Vitamin D Deficiency Prevalence and Its Association with Bacterial Load Sputum in Newly Diagnosed TB Patients

Vitamin D plays a role in innate and adaptive immune functions, and its deficiency has become a risk factor for
tuberculosis (TB) infection. This study aimed to describe the prevalence of vitamin D deficiency in newly diagnosed
TB patients and to examine the relationship between vitamin D levels and sputum smear positivity that reflects
bacterial load. This is a cross-sectional study conducted at several primary health care facilities in Medan and
Deli Serdang from November 2015 to June 2016. As many as 86 subjects adult TB patients with positive smear
sputum who had not received therapy or had at most 1 week on therapy were recruited. Sputum examination
were interpreted using International Union Against Tuberculosis and Lung Disease (IUATLD) grading scale.
Serum 25(OH) vitamin D level was estimated using enzyme-linked immunosorbent assay (ELISA) and interpreted
as deficiency (<20 ng/mL), insufficiency (20–29 ng/mL), or optimum (30–100 ng/mL). The association between
vitamin D level and positivity level of AFB sputum was analyzed using Spearman correlation test. The prevalence
of VDD in new pulmonary TB patients with positive smear sputum was 17.4%. There was a weak relationship
between vitamin D level and positivity level of AFB sputum (p=0.014), with a correlation coefficient of (-0.264).
Many of newly diagnosed TB patients had vitamin D deficiency despite the fact that Indonesia is an equatorial
area with sufficient sunshine throughout the year. This study shows vitamin D indeed affect bacterial load and a
low 25(OH) vitamin D level is associated with higher bacterial load