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Home / The International Journal of Tuberculosis and Lung Disease, Volume 26, Number 9

Case-control study of vitamin D status and adult multidrug-resistant pulmonary TB

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BACKGROUND: India has the highest prevalence of multidrug-resistant TB (MDR-TB) globally. Vitamin D deficiency is potentially an important risk factor for MDR-TB.

METHODS: We conducted a case-control study of 90 newly diagnosed adult MDR-TB cases, 180 household controls and 82 non-household controls in Mumbai, India. Serum 25-hydroxyvitamin D (25(OH)D), anthropometry, clinical status and history, dietary data and sociodemographic data were collected from each participant. Interferon-gamma release assay (IGRA) was also performed in controls to assess latent TB. Multivariable regression was performed to estimate associations between 25(OH)D vs. case status and IGRA positivity.

RESULTS: Mean participant age was 33.8 ± 12.0 years; 72.8% had 25(OH)D <20 ng/ml. Mean 25(OH)D was significantly (P < 0.05) lower in cases (12.5 ± 7.9) than both household (17.5 ± 11.2) and non-household controls (16.4 ± 9.1). In multivariable models, 25(OH)D concentration was inversely associated with MDR-TB case status among cases and household controls (OR 0.95 per 1 ng/ml, 95% CI 0.92–0.99; P = 0.015), and among cases and non-household controls (OR 0.94 per 1 ng/ml, 95% CI 0.89–1.00; P = 0.033); 53.6% of controls were IGRA-positive. 25(OH)D status was not associated with IGRA positivity.

CONCLUSION: Vitamin D status was independently associated with MDR-TB case status. Research should evaluate the effectiveness of vitamin D supplementation in prevention and adjunctive treatment of MDR-TB.

Keywords: clinical management; host-directed therapy; nutrition support; nutritional epidemiology; slum-dwelling populations

Document Type: Research Article

Affiliations: 1: Department of Tuberculosis Research, Foundation for Medical Research, Mumbai, India 2: Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA 3: Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA 4: Municipal Corporation of Greater Mumbai, Mumbai, India 5: Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA 6: Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA 7: Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA, Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA, Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA

Publication date: September 1, 2022

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

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