A longitudinal community-based ototoxicity monitoring programme and treatment effects for drug-resistant tuberculosis treatment, Western Cape

South African Journal of Communication Disorders

Field Value
Title A longitudinal community-based ototoxicity monitoring programme and treatment effects for drug-resistant tuberculosis treatment, Western Cape
Creator Stevenson, Lucia J. Biagio-de Jager, Leigh Graham, Marien A. Swanepoel, De Wet
Subject Audiology community-based services; community health workers; decentralised services; tuberculosis; drug-resistant tuberculosis; hearing loss; ototoxicity monitoring; audiometry; South Africa
Description Background: South Africa has a high burden of drug-resistant tuberculosis (DRTB) and until recently, ototoxic aminoglycosides were predominant in treatment regimens. Community-based ototoxicity monitoring programmes (OMPs) have been implemented for early detection of hearing loss and increased patient access.Objectives: A longitudinal study was conducted to describe the service delivery characteristics of a community-based OMP for DRTB patients facilitated by CHWs as well as observed ototoxic hearing loss in this population.Method: A descriptive retrospective record review of longitudinal ototoxicity monitoring of 194 DRTB patients undergoing treatment at community-based clinics in the city of Cape Town between 2013 and 2017.Results: Follow-up rates between consecutive monitoring assessments reached as high as 80.6% for patients assessed by CHWs. Few patients (14.2% – 32.6%) were assessed with the regularity (≥ 6 assessments) and frequency required for effective ototoxicity monitoring, with assessments conducted, on average, every 53.4–64.3 days. Following DRTB treatment, 51.5% of patients presented with a significant ototoxic shift meeting one or more of the American Speech-Language-Hearing Association (ASHA) criteria. Deterioration in hearing thresholds was bilateral and most pronounced at high frequencies (4 kHz – 8 kHz). The presence of pre-existing hearing loss, human immunodeficiency virus co-infection and a history of noise exposure were significant predictors of ototoxicity in patients.Conclusion: DRTB treatment with kanamycin resulted in significant deterioration of hearing longitudinally, predominantly at high frequencies. With ongoing training and supportive supervision, CHWs can facilitate community-based ototoxicity monitoring of DRTB patients. Current protocols and guidelines may require reassessment for appropriate community-based ototoxicity monitoring.
Publisher AOSIS
Date 2022-03-31
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — A contextually based longitudinal retrospective correlational descriptive research design using quantitative data
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajcd.v69i1.886
Source South African Journal of Communication Disorders; Vol 69, No 1 (2022); 13 pages 2225-4765 0379-8046
Language eng
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https://sajcd.org.za/index.php/sajcd/article/view/886/1663 https://sajcd.org.za/index.php/sajcd/article/view/886/1664 https://sajcd.org.za/index.php/sajcd/article/view/886/1665 https://sajcd.org.za/index.php/sajcd/article/view/886/1666
Coverage Western Cape, South Africa longitudinal; 2013 to 2017 mean age = 36.2 years; males = 35.%; females = 31.4%
Rights Copyright (c) 2022 Lucia J. Stevenson, Leigh Biagio-de Jager, Marien A. Graham, De Wet Swanepoel https://creativecommons.org/licenses/by/4.0