Efficacy and safety of vitamin D supplementation in treating pulmonary tuberculosis: a systematic review and meta-analysis
Abstract
OBJECTIVE: This study endeavors to assess the efficacy and safety of vitamin D (VD) supplementation among pulmonary tuberculosis (PTB) adults receiving standard anti-tuberculosis (TB) therapy. METHODS: This systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies evaluating VD supplementation as an adjunct to standard therapy in patients with drug-susceptible TB were included. Eligible studies compared clinical outcomes between patients receiving VD supplementation regardless of formulation or route of administration (RoA) and those receiving standard therapy alone. The number of included studies and participants varied across outcomes. Data on study design, participant characteristics, VD regimens, and outcome measures were systematically extracted. Risk ratio (RR) was calculated for dichotomous outcomes, and standardized mean difference (SMD) was used for continuous outcomes. Statistical heterogeneity was assessed using the I² statistic. Publication bias was evaluated using funnel plots and Egger’s test. Sensitivity analyses and predefined subgroup analyses (e.g., by treatment duration and RoA) were performed. The certainty of evidence was assessed using the GRADE framework. RESULTS: Adjunctive VD supplementation significantly increased the sputum smear conversion (SSC) rate (RR: 1.12; 95% confidence interval (CI): 1.05–1.19; P = 0.0001; high GRADE certainty;…
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