Abstract
Hearing impairment is due to various causes including ototoxicity from aminoglycosides. The susceptibility to aminoglycosides increases in the presence of certain mitochondria gene mutations. There is unrestrained use of aminoglycosides in many developing nations which may worsen the burden of hearing impairment in these countries but there is lack of data to drive required policy changes. Streptomycin (an aminoglycoside) is part of the drug regimen in re-treatment of tuberculosis. Exploring the impact of streptomycin ototoxicity in tuberculosis patients provides a unique opportunity to study aminoglycoside ototoxicity within the population thus providing data that can inform policy. Also, since streptomycin ototoxicity could adversely affect treatment adherence in tuberculosis patients this study could enable better pre-treatment counseling with subsequent better treatment adherence. Patients on tuberculosis re-treatment will be recruited longitudinally from Direct Observation Therapy-Short course centers. A baseline full audiologic assessment will be done before commencement of treatment and after completion of treatment. Early detection of ototoxicity will be determined using the American Speech and Hearing Association criteria and genetic analysis to determine relevant mitochondria gene mutations will be done. The incidence of ototoxicity in the cohort will be analyzed. Both Kaplan–Meier survival curve and Cox proportional hazards tests will be utilized to determine factors associated with development of ototoxicity and to examine association between genotype status and ototoxicity. This study will provide data on the burden and associated predictors of developing aminoglycoside induced ototoxicity. This will inform public health strategies to regulate aminoglycoside usage and optimization of treatment adherence and the management of drug-induced ototoxicity among TB patients. Furthermore the study will describe mitochondrial gene mutations associated with ototoxicity in the African population.Electronic supplementary materialThe online version of this article (doi:10.1186/s40064-016-2429-5) contains supplementary material, which is available to authorized users.
Highlights
Hearing ability is one of the key human senses and it could be argued to be essential for satisfactory quality of life
According to the World Health Organization (WHO) majority of hearing impaired people resides in developing countries; while a number of etiological factors have been identified as a cause of the impairment in these countries, ototoxicity from both antibiotics and antimalarial drugs feature prominently (WHO 2014) and aminoglycoside antibiotics are the commonest cause of ototoxicity (WHO 1994)
Irrational prescription of Adeyemo et al SpringerPlus (2016) 5:758 aminoglycosides have been reported in many developing countries (Gwimile et al 2012) and this unrestrained use may keep eliciting a huge burden of hearing impairment unless a significant policy change comes into effect in these countries
Summary
Hearing ability is one of the key human senses and it could be argued to be essential for satisfactory quality of life. This disability becomes more apparent in the communal cultural setting prevalent in many developing countries where hearing impaired people may suffer from social stigmatization and isolation. Hearing loss imposes significant social and economic disadvantages on both individuals and communities. Hearing impaired children often experience delayed development of speech, language, and According to the World Health Organization (WHO) majority of hearing impaired people resides in developing countries; while a number of etiological factors have been identified as a cause of the impairment in these countries, ototoxicity from both antibiotics and antimalarial drugs feature prominently (WHO 2014) and aminoglycoside antibiotics are the commonest cause of ototoxicity (WHO 1994). Irrational prescription of Adeyemo et al SpringerPlus (2016) 5:758 aminoglycosides have been reported in many developing countries (Gwimile et al 2012) and this unrestrained use may keep eliciting a huge burden of hearing impairment unless a significant policy change comes into effect in these countries. There is inadequate locally derived data to drive such a policy change
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