Abstract
BackgroundThe increased incidence of multi-drug-resistant tuberculosis (MDR-TB) and the consequent use of aminoglycosides with their ototoxic potential necessitate a better understanding of the audiological pattern of infected patients.ObjectiveTo describe the occurrence and nature of hearing loss in patients with MDR-TB receiving aminoglycosides over a period of 6 months.MethodsBaseline and five consecutive monthly audiological assessments were conducted on 52 adults at a hospital in KwaZulu-Natal. A longitudinal descriptive study was implemented. A conventional audiological test battery, extended high frequency audiometry and otoacoustic emission testing were conducted. Data were analysed using SPSS version 19 statistical software package.ResultsDecreased hearing was the most common audiological symptom experienced. Bilateral sensorineural hearing loss was predominant. Ototoxic hearing loss was noted in 27 participants (52%) in 1 month post-treatment. Hearing loss progressed from mild to moderate at post-treatment one, to moderate to severe at post-treatment three and severe to profound at post-treatment five. Changes in hearing function were noted in 52 participants (100%) by post-treatment five. High and ultra-high frequencies were most affected. Speech discrimination scores deteriorated over time. The number of patients with absent distortion product otoacoustic emissions increased over treatment duration.ConclusionThe greatest effects were observed in the high frequencies before manifesting in the lower frequencies. This highlights the importance of inclusion of high frequency audiometry in the early detection of ototoxicity which can go undiagnosed with traditional audiometry. The high prevalence of hearing loss has implications for the provision of audiological service to this patient population.
Highlights
South Africa is in the midst of a tuberculosis (TB) epidemic and is ranked fourth out of the 22 high-burden countries identified worldwide in terms of TB by the World Health Organization (WHO) (2008)
The emergence of multi-drug-resistant tuberculosis (MDR-TB) associated with antibiotic resistance poses a barrier to the ongoing struggle of global TB control and is subsequently a major challenge to health care needs within South Africa (Zager & McNerney, 2008)
Reports of hearing loss increased with each successive assessment over treatment duration
Summary
South Africa is in the midst of a tuberculosis (TB) epidemic and is ranked fourth out of the 22 high-burden countries identified worldwide in terms of TB by the World Health Organization (WHO) (2008). According to the 2011 statistics of the estimated 10 819 139 people living in KwaZulu-Natal, the prevalence of TB was 400 per 100 000, with an incidence of 490 per 100 000 population (WHO, 2011). Whilst these statistics are high, the actual burden of tuberculosis may yet be underestimated in this region (Mitnick, Appelton & Shin, 2008). The increased incidence of multi-drug-resistant tuberculosis (MDR-TB) and the consequent use of aminoglycosides with their ototoxic potential necessitate a better understanding of the audiological pattern of infected patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: The South African journal of communication disorders = Die Suid-Afrikaanse tydskrif vir Kommunikasieafwykings
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
