Abstract
BackgroundOtotoxicity linked to medications used to treat tuberculosis (TB) remains a global challenge.ObjectivesThe aim was to describe the audiological function in a group of adults with drug-resistant tuberculosis (DR-TB) on bedaquiline (G-BDQ) treatment attending a TB hospital in South Africa and compare this with patients on kanamycin (G-KCIN).MethodsA quantitative paradigm was adopted within a non-experimental retrospective record review design. The sample consisted of 30 records of adults with DR-TB between the ages of 18 and 50 years, recruited from a Tropical Diseases Hospital in South Africa. Data were analysed through both descriptive and inferential statistical measures.ResultsClear and statistically significant differences in the audiological function were found between the two groups. The group receiving G-KCIN presented with ototoxicity that was clearly demonstrated by sensorineural hearing loss of high-frequency worsening of thresholds in over 73% of the records, which was statistically (p < 0.05) and clinically significant, over the three testing sessions, demonstrating the cumulative effects of dosage. Increased evidence of tinnitus was also found in this group. The group receiving G-BDQ presented with neither statistically (p > 0.05) nor clinically significant changes in hearing thresholds across all frequencies over the same monitoring timeframe. Additionally, only one report (7%) of tinnitus was found in this group.ConclusionThe results indicating that bedaquiline does not cause hearing loss when compared with G-KCIN highlight the need for increased availability of bedaquiline for the treatment of DR-TB within the South African context, to preserve both the quantity and quality of life of those infected.
Highlights
The World Health Organization (WHO, 2020) reports that multidrug-resistant tuberculosis (DR-TB) remains a public health crisis and a health security threat globally, with estimates of 484 000 new cases with resistance to rifampicin, which is the most effective first-line drug
The primary aim of this study was to describe the audiological function in a group of adults with DR-TB on bedaquiline treatment (G-BDQ), who are attending a TB hospital in South Africa, and compare this with patients on G-KCIN treatment
All of the participants had been diagnosed with DR-TB, with one half on G-KCIN injectable treatment and the other half on G-BDQ treatment
Summary
The World Health Organization (WHO, 2020) reports that multidrug-resistant tuberculosis (DR-TB) remains a public health crisis and a health security threat globally, with estimates of 484 000 new cases with resistance to rifampicin, which is the most effective first-line drug. South Africa reported an estimated incidence of 301 000 cases of active TB in 2018, with 11 000 people having become ill with MDR or rifampicin-resistant TB in 2018 (WHO, 2019a). As with the HIV 90-90-90 targets, South Africa committed to the Global Plan to End TB 2016–2020 strategy, which involves implementing the 90-90-90 strategy. This entails that 90% of all TB cases should be found and given effective treatment, that 90% of the TB cases in key populations should be found and provided with appropriate treatment and that there should be a 90% treatment success rate amongst people identified as needing treatment (WHO, 2020). Ototoxicity linked to medications used to treat tuberculosis (TB) remains a global challenge
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Schedule a callMore From: The South African journal of communication disorders = Die Suid-Afrikaanse tydskrif vir Kommunikasieafwykings
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