Evidence map›Paper›PMID 24247327›Full record

ArticleBMJ open2013

Vitamin D status and TB treatment outcomes in adult patients in Tanzania: a cohort study.

Saurabh Mehta, Ferdinand M Mugusi, Ronald J Bosch, Said Aboud, Willy Urassa, Eduardo Villamor, Wafaie W Fawzi

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00197704 (Nutrition, Immunology and Epidemiology of Tuberculosis), which is not on this map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00197704 phase3completednot on this map

Nutrition, Immunology and Epidemiology of Tuberculosis

TypeinterventionalSponsorHarvard School of Public Health (HSPH)Ran2000 to 2004Enrolled876ConditionsTuberculosisArmsMultivitamins, Placebo
3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Article
  6. A scoping review on climate change and tuberculosis.International journal of biometeorology · 2021
    Article
  7. Review
  8. Review
  9. Article
  10. Article
  11. Observational
  12. Review
  13. Review
  14. Vitamin D deficiency in Malawian adults with pulmonary tuberculosis: risk factors and treatment outcomes.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2015
    Article
  15. Article
  16. Cell death and autophagy in tuberculosis.Seminars in immunology · 2014
    Review
  17. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 4 countries.

Saurabh MehtaDivision of Nutritional Sciences, Cornell University, Ithaca, New York, USA.
Ferdinand M Mugusi
Ronald J Bosch
Said Aboud
Willy Urassa
Eduardo Villamor
Wafaie W Fawzi
Harvard University · USMuhimbili University of Health and Allied Sciences · TZCornell University · USUniversity of Michigan · USWorld Health Organization - Pakistan · PK

Funding

NUTRITION, IMMUNOLOGY, AND EPIDEMIOLOGY OF TUBERCULOSISU01AI045441 · NIAID · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI FAWZI, WAFAIE W · 1999 to 2004
$2.0M
NIAID NIH HHS U01 AI045441
6 · The paper itself

Abstract

objectivesVitamin D is an immunomodulator and can alter response to tuberculosis (TB) treatment, though randomised trials have been inconclusive to date. We present one of the first comprehensive analysis of the associations between vitamin D status and TB treatment, T-cell counts and nutritional outcomes by HIV status.

designCohort study.

settingOutpatient clinics in Tanzania.

participants25-hydroxyvitamin D levels were assessed in a cohort of 677 patients with TB (344 HIV infected) initiating anti-TB treatment at enrolment in a multivitamin supplementation (excluding vitamin D) trial (Clinicaltrials.gov identifier: NCT00197704). PRIMARY AND SECONDARY OUTCOME MEASURES: Information on treatment outcomes such as failure and relapse, HIV disease progression, T-cell counts and anthropometry was collected routinely, with a median follow-up of 52 and 30 months for HIV-uninfected and HIV-infected patients, respectively. Cox and binomial regression, and generalised estimating equations were used to assess the association of vitamin D status with these outcomes.

resultsMean 25-hydroxyvitamin D concentrations at enrolment were 69.8 (±21.5) nmol/L (27.9 (±8.6) ng/mL). Vitamin D insufficiency (<75 nmol/L) was associated with a 66% higher risk of relapse (95% CI 4% to 164%; 133% higher risk in HIV-uninfected patients). Each unit higher 25-hydroxyvitamin D levels at baseline were associated with a decrease of 3 (p=0.004) CD8 and 3 (p=0.01) CD3 T-cells/µL during follow-up in patients with HIV infection. Vitamin D insufficiency was also associated with a greater decrease of body mass index (BMI; -0.21 kg/m(2); 95% CI -0.39 to -0.02), during the first 8 months of follow-up. No association was observed for vitamin D status with mortality or HIV disease progression.

conclusionsAdequate vitamin D status is associated with a lower risk of relapse and with improved nutritional indicators such as BMI in patients with TB, with or without HIV infection. Further research is needed to determine the optimal dose of vitamin D and effectiveness of daily vitamin D supplementation among patients with TB.

Indexed as

AfricaHIVVitamin D

Identifiers

PMID24247327
PMCPMC3840339
OpenAlexW2135705314

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.