Does Micronutrient Supplementation Reduce Tuberculosis Treatment Failure among Adult Tuberculosis Patients

Abstract

Tuberculosis remains a major global public health challenge. However, the effectiveness of micronutrient supplementation on tuberculosis treatment outcomes has been debated for decades. Therefore, this systematic review and meta-analysis was aimed to summarize the large body of evidence from randomized controlled trials regarding the effectiveness of micronutrient supplementation on tuberculosis treatment outcomes. A systematic literature search for randomized controlled trials was performed in Psych-INFO, MEDLINE, Google Scholar, Web of science based on predefined criteria for inclusion of selected studies. The analysis was done using STATA se version 14, and a fixed-effects model was used to estimate risk ratios with 95% confidence intervals. The quality of evidence was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. Seven studies, representing 2,666 participants, met the inclusion criteria. Although statistically non-significant, the overall Risk Ratio was 0.96 (95% CI: 0.86 to 1.07), suggesting 4% improvement of TB treatment outcomes up on micronutrient supplementation. Because of low heterogeneity with I2=18.7%, p=0.29, we did not perform subgroup analysis. The risk of bias was not significant and the level of evidence quality was „moderate‟. The study indicates that micronutrient supplementation does not have a positive impact on tuberculosis treatment outcomes. However, further studies with well-controlled design are necessary before a clinically important effect can be excluded.