Frequency and Impact of Micronutrient Deficiencies in Patients with Active Pulmonary Tuberculosis

Abstract

Background: Active pulmonary tuberculosis (TB) is a leading infectious disease, particularly prevalent in low-income countries like Pakistan. Micronutrient deficiencies, including vitamins A, C, D, E, and minerals such as zinc and iron, are commonly observed in patients with active TB. These deficiencies may compromise immune response, slow recovery, and worsen disease outcomes. Objective: To evaluates the micronutrient status of Pakistani patients diagnosed with active pulmonary DS-TB and explores the correlation between deficiency levels and disease progression. Methodology: A cross-sectional study was carried out at the DOTS center District Headquarter Hospital, Haripur. About 200 active DS-TB patients’ sample between January 2021 and January 2022 are process by   collected blood samples under fasting conditions to avoid dietary influences. Measurement of specific micronutrients (e.g., vitamins A and D) High-Performance Liquid Chromatography (HPLC)  method are used while for minerals like iron, zinc, and selenium  Colorimetric Assay methods are apply.Additional inflammatory markers (e.g., CRP) to correlate with disease severity and micronutrient levels. For data analysis SPSS software (version 27) is used. Results: The study had 200 active TB patients in which the mean age was approximately 36 years, with a slight majority of male patients (60%) with low socioeconomic backgrounds (75%). Sputum smear grading further classifies these positive cases by the density of Acid-Fast Bacilli (AFB) in which 1+ (32.5%) had greater frequency. Vitamin D deficiency was most prevalent, affecting 70% of patients, which is concerning given its role in immune function. The correlations between various micronutrient levels and clinical indicators of TB severity, as well as inflammation (measured by CRP levels) in which Vitamin D levels were the most strongly correlated with both TB severity and CRP levels, indicating that deficiencies in Vitamin D are linked to worsened TB symptoms and increased inflammation. Conclusion: These findings underscore the need for integrated nutritional support in TB treatment protocols to improve patient outcomes and reduce TB morbidity in Pakistan. Enhanced focus on dietary interventions and supplementation may aid in managing TB in this vulnerable population.