Vitamin D, Zinc Supplementation, And Counselling Diet To Prevent Tuberculosis Infection In Toddlers Household Contacts With Bacteriologic Pulmonary Tuberculosis In Jakarta

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Ika Dewi Subandiyah, Nurhayati Adnan, Nastiti Kaswandani, Ratna Djuwita

Abstract

Vitamin D and zinc deficiencies increase the risk of infection, while public understanding of balanced nutrition is still low. Vitamin D and zinc supplementation, plus structured dietary counseling, are important strategies to reduce TB incidence in this high-risk group. This study aims to determine the effect of vitamin D and zinc supplementation and dietary counseling on the incidence of tuberculosis (TB) infection in toddlers who have household contact with bacteriologically confirmed pulmonary TB patients in DKI Jakarta. This study used a quasi-experimental design. The research sites were health centers in DKI Jakarta which were divided into two clusters: West and South Jakarta as intervention groups, and North and East Jakarta as controls, with a total study duration of 4 months. Samples were taken by consecutive sampling with a minimum number of 196 samples after taking into account the possibility of loss to follow-up. The results showed that the intervention of vitamin D supplementation (400-600 IU/day), zinc (10-20 mg/day), and intensive dietary counseling significantly reduced the incidence of TB infection among under-five household contacts by 73%, from 26% in the control group to 5% in the intervention group (RR 0.27; 95% CI 0.15-0.49; p<0.001). Supplementation also increased vitamin D and zinc consumption to meet daily requirements, improved nutritional status and reduced the prevalence of malnutrition based on BB/U from 35% to 25% and stunting based on TB/U from 38% to 28%. Although energy adequacy was not significantly affected (p=0.14), protein adequacy increased significantly (p=0.008), with the proportion of protein-deficient children under five declining from 47% to 37%. This finding confirms the effectiveness of nutritional interventions in the prevention of TB infection among household contact children.

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