Poor micronutrient status of active pulmonary tuberculosis patients in Indonesia

Malnutrition is observed frequently in patients with pulmonary tuberculosis (TB), but their nutritional status, especially of micronutrients, is still poorly documented. The objective of this study was to investigate the nutr itional status of patients with active TB compared with that of healthy con trols in Jakarta, Indonesia. In a case-control study, 41 out-patients aged 15-55 y with untreated active pulmonary TB were compared with 41 healthy co ntrols selected from neighbors of the patients and matched for age and sex. Cases had clinical and radiographic abnormalities consistent with pulmonar y TB and at least two sputum specimens showing acid-fast bacilli. Anthropom etric and micronutrient status data were collected. Compared with the contr ols, TB patients had significantly lower body mass index, skinfold thicknes ses (triceps, biceps, subscapular, suprailiac), mid-upper arm circumference , proportion of fat, and concentrations of serum albumin, blood hemoglobin, plasma retinol and plasma zinc, whereas plasma zinc protoporphyrin concent ration, as a measure of free erythrocyte protoporphyrin concentration, was greater. When patients and controls were subdivided on the basis of nutriti onal status, concentrations of serum albumin, blood hemoglobin, and zinc an d retinol in plasma were lower in malnourished TB patients than in well-nou rished healthy controls, well-nourished TB patients and malnourished health y controls. In conclusion, the nutritional status of patients with active p ulmonary TB was poor compared with healthy subjects, i.e., significantly mo re patients were anemic and more had low plasma concentrations of retinol a nd zinc. Low concentrations of hemoglobin, and of retinol and zinc in plasm a were more pronounced in malnourished TB patients.