Abstract: | Tuberculosis remains a major global public health challenge. However, the
effectiveness of micronutrient supplementation on tuberculosis treatment
outcomes has been debated for decades. Therefore, this systematic review
and meta-analysis was aimed to summarize the large body of evidence from
randomized controlled trials regarding the effectiveness of micronutrient
supplementation on tuberculosis treatment outcomes. A systematic literature
search for randomized controlled trials was performed in Psych-INFO,
MEDLINE, Google Scholar, Web of science based on predefined criteria for
inclusion of selected studies. The analysis was done using STATA se version
14, and a fixed-effects model was used to estimate risk ratios with 95%
confidence intervals. The quality of evidence was assessed using the Grades
of Recommendation, Assessment, Development, and Evaluation (GRADE)
approach. Seven studies, representing 2,666 participants, met the inclusion
criteria. Although statistically non-significant, the overall Risk Ratio was
0.96 (95% CI: 0.86 to 1.07), suggesting 4% improvement of TB treatment
outcomes up on micronutrient supplementation. Because of low
heterogeneity with I2=18.7%, p=0.29, we did not perform subgroup analysis.
The risk of bias was not significant and the level of evidence quality was
„moderate‟. The study indicates that micronutrient supplementation does not
have a positive impact on tuberculosis treatment outcomes. However, further
studies with well-controlled design are necessary before a clinically
important effect can be excluded. |