The Effect of Complementary Vitamin D on Sputum Conversion in Pulmonary TB Patients

Background: Pulmonary TB is one of the most important health problems in Indonesia. The number of pulmonary TB patients ranked second after India. Vitamin D has a complex effect in the immune system. One of the effects of vitamin D is to stimulate the production of Cathelicidin which increases macrophage phagocytosis. This study aimedto analyze the effect of complementary vitamin D on sputum conversion in pulmonary tuberculosis patients.Subjects and Method: This studywas a randomizedcontrolled trial conducted at several health centersin Deli Serdang, North Sumatera, from November 2015 to June 2016. A total sample of 80 patients with positive acid-resistant bacilli (BTA) wasselectedfor this studyby consecutive sampling. The samplewasallocated randomly into two groups: (1) TB drug group + 2.5 mg vitamin D; (2) TB drug group + placebo. The dependent variable wassputum conversion.The independent variablewascomplementary vitamin D. Pre and post vitamin D levels were examined by ELISA technique. Sputum conversion was examinedby TB laboratory workerat the health center where patients received TB drug treatment. Difference in percent of sputum conversion between the two groups was tested by chi-square test. Difference in mean of sputum conversion timebetween the two groups was tested by t-test.Results: The mean serum vitamin D level in the intervention group (62.05±22.08) was higher than the control group (28.56±7.48) after the intervention, and it was statistically significant (p<0.001). After 56 days, all subjects in the vitamin D group experienced sputumconversion (100%) with a median sputum conversion time of 28 days, whereas90% of subjects inthe placebo group experienced sputumconversion with a median sputum conversion timeof 48 days (p= 0.002).Conclusion: Addingvitamin D to anti-TB drug treatment effectively improves and accelerates sputum conversion of patients withtuberculosisacid-fastbacillismear positive.