Pemberian kombinasi probiotik dan zinc terhadap perubahan kadar hemoglobin, albumin, dan indeks massa tubuh pada pasien tuberkulosis paru

https://doi.org/10.22146/ijcn.23024

Meika Rahmawati Arifah(1*), Darmono Darmono(2), Muchlis Achsan Udji Sofro(3)

(1) Program Studi Magister Ilmu Gizi, Fakultas Kedokteran Universitas Diponegoro
(2) Program Studi Ilmu Gizi, Fakultas Kedokteran Universitas Diponegoro
(3) Bagian Penyakit Dalam, Fakultas Kedokteran Universitas Diponegoro / Rumah Sakit Dr. Kariadi
(*) Corresponding Author

Abstract


Background: TB patients are generally the most productive age group and suffer from chronic energy deficiency. Therefore, patients with TB requires a combination of chemotherapy and supplementary feeding as probiotics and zinc to boost the immune response and nutritional status.

Objective: To analyze the effect of a combined of probiotics and zinc on the changes of hemoglobin, albumin level, and BMI.

Method: This study is a quasi-experimental, randomized design with pre-post test control group involving 52 respondents. They were divided into two groups. The treatment group was given a combination of 1 capsule of probiotics (2 billion probiotics) and zinc 20 mg per day for 28 days. The analysis is paired t-test, independent t-test, Mann-Whitney, Pearson, Spearman, Covariance.

Results: There was an increase in hemoglobin (p=0.01), albumin (p=0.01) and BMI (p=0.01). There is no difference between the two groups in the levels of hemoglobin parameter (p=0.21) and BMI (p=0.12), whereas there is a difference parameter albumin levels (p=0.01). The effectiveness of interventions is 4% for hemoglobin levels, 16% to albumin, and 1% for IMT.

Conclusion: Probiotics and zinc for 28 days in patients with pulmonary tuberculosis may increase levels of hemoglobin, albumin, and BMI, but there is no significant difference in the changes of BMI. The most powerful influence of intervention effectiveness is on albumin.


Keywords


albumin; BMI; hemoglobin; probiotics; pulmonary tuberculosi; zinc

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References

  1. WHO. WHO Report 2009: Global tuberculosis control epidemiology, strategy, financing. Geneva, Switzerland: WHO Press; 2009.
  2. Paton NI, Chua YK, Earnest A, Chee CBE. Randomized controlled trial of nutritional supplementation in patients with newly diagnosed tuberculosis and wasting. Am J Clin Nutr 2004;80(2):460-5.
  3. Sahiratmadja E, Alisjahbana B, de Boer T, Adnan I, Maya A, Ottenhoff TH, et al. Dynamic changes in pro- and anti-inflammatory cytokine profiles and gamma interferon receptor signaling integrity correlate with tuberculosis disease activity and response to curative treatment. Infect Immun 2007;75(2):820-9.
  4. Verbon A, Juffermans NP, van Deventer SJ. Serum concentration of cytokines in patients with active tuberculosis and after treatment. Clin Exp Immunol 199;115:110-3.
  5. Juffermans NP, Verbon A, van Deventer SJ, van Deutekom H, Speelman P, van der Poll T. Tumor necrosis factor and interleukin-1 inhibitors as marker of disease activity of tuberculosis. Am J Respir Crit Car Med 1998;157(4 Pt 1):1328-31.
  6. Gupta H, Kant S, Jain A, Ahluwalia S, Natu S. Association of nutritional factors with tuberculosis treatment outcome. Proceedings published in International Journal of Computer Applications® (IJCA) (0975 – 8887). National Seminar on Application of Artificial Intelligence in Life Sciences (NSAAILS - 2013); 2013.
  7. Karyadi E, West CE, Schultink W, Nelwan RHH, Gross R, van der Meer JW. A double-blind, placebo controlled study of vitamin A and zinc supplementation in persons with tuberculosis in Indonesia: effects on clinical response and nutritional status. Am J Clin Nutr 2002;75(4):720-7.
  8. Karyadi E, Schultink W, Nelwan RHH, Gross R, Amin Z, West CE, et al. Poor micronutrient status of active pulmonary tuberculosis patients in Indonesia. J Nutr 2000;130(12):2953-8.
  9. Lee SW, Kang YA, Yoon YS, Um SW, Lee SM, Yim JJ, et al. The prevalence and evolution of anemia with tuberculosis. J Korean Med Sci 2006;21(6):1028-32.
  10. Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med 2005;352:1011-23.
  11. Sanders ME. Consideration for use of probiotic bacteria to modulate human health. J Nutr 2000;130(2S Suppl):384S-390S.
  12. Sullivan A, Nord CE. Probiotic in human infection. J Antimicrob Chemother 2002;50(5):625-7.
  13. WHO. The stop TB strategy. [series online] 2010 [cited 2015 Jun 5]. Available from: URL: http://www.who.int/tb/strategy/stop_tb_strategy/en/
  14. Alisjahbana B. Tuberculosis in indonesia: host response and patients care [Dissertation]. The Netherlands: Universiteit Nijmegen; 2007.
  15. Suparman, Hardinsyah, Kusharto CM, Sulaeman A, Alisjahbana B. Efek pemberian suplemen sinbiotik dan zat gizi mikro (vitamin A dan zinc) terhadap status gizi penderita TBC paru orang dewasa yang mengalami kekurangan energi kronik. Gizi Indon 2011:32-42.
  16. Range N, Andersen AB, Magnussen P, Mugomela A, Friis H. The effect of micronutrient supplementation on treatment outcome in patients with pulmonary tuberculosis: a randomized controlled trial in Mwanza, Tanzania. Trop Med Int Health 2005;10(9):826-32.
  17. Gavrilova NN, Ratnikova IA, Sadanov AK, Bayakisheva K, Tourlibaeva ZJ, Belikova OA. Application of probiotics in complex treatment of tuberculosis. Int. Journal of Engineering Research and Applications 2014:4(11):13-8.
  18. Sihombing H, Sembiring H, Amir Z, Sinaga B. Pola resistensi primer pada penderita TB paru kategori I di RSUP H. Adam Malik, Medan. J Respir Indo 2012;32(3):138-45.
  19. Pertiwi R, Wuryanto MA, Sutiningsih D. Hubungan antara karakteristik individu, praktik hygiene dan sanitasi lingkungan dengan kejadian tuberculosis di Kecamatan Semarang Utara Tahun 2011. Jurnal Kesehatan Masyarakat 2012;1(2):434-45.
  20. Hiswani. Tuberkulosis merupakan penyakit infeksi yang masih menjadi masalah kesehatan masyarakat. [series online] 2009 [cited 2016 Jan 23]. Available from: URL: http://librarv.usu.ac.id/download/fkmhiswani6.pdf
  21. Kementerian Kesehatan. Riset kesehatan dasar (Riskesdas) tahun 2013. Jakarta: Kementerian Kesehatan RI; 2013
  22. Herryanto D, Musadad DA, Komalig FM. Riwayat pengobatan penderita TB paru meninggal di Kabupaten Bandung. Jurnal Ekologi Kesehatan 2004;3(1):1-6.
  23. Departemen Kesehatan Republik Indonesia. Pedoman nasional penanggulangan tuberkulosis. cetakan ke 6. Jakarta: Departemen Kesehatan Republik Indonesia; 2001.
  24. Suswati E. Hubungan tingkat pendidikan dengan kepatuhan minum obat pada penderita tuberkulosis paru. Pengembangan Pendidikan 2006;3(1):67-73.
  25. Manalu HSP. Faktor-faktor yang mempengaruhi kejadian TB paru dan upaya penanggulangannya. Jurnal Ekologi Kesehatan 2010;9(4):1340-6.
  26. Martina AD. Hubungan usia, jenis kelamin dan status nutrisi dengan kejadian anemia pada pasien tuberkulosis. Media Medika Muda 2012;1(1).
  27. Ramakrishnan U. Nutritional anemias. New York Washingon, DC: CRC Press, Boca London; 2001.
  28. Puspitasari P, Wongkar MCP, Surachmanto E. Profil pasien tuberkulosis paru RSUP Prof.Dr. R.D. Kandou Manado [skripsi]. Manado: Universitas Sam Ratulangi; 2013.
  29. WHO. Global tuberculosis programme: global tuberculosis control. Geneva: WHO report; 2013.
  30. Dye C, Scheele S, Dolin P, Pathana V, Raviglione MC. Consensus statement. Global burden of tuberculosis: estimated incidence, prevalence, and mortality by country. WHO Global Surveillance and Monitoring Project. JAMA 1999;282(7):677-86.
  31. Rahmadani RP. Aplikasi yoghurt dan koumiss susu kambing probiotik
    dengan penambahan ekstrak kelopak bunga Rosella (Hibiscus sabdariffa) sebagai pangan terapis bagi penderita tuberkulosis paru. Bogor: Program Kreativitas Mahasiswa-Penelitian Institut Pertanian Bogor; 2013.
  32. Fukushima Y, Miyaguchi S, Yamano T, Kaburagi T, Iino H, Sato K. Improvement of nutritional status and incidence of infection in hospitalised, enterally fed elderly by feeding of fermented milk containing probiotic Lactobacillus johnsonii La1 (NCC533). Br J Nutr 2007;98(5):969-77.
  33. Lu X, Han CM, Yu JX, Fu SZ. Preliminary comparative study on the effects of early enteral supplementation of synbiotics on severely burned patients. Zhonghua Shao Shang Za Zhi 2004;20(4):198-201.
  34. Harding SV, Fraser KG, Wykes LJ. Probiotics stimulate liver and plasma protein synthesis in piglets with dextran sulfate-induced colitis and macronutrient restriction. J Nutr 2008;138(11):2129-35.
  35. Jeschke MG, Klein D, Herndon DN. Insulin treatment improves the systemic inflammatory reaction to severe trauma. Ann Surg 2004;239(4):553-60.
  36. Fischer Walker C, Black RE. Zinc and the risk for infectious disease. Annu Rev Nutr 2004;24:255-75.
  37. Berdanier CD, Zempleni J. Advanced nutrition: macronutriens, micronutrients and metabolism. Boca Raton: CRC Press; 2009.
  38. Artana WD, Suraatmaja S, Aryasa KN, Suandi IKG. Peran suplementasi mineral mikro seng terhadap kesembuhan diare. Sari Pediatri 2005;7(1):15-8.
  39. Suharto, Saptaningrum E, Wijayanti K, Sutarmi, Warijan, Hendromastuti A, et al. The influence of zinc supplementation on nutritional status among children under five years of age at Blora District. Jurnal Ilmu Keperawatan Indonesia 2011;1(1):1-9.
  40. Karyadi E, Pakasi TA, Nelwan RHH, Amin Z, Dolmans WMV, et al. The effects of vitamin A and zinc supplementation on cytokines in patients treated for tuberculosis – results from two randomised placebo-controlled trials. Nijmegen, Netherlands: Radboud University; 1972.



DOI: https://doi.org/10.22146/ijcn.23024

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