Middle ear pathologies in children living with HIV: A scoping review.
Ben Sebothoma, Minkhenso Maluleke
PMID 36453796WHAT IT FOUND
Children living with HIV showed higher rates of middle ear problems than those without HIV.
The evidence is thin, based on six small studies, and the tests used were insensitive, so these findings do not confirm a direct cause or effect.
Key findings
01Six studies involving 1053 children were identified, showing children with HIV had more middle ear pathologies, such as abnormal tympanograms and otorrhea, than HIV-negative children.
02Conductive hearing loss was the most frequent type of hearing loss reported in these children, linked to ear infections and low CD4 counts.
03All included studies used single-probe-tone tympanometry, which has poor sensitivity and may miss up to 20% of conductive hearing loss cases.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Very limited evidence: only six studies were included, one of which was itself a review. Insensitive measurement: all studies used single-probe-tone tympanometry, which the authors note has poor sensitivity and specificity and may miss up to 20% of conductive hearing loss. Heterogeneity: the included studies used different designs (case-control, cross-sectional, longitudinal) and varied in sample size and age ranges, making direct comparison difficult. No risk of bias assessment: the review did not evaluate the quality of the included studies. Geographic restriction: all studies were conducted in low- and middle-income countries, which may limit generalisability to other settings.
The easy way to misread this
Do not assume that a normal tympanometry result rules out middle ear pathology in children with HIV. The studies reviewed used insensitive screening methods, and the evidence base is too small and heterogeneous to confirm the true prevalence or nature of these conditions.