Effect of a Combination of Anti-tuberculosis Drugs (ATTs) and Pumpkin Seed Capsules on Sputum Bacterial Load Among TB Patients in Majene Regency, Indonesia

Tuberculosis remains a major public health challenge globally, particularly in low- and middle-income countries where the disease exhibits high prevalence and mortality. Despite the global implementation of standardized anti-tuberculosis drug regimens, therapeutic outcomes are often limited by treatment non-adherence, prolonged duration, and the emergence of multidrug-resistant strains. As a response, there is growing interest in integrating functional food-based interventions into tuberculosis treatment protocols. Pumpkin seeds (Cucurbita moschata), known for their bioactive compounds including zinc, polyphenols, and flavonoids, have demonstrated antimicrobial, immunomodulatory, and antioxidant properties, offering potential as a supportive adjunct in tuberculosis therapy. This study aimed to examine the effectiveness of combining anti-tuberculosis drugs with pumpkin seed capsule supplementation in reducing the bacterial load of Mycobacterium tuberculosis in sputum samples of patients diagnosed with tuberculosis in Majene Regency, Indonesia. A quasi-experimental design was applied, utilizing a non-randomized pre-test and post-test control group methodology. A total of 57 tuberculosis patients were selected using purposive sampling, with 28 participants assigned to the intervention group receiving standard anti-tuberculosis drugs alongside 700 mg of pumpkin seed capsules administered twice daily for 90 days. The remaining 29 participants served as the control group and received only the standard drug regimen. Sputum samples were collected and analyzed at baseline, one month, and three months using the polymerase chain reaction method to determine bacterial load. Data were statistically evaluated using paired t-tests, independent t-tests, and chi-square tests, with a confidence interval set at 95 percent. The intervention group exhibited a significant decrease in mean bacterial count from 110.8 to 0.0 colony-forming units after three months, while the control group showed a modest decline to 0.6. Additionally, by the end of the first month, 61.29 percent of the intervention group had negative sputum conversion compared to 38.71 percent in the control group, indicating a statistically significant improvement in bacterial clearance. The findings suggest that pumpkin seed supplementation may effectively support faster recovery in tuberculosis patients when used in conjunction with anti-tuberculosis drugs. The integration of pumpkin seed capsules into therapeutic protocols offers a promising functional food-based strategy to enhance bacterial eradication and shorten treatment duration. Further longitudinal studies are required to investigate long-term safety, optimal dosing, and the mechanistic pathways contributing to this therapeutic synergy. Key words: Anti-Tuberculosis Drugs, Capsules, Food, Functional, Mycobacterium, Pumpkin, Seed, Sputum, Tuberculosis