A randomized trial of multivitamin supplementation in children with tuberculosis in Tanzania
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Date
2011
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Nutrition journal
Abstract
Background:Children with tuberculosis often have underlying nutritional deficiencies. Multivitaminsupplementation has been proposed as a means to enhance the health of these children; however, the efficacy ofsuch an intervention has not been examined adequately.
Methods:255 children, aged six weeks to five years, with tuberculosis were randomized to receive either a dailymultivitamin supplement or a placebo in the first eight weeks of anti-tuberculous therapy in Tanzania. This wasonly 64% of the proposed sample size as the trial had to be terminated prematurely due to funding constraints.They were followed up for the duration of supplementation through clinic and home visits to assessanthropometric indices and laboratory parameters, including hemoglobin and albumin.
Results:There was no significant effect of multivitamin supplementation on the primary endpoint of the trial:weight gain after eight weeks. However, significant differences in weight gain were observed among children agedsix weeks to six months in subgroup analyses (n = 22; 1.08 kg, compared to 0.46 kg in the placebo group; 95% CI= 0.12, 1.10; p = 0.01). Supplementation resulted in significant improvement in hemoglobin levels at the end offollow-up in children of all age groups; the median increase in children receiving multivitamins was 1.0 g/dL,compared to 0.4 g/dL in children receiving placebo (p < 0.01). HIV-infected children between six months and threeyears of age had a significantly higher gain in height if they received multivitamins (n = 48; 2 cm, compared to 1cm in the placebo group; 95% CI = 0.20, 1.70; p = 0.01; p for interaction by age group = 0.01).
Conclusions:Multivitamin supplementation for a short duration of eight weeks improved the hematologicalprofile of children with tuberculosis, though it didn’t have any effect on weight gain, the primary outcome of thetrial. Larger studies with a longer period of supplementation are needed to confirm these findings and assess theeffect of multivitamins on clinical outcomes including treatment success and growth failure.
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Tuberculin Skin, Test Supplement Group, Muhimbili National Hospital
Citation
Mehta, S., Mugusi, F.M., Bosch, R.J., Aboud, S., Chatterjee, A., Finkelstein, J.L., Fataki, M., Kisenge, R. and Fawzi, W.W., 2011. A randomized trial of multivitamin supplementation in children with tuberculosis in Tanzania. Nutrition journal, 10(1), p.120.