Publication:

Effect of zinc on sputum conversion time of drug sensitive tuberculosis patients in Naypyitaw Union Territory: a quasi-experimental study

Background Tuberculosis (TB) remains a major global health problem, particularly in high-burden countries such as Myanmar. Malnutrition and zinc deficiency are common among TB patients and may impair immune response. Zinc supplementation has been proposed as an adjunct to standard anti-TB treatment to accelerate sputum conversion, but evidence remains inconsistent.

Methods A quasi-experimental study was conducted from January 2024 to December 2025 in Naypyitaw territory, Myanmar, enrolling 310 newly diagnosed drug-sensitive tuberculosis patients. Participants in one district received standard anti-TB therapy plus zinc supplementation (20 mg daily), while those in another district received standard therapy alone. Data on socio-demographic, clinical, behavioral, and health belief variables were collected. Survival analysis and Cox proportional hazards regression with propensity score adjustment was used to compare sputum conversion times between groups.

Results Zinc supplementation significantly improved sputum conversion time, with 72.9% reaching conversion earlier than 41.9% in the control group (adjusted hazard ratio [aHR]=1.93; 95% CI: 1.31–2.85; p=0.001). Additional factor positively influencing early sputum conversion was initial sputum grading. The findings indicated that zinc supplementation accelerates sputum smear conversion, likely by enhancing host immune defense.

Conclusions The findings underscored the critical roles of nutritional support in influencing treatment outcomes. Integrating zinc into TB treatment protocols, particularly among malnourished populations, represented a cost-effective and feasible strategy to enhance early microbiological response, improve clinical recovery, and potentially reduce TB transmission risk.