Nutrition, diabetes and pulmonary TB/HIV


Start date: 31 December, 2005 End date: 31 December, 2008 Project type: Smaller projects: Postdoc Project code: 898-LIFE Countries: Thematic areas: Health, Lead institution: University of Copenhagen (UCPH), Denmark Project coordinator: Henrik Friis Total grant: 2,137,947 DKK

Project summary

The aim of the project was to assess the effect of nutritional support on TB treatment outcomes, and to assess the role of diabetes on risk and severity of TB, and TB treatment outcomes. The project comprised two trials among 1250 TB patients on the effect of nutritional support during the intensive phase of TB treatment on weight gain and grip strength: one with energy-protein supplementation among sputum positive patient with HIV-coinfection, and one on micronutrient supplementation among other categories of TB patients. In addition, observational studies were conducted to assess the role of diabetes as a risk factor for TB, as well as adverse manifestations and treatment outcomes. The studies have been successfully completed, and we have found that MN supplementation during TB treatment increased weight and grip strength, however, in TB patients with HIV co-infection, MN supplementation reduced weight gain, apparently due to sustained inflammation. EP supplementation had no overall effects on these outcomes, probably due to inappropriate composition of the supplement. In addition, based on carefully selected no-TB controls, we found a 9% prevalence of diabetes in the population. Furthermore, diabetes was shown to increase the risk of TB, both in HIV-infected and –uninfected. Interestingly, we have also been able to show that BCG vaccination, also among those with HIV-infection, reduces the risk of TB and, furthermore, improves the effect of treatment on sputum conversion. Based on the funding from Danida, as well as additional funding, one Tanzanian obtained a PhD-degree and one Tanzanian a Master in International Health. Furthermore, one Danish student will obtain a PhD-degree based on data from this project.

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