Perbedaan Kadar Zinc Serum dan Status Gizi pada Terapi Fase Intensif Dibandingkan Fase Lanjutan pada Tuberkulosis Anak

Abstract

Background: Zinc deficiency (serum zinc levels of ≤65 μg/dl) leads to increase susceptibility to infection and known to impair cellular mediated immunity which plays an important role in tuberculosis. Objective: To evaluate the serum zinc levels and nutritional status of the tuberculous children on the intensive and continuation phase of tuberculosis treatment. Methods : A cohort prospective study was conducted on May to October 2018 in H. Adam Malik General hospital and University of Sumatera Utara hospital. The serum zinc levels and nutritional status of 29 children with various form of tuberculosis were measured on the intensive and continuation phase of tuberculosis treatment. Results: The mean serum zinc levels in children with pulmonary tuberculosis (n=21) was 59.2±15.0 μg/dl, lymphadenitis tuberculosis (n=3) was 59.0±10.4 μg/dl, and meningitis tuberculosis (n=5) was 53.2±18.3 μg/dl on the intensive phase of tuberculosis treatment. Serum zinc levels measured on the intensive and continuation phase were 58.1±14.9 μg/dl and 68.9±16.4 μg/dl, respectively, and significant rise in serum zinc levels was noted (mean increment of serum zinc levels=10.8 μg/dl; P<0.001). Despite of significant rise in serum zinc levels, the proportion of tuberculous children with zinc deficiency state remained high (51.7%). The proportion of tuberculous children with malnutrition was decreased from 82.8% to 55.2%. There was no association between serum zinc levels and nutritional status in the sample population. Conclusion: Increase of serum zinc levels is demonstrated along the phase of antituberculosis treatment, nevertheless the proportion of tuberculous children with zinc deficiency state remains high. Further studies regarding zinc supplementation in childhood tuberculosis are warranted.