Numerous studies in adults have shown the beneficial association between vitamin D and tuberculosis (TB). For example, the vitamin has been found to be instrumental in disease management.
However, research on such associations in children were lacking, especially in Indonesia.
The South East Asian nation has the second-highest incidence of TB globally (the first being India) according to the Global Tuberculosis Report 2020 by the World Health Organisation (WHO).
Specifically, it also noted that children under 15 years old accounted for 12 per cent or 1.2 million of the TB cases globally.
Hence, Indonesian researchers from the Faculty of Medicine, Universitas Padjadjaran, in Bandung, West Java, and the Bethesda Serukam Hospital in Bengkayang, West Borneo, conducted an RCT to assess the role of vitamin D in improving fever and cough resolution among children battling the disease.
The research study titled “Effects of Vitamin D supplementation on resolution of fever and cough in children with pulmonary tuberculosis: A randomized double-blind controlled trial in Indonesia” was published in the Journal of Global Health.
The RCT was conducted on 84 patients aged six to 18 years old living in West Borneo and newly diagnosed with pulmonary TB and vitamin D insufficiency from December 2020 to May 2021.
A total of 80 patients (95.2 per cent) completed the six-month trial. During that period, they were randomly allocated to receive either 1,000 IU vitamin D or a placebo daily after commencing standard TB treatment.
Results showed that the subjects’ fevers, cough, and malnutrition status improved after receiving vitamin D, compared to the placebo group.
According to the researchers, the median time for fever resolution in the intervention group was two weeks compared to three weeks in the placebo group. Resolution of cough symptoms was halved among the intervention group, from four weeks to two.
The study also detailed broader nutritional benefits of supplementation, which is important because Indonesia is one of the countries that faces the triple burden of malnutrition – namely undernutrition, micronutrient deficiencies and overweight.
The majority of the children in the study (62 per cent) were undernourished.
Malnutrition, which affects immune function, increases the risk of children contracting TB. Conversely, TB can exacerbate the condition of malnutrition.
Upon completion of the study, the intervention group had a better nutritional status after finishing their respective TB treatments.
This included statistically significant improvements in BMI, weight-for-age, and height-for-age measurements.
In conclusion, the study adds evidence to the role of vitamin D in improving fever and cough resolution. It also shows improved nutritional status in children with pulmonary TB and vitamin D insufficiency.
The researchers wrote: “This research is the first study in Indonesia to evaluate the effects of vitamin D supplementation on clinical outcomes in children with pulmonary TB. This study highlights that vitamin D improves fever and cough resolutions. Vitamin D also significantly improves the anthropometric status after the end of TB treatment. No safety issues were found”.
However, they added that more research is required to enable children to attain normal vitamin D levels while both undergoing and after receiving pulmonary TB treatment because none of the study subjects achieved normal vitamin D levels post-trial.
Source: International Journal of Global Health
DOI: 10.7189/jogh.12.04013
“Effects of Vitamin D supplementation on resolution of fever and cough in children with pulmonary tuberculosis: A randomized double-blind controlled trial in Indonesia”
Authors: Tamara L, et al