A longitudinal community-based ototoxicity monitoring programme and treatment effects for drug-resistant tuberculosis treatment, Western Cape.
Lucia J Stevenson, Leigh Biagio-de Jager, Marien A Graham and 1 others
PMID 35384675WHAT IT FOUND
Patients taking kanamycin for drug-resistant TB experienced significant hearing loss, particularly at high frequencies.
Community health workers successfully facilitated monitoring but missed recommended assessment intervals. Those with pre-existing hearing loss, HIV co-infection, or noise exposure faced the highest risk of deterioration.
Key findings
01More than half of the patients presented with a significant ototoxic shift meeting ASHA criteria following treatment.
02Patients with pre-existing hearing loss had significantly greater deterioration in hearing thresholds than those without.
03Community health workers achieved high follow-up rates but patients attended fewer monitoring assessments than recommended by guidelines.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was retrospective, relying on paper records with missing data such as patient gender. Assessments were conducted every two months on average, missing the recommended 14-30 day window, which may have delayed detection of hearing changes. No imittance measures were used, so middle-ear disorders may have influenced hearing loss prevalence estimates. Non-probability sampling limits the generalisability of the results.
Declared interests
The study was approved by institutional review boards and the Western Cape Department of Health, with no specific commercial funding or conflicts of interest declared in the provided text.
The easy way to misread this
Do not assume community-based monitoring alone is sufficient to prevent hearing loss, as the study showed significant deterioration despite monitoring, and the frequency of assessments was far lower than recommended.