Hearing thresholds in patients with drug-resistant tuberculosis: baseline audiogram configurations and associations

Abstract

Objective:To use baseline audiogram parameters in order to ascertain whether drug-resistant tuberculosis (DR-TB) has effects on hearing, as well as to describe the configurations of the audiograms and to determine whether there are parameters that can be associated with those configurations. Methods:This was a prospective study involving patients diagnosed with DR-TB at a tuberculosis treatment center in the state of Ogun, in Nigeria. The patients included in the study were submitted to pure tone audiometry at baseline (within two weeks after treatment initiation). For comparative analyses, data regarding demographic and clinical characteristics were collected from the medical records of the patients. Results:The final sample comprised 132 patients. The mean age of the patients was 34.5 ± 12.6 years (range, 8-82 years), and the male:female ratio was 2:1. Of the 132 patients, 103 (78.0%) resided in neighboring states, 125 (94.7%) had previously experienced antituberculosis treatment failure, and 18 (13.6%) were retroviral-positive. Normal audiograms were found in 12 patients (9.1%), whereas sensorineural hearing loss was identified in 104 (78.8%), the two most common configurations being ascending, in 54 (40.9%), and sloping, in 26 (19.7%). Pure-tone averages at low frequencies (0.25-1.0 kHz) and high frequencies (2.0-8.0 kHz) were 33.0 dB and 40.0 dB, respectively. Regarding the degree of hearing loss in the better ear, 36 patients (27.3%) were classified as having normal hearing and 67 (50.8%) were classified as having mild hearing loss (26-40 dB), whereas 29 (21.9%) showed moderate or severe hearing loss. Among the variables studied (age, gender, retroviral status, previous treatment outcome, and weight at admission), only male gender was associated with audiometric configurations. Conclusions:In this sample of patients with DR-TB, most presented with bilateral, mild, suboptimal sensorineural hearing loss, and ascending/sloping audiometric configurations were associated with male gender.

Comparison of Hearing Thresholds among Patients on Treatment for Drug-Resistant Versus Drug-Susceptible Pulmonary Tuberculosis in A SubSaharan African Healthcare Setting

“…There was no statistically significant difference in gender between the two groups. These ratios are similar to those of similar studies by Sogebi et al [10], Ibekwe et al [11], Ramma and Ibekwe [12] and Vasconcelos et al [13].…”

“…The prevalence of HIV positivity in this study was 18.4% among the drug-resistant group and 15.8% among the drug-susceptible group (p = 0.113). These proportions are relatively comparable to that found by Sogebi et al [10] in Southwest Nigeria (13.6%) and by Akpaka et al [14] in Jamaica (11.6%) but much lower than the proportion noted by Sagwa et al [15] in Namibia (46.9%). These differences may be due to the variation in HIV prevalence among the different populations.…”

“…Noteworthy, 39.5% of patients in the drug-resistant group had some form of prior first line treatment before presentation and enrollment at our centre to commence second line treatment. This figure was as high as 94.7% in the study by Sogebi et al [10].…”

Aminoglycoside Therapy for Tuberculosis: Evidence for Ototoxicity among Tuberculosis Patients in Ghana

“…These results are consistent with findings from studies conducted by Duggal and Sarkar [ 19 ], Sagwa et al [ 26 ], Ibekwe and Nwosu [ 27 ], and Sogebi et al [ 28 ], who compared the baseline hearing thresholds with post-treatment hearing thresholds of patients initiated on an anti-TB regimen. Their findings revealed that most of the patients presented with elevated thresholds at the end of the therapy.…”

“…The proportion of patients who had their hearing affected in this study is consistent with the findings reported in other studies conducted all over the world. These included findings such as 18.75% reported by Duggal and Sarkar [ 19 ]; 36.83% by Javaid et al [ 20 ] in Asia; 18% and 28% reported by De Jager and Van Altena [ 21 ] and Sturdy et al [ 22 ], respectively, in Europe; 23.7% by Vasconcelos et al [ 23 ] in South America; 37% by Peloquin et al [ 24 ] in North America; 47% by Ramma and Ibekwe [ 25 ] and 58% by Sagwa et al [ 26 ], both in southern Africa; and 61% and 22.9% reported by Ibekwe and Nwosu, [ 27 ] and Sogebi et al [ 28 ], respectively, in West Africa. The wide variation in the hearing loss prevalence could be ascribed to the difference in geographical locations and in the audiology test used by the various studies.…”