Dr Muhammad Imran Hussain

Tuberculosis (TB) is an infectious bacterial disease caused by Mycobacterium tuberculosis which is prevailing from 3000-5000 years BC. According to WHO, tuberculosis is a global health emergency and is one of the leading causes of unavoidable death in young adults. It has been estimated that about 33% population of the world is at risk due to Mycobacterium tuberculosis. Previously it was thought that TB is the disease of third world country but from last decade prevalence of TB in developed countries is also augmented. Pakistan is graded at fifth position among 22 high graded countries and is increasing day by day.

In TB patients, there is continuous decline in levels of macro- and micro-nutrient which badly affects their muscle and immune response. Patients in hospitals require urgent dietary support along with the recommended treatment. Deficiency of various micronutrients is causing secondary immunodeficiency and predominate the individuals for infections related morbidity. It has been observed that during the course of the disease, the demand for various nutrients also increases to maintain homeostasis and tissue repair.

Studies showed that patients with pulmonary tuberculosis have lower vitamin E level than normal person. Vitamin E and Selenium plays an important role, as micronutrient, in improving health quality and immunomodulation during the course of the disease. In body, vitamin E works with selenoprotein and glutathione peroxidase and blocks the production of free radicals and ultimately the damaging process by these radicals is blocked. Selenium plays an important role in removal and immunomodulation against various pathogens especially Mycobacterium and is considered an important component in various metabolic processes including metabolic activity of thyroid gland, defense system and immunity. Deficiency of selenium in vegetables and fruits is linked with deficiency of selenium in soil. Consumption of selenium deficient vegetables and fruits is not full filling the daily dietary requirement of selenium. Vitamin E and selenium have a combined anti-oxidative and Immunomodulatory function with anti-tuberculosis drugs to increase the efficacy of the anti-tuberculosis treatment.

Dietary counseling is one of the effective tools to control malnutrition/wasting associated with tuberculosis. In Pakistan there are no proper dietary protocols for tuberculosis patients and they have poor nutritional status. A study conducted at Department of Food Science and human Nutrition, University of Veterinary and Animal Sciences, Lahore proved that dietary counseling would increase nutrient intake and can improve nutritional status in patients with tuberculosis. Further if TB affected patients are given Vitamin E and selenium in combination along with anti-tuberculosis therapy, it improves the treatment outcomes and immunity of TB patients. The emphasis of TB care unit should be made on improving nutritional status of patients to the best possible level.

The writer is a PhD (Scholar) at University of Veterinary and Animal Sciences, Lahore.