Daily multi-micronutrient supplementation during tuberculosis treatment increases weight and grip strength among HIV uninfected but not HIV infected patients in Mwanza, Tanzania

TY - ABST

T1 - Daily multi-micronutrient supplementation during tuberculosis treatment increases weight and grip strength among HIV uninfected but not HIV infected patients in Mwanza, Tanzania

AU - Range, Nyagosya

AU - PrayGod, George

AU - Faurholt-Jepsen, Daniel

AU - Jeremiah, Kidola

AU - Faurholt-Jepsen, Maria

AU - Aabye, Martine G.

AU - Jensen, Lotte

AU - Jensen, Andreas V.

AU - Grewal, Harleen M.S.

AU - Magnussen, Pascal

AU - Changalucha, John

AU - Andersen, Aase Bengaard

AU - Friis, Henrik

PY - 2011/4/1

Y1 - 2011/4/1

N2 - Undernutrition is common among tuberculosis (TB) patients. The objective of this study was to assess the effect of multi-micronutrient supplementation during TB treatment on weight, body composition, and handgrip strength. A total of 865 patientswith smear-positive (PTB+) or -negative (PTB-) pulmonary TBwere randomly allocated to receive a daily biscuitwith or without multi-micronutrients for 60 d during the intensive phase of TB treatment.Weight, arm fat area, arm muscle area, and handgrip strength were assessed at baseline and after 2 and 5 mo. At 2 mo, the multi-micronutrient supplementation led to a higher handgrip gain (1.22 kg; 95% CI = 0.50, 1.94; P = 0.001) but had no effects on other outcomes. The effects of multimicronutrient supplementation were modified by HIV infection (P-interaction = 0.002). Among HIV- patients, multimicronutrient supplementation increased weight gain by 590 g (95% CI =240, 1210; P = 0.07) and handgrip strength by 1.6 kg (95%CI = 0.78, 2.47; P < 0.001), whereas among HIV+ patients, it reduced weight gain by 1440 g (95%CI = 290, 2590; P = 0.002) and had no effect on handgrip strength (0.07 kg; 95% CI =21.30, 1.46; P = 0.91). The reducedweight gain among HIV+ patients receiving multi-micronutrient supplementation seemed to be explained by a higher proportion of patients reporting fever. At 5mo, the effects on weight were sustained, whereas there was no effect on handgrip strength. In conclusion, multimicronutrient supplementation given as a biscuit is beneficial among HIV2 PTB patients and may be recommended to TB programs. More research is needed to develop an effective supplement for HIV+ PTB patients.

AB - Undernutrition is common among tuberculosis (TB) patients. The objective of this study was to assess the effect of multi-micronutrient supplementation during TB treatment on weight, body composition, and handgrip strength. A total of 865 patientswith smear-positive (PTB+) or -negative (PTB-) pulmonary TBwere randomly allocated to receive a daily biscuitwith or without multi-micronutrients for 60 d during the intensive phase of TB treatment.Weight, arm fat area, arm muscle area, and handgrip strength were assessed at baseline and after 2 and 5 mo. At 2 mo, the multi-micronutrient supplementation led to a higher handgrip gain (1.22 kg; 95% CI = 0.50, 1.94; P = 0.001) but had no effects on other outcomes. The effects of multimicronutrient supplementation were modified by HIV infection (P-interaction = 0.002). Among HIV- patients, multimicronutrient supplementation increased weight gain by 590 g (95% CI =240, 1210; P = 0.07) and handgrip strength by 1.6 kg (95%CI = 0.78, 2.47; P < 0.001), whereas among HIV+ patients, it reduced weight gain by 1440 g (95%CI = 290, 2590; P = 0.002) and had no effect on handgrip strength (0.07 kg; 95% CI =21.30, 1.46; P = 0.91). The reducedweight gain among HIV+ patients receiving multi-micronutrient supplementation seemed to be explained by a higher proportion of patients reporting fever. At 5mo, the effects on weight were sustained, whereas there was no effect on handgrip strength. In conclusion, multimicronutrient supplementation given as a biscuit is beneficial among HIV2 PTB patients and may be recommended to TB programs. More research is needed to develop an effective supplement for HIV+ PTB patients.

M3 - Conference abstract for conference

T2 - The 25th Annual Joint Scientific Conference and 10th Anniversary of the Tanzania National Health Research Forum

Y2 - 5 April 2011 through 7 April 2011

ER -