrease of TNF-α.
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