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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Effects of a food supplement rich in arginine in patients with smear positive pulmonary tuberculosis - A randomised trial
Tuberculosis, Volume 91, No. 5, Year 2011
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Description
In tuberculosis (TB), the production of nitric oxide (NO) is confirmed but its importance in host defense is debated. Our aim was to investigate whether a food supplement rich in arginine could enhance clinical improvement in TB patients by increased NO production. Smear positive TB patients from Gondar, Ethiopia (n = 180) were randomized to a food supplementation rich in arginine (peanuts, equivalent to 1 g of arginine/day) or with a low arginine content (wheat crackers, locally called daboqolo) during four weeks. The primary outcome was cure rate according to the WHO classification and secondary outcomes were sputum smear conversion, weight gain, sedimentation rate, reduction of cough and chest X-ray improvement as well as levels of NO in urine (uNO) or exhaled air (eNO) at two months. There was no effect of the intervention on the primary outcome (OR 1.44, 95% CI: 0.69-3.0, p = 0.39) or secondary outcomes. In the subgroup analysis according to HIV status, peanut supplemented HIV+/TB patients showed increased cure rate (83.8% (31/37) vs 53.1% (17/32), p < 0.01). A low baseline eNO (<10 ppb) in HIV+/TB patients was associated with a decreased cure rate. We conclude that nutritional supplementation with a food supplement rich in arginine did not have any overall clinical effect. In the subgroup of HIV positive TB patients, it significantly increased the cure rate and as an additional finding in this subgroup, low initial levels of NO in exhaled air were associated with a poor clinical outcome but this needs to be confirmed in further studies. © 2011 Elsevier Ltd. All rights reserved.
Authors & Co-Authors
Schön, Thomas
Sweden, Linkoping
Linköpings Universitet
Sweden, Kalmar
Kalmar County Hospital
Idh, Jonna
Sweden, Linkoping
Linköpings Universitet
Westman, Anna
Sweden, Stockholm
Karolinska Universitetssjukhuset
Elias, Daniel
Ethiopia, Addis Ababa
Armauer Hansen Research Institute
Abate, Ebba
Sweden, Linkoping
Linköpings Universitet
Ethiopia, Addis Ababa
Armauer Hansen Research Institute
Ethiopia, Gondar
University of Gondar
Diro, Ermias
Ethiopia, Gondar
University of Gondar
Moges, Feleke
Ethiopia, Gondar
University of Gondar
Kassu, Afework
Ethiopia, Gondar
University of Gondar
Ayele, Belete Achamyelew
Ethiopia, Gondar
University of Gondar
Forslund, Tony
Sweden, Linkoping
Linköpings Universitet
Getachew, Assefa
Ethiopia, Gondar
University of Gondar
Britton, Sven F.F.
Sweden, Stockholm
Karolinska Universitetssjukhuset
Stendahl, Olle I.
Sweden, Linkoping
Linköpings Universitet
Sundqvist, Tommy
Sweden, Linkoping
Linköpings Universitet
Statistics
Citations: 39
Authors: 14
Affiliations: 5
Identifiers
Doi:
10.1016/j.tube.2011.06.002
ISSN:
14729792
e-ISSN:
1873281X
Research Areas
Environmental
Food Security
Infectious Diseases
Study Design
Randomised Control Trial
Study Locations
Ethiopia