Abstract
BackgroundIn a previous study, severe and cerebral malaria have been connected with acute cochlear malfunction in children, demonstrated by a decrease of transitory evoked otoacoustic emissions (TEOAEs) reproducibility. This study aims to determine whether cochlear malfunction persists for 4 years after recovery from severe malaria in a subset of the previous study’s collective. Follow-up TEOAEs were performed on site (CERMEL, Hôpital Albert Schweitzer, Lambaréné, Gabon) or at the participants’ homes; 33 out of 90 participants included in the initial investigation by Schmutzhard et al. could be retrieved and were re-examined, 31/33 could be included. Of the 57 missing participants, 51 could not be contacted, 1 had moved away, 4 refused to cooperate, and 1 had died.MethodsAs in the initial investigation, participants of this prospective follow-up study were subjected to TEOAE examination on both ears separately. A wave correlation rate of > 60% on both ears was considered a “pass”; if one ear failed to pass, the examination was considered a “fail”. The results were compared to the primary control group. Additionally, a questionnaire has been applied focusing on subsequent malaria infections between the primary inclusion and follow-up and subjective impairment of hearing and/or understanding.ResultsThe cohort’s mean age was 9 years, 14 children were female, 18 male. 31 had been originally admitted with severe, one with cerebral malaria. 83.8% of participants (n = 26) presented with a TEOAE correlation rate of > 60% on both ears (the cut-off for good cochlear function); in the control group, 92.2% (n = 83) had passed TEOAE examination on both ears. Recurrent severe malaria was associated with a worse TEOAE correlation rate. Age at infection and gender had no influence on the outcome.ConclusionsCochlear malfunction seems to be persistent after 4 years in more than 16% of children hospitalized for malaria. In a healthy control group, this proportion was 7.8%. Yet, the severity of the initial TEOAE-decrease did not predict a worse outcome.
Highlights
In a previous study, severe and cerebral malaria have been connected with acute cochlear malfunction in children, demonstrated by a decrease of transitory evoked otoacoustic emissions (TEOAEs) reproducibility
The follow-up study was designed as a prospective study and aimed to repeat transient OAE measurements in children, which had been included in the prior study in 2011 at the Centre de Recherches Médicales Lambaréné
Out of the 57 nonreachable participants, 22 did not leave any contacts, 5 phone numbers were invalid, 3 phone numbers were used by a different person, in 20 cases the contact person was impossible to reach, 1 patient had moved away, in 4 cases the parents refused to cooperate, 1 participant could not be found and was unknown to the inhabitants of his village, and 1 participant had died of cerebral malaria
Summary
Severe and cerebral malaria have been connected with acute cochlear malfunction in children, demonstrated by a decrease of transitory evoked otoacoustic emissions (TEOAEs) reproducibility. Severe and cerebral malaria, have been known to Reiterer et al Malar J (2019) 18:212 from severe Plasmodium falciparum malaria This association of P. falciparum malaria and neurological impairment was confirmed later [3], with Carter et al [4] postulating malaria as possibly one of the most common causes of paediatric neurocognitive impairment in tropical countries, maybe even worldwide. Apart from the already known neurological sequelae, an explicit connection between malaria and acute hearing loss has been established since the beginning of the 1990s. Mefloquine has been reported to cause acute high tone hearing loss, sometimes in combination with tinnitus. A lack of high-quality evidence remains due to the heterogeneity of the studies and data for young children is still missing [9]
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