dc.contributor.author |
Schwalb Calderon, Alvaro |
|
dc.contributor.author |
Bergstrom, Malin |
|
dc.contributor.author |
Woodd, Susannah |
|
dc.contributor.author |
Rehman, Andrea M. |
|
dc.contributor.author |
PrayGod, George |
|
dc.contributor.author |
Kasonka, Lackson |
|
dc.contributor.author |
Koethe, John R. |
|
dc.contributor.author |
Filteau, Suzanne |
|
dc.contributor.author |
Houben, Rein M. G. J. |
|
dc.coverage.spatial |
Mwanza, Tanzania |
|
dc.coverage.spatial |
Lusaka, Zambia |
|
dc.date.accessioned |
2023-09-06T20:45:09Z |
|
dc.date.available |
2023-09-06T20:45:09Z |
|
dc.date.issued |
2023 |
|
dc.identifier.uri |
https://hdl.handle.net/20.500.12866/14076 |
|
dc.description.abstract |
Macronutrient and micronutrient deficiencies are associated with tuberculosis (TB) incidence. However, evidence is limited on the impact of micronutrient (vitamins and minerals) supplementation among underweight individuals. We conducted a secondary data analysis of a randomised controlled trial of lipid nutritional supplements with and without high-dose vitamin and mineral supplementation (LNS-VM vs LNS) for underweight (Body Mass Index [BMI] <18.5 kg/m2) adults with human immunodeficiency virus (HIV) initiating antiretroviral therapy (ART) in Tanzania and Zambia (2011-2013). Incident TB disease diagnoses were extracted from trial records. We used multivariable Cox regression to estimate hazard ratios (HR) for the impact of receiving LNS-VM on TB incidence, and the dose-response relationship between baseline BMI and TB incidence. Overall, 263 (17%) of 1506 participants developed TB disease. After adjusting for age, sex, CD4 count, haemoglobin, and C-reactive protein, receiving LNS-VM was not associated with TB incidence (aHR [95%CI] = 0.93 [0.72-1.20]; p = 0.57) compared to LNS alone. There was strong evidence for an association between lower BMI and incident TB (aHR [95%CI]: 16-16.9kg/m2 = 1.15 [0.82-1.62] and <16kg/m2 = 1.70 [1.26-2.30] compared to 17-18.5kg/m2; linear trend p<0.01). There was strong evidence that the rate of developing TB was lower after initiating ART (p<0.01). In conclusion, the addition of micronutrient supplementation to LNS was not associated with lower TB incidence in this underweight ART-naive population. |
en_US |
dc.language.iso |
eng |
|
dc.publisher |
PLoS |
|
dc.relation.ispartofseries |
PLOS Global Public Health |
|
dc.rights |
info:eu-repo/semantics/restrictedAccess |
|
dc.rights.uri |
https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es |
|
dc.subject |
Tuberculosis |
en_US |
dc.subject |
Epidemiology |
en_US |
dc.subject |
Nutrition |
en_US |
dc.subject |
Vitamins |
en_US |
dc.subject |
HIV |
en_US |
dc.subject |
C-reactive proteins |
en_US |
dc.subject |
Lipids |
en_US |
dc.subject |
HIV epidemiology |
en_US |
dc.subject.mesh |
Tuberculosis |
|
dc.subject.mesh |
Epidemiología |
|
dc.subject.mesh |
Ciencias de la Nutrición |
|
dc.subject.mesh |
Vitaminas |
|
dc.subject.mesh |
VIH |
|
dc.subject.mesh |
Proteína C-Reactiva |
|
dc.subject.mesh |
Lípidos |
|
dc.subject.mesh |
Epidemiología |
|
dc.title |
Impact of micro- and macronutrient status on the incidence of tuberculosis: An examination of an African cohort initiating antiretroviral therapy. |
en_US |
dc.type |
info:eu-repo/semantics/article |
|
dc.identifier.doi |
https://doi.org/10.1371/journal.pgph.0002007 |
|
dc.subject.ocde |
https://purl.org/pe-repo/ocde/ford#3.03.08 |
|
dc.relation.issn |
2767-3375 |
|