South African adolescents' lived experiences of acquired hearing loss following multidrug-resistant tuberculosis treatment.
Tarryn Sparg, Lucretia Petersen, Pat Mayers and 1 others
PMID 38469378WHAT IT FOUND
Six adolescents with hearing loss from MDR-TB treatment described a triple burden: poverty, life-threatening TB, and permanent hearing damage.
They faced stigma, unemployment, and isolation. Hearing aids were provided but unused due to cost, embarrassment, and fear of theft.
Key findings
01Participants experienced a triple burden of socio-economic hardship, life-threatening MDR-TB, and life-changing hearing loss.
02All but one participant had received hearing aids, but none used them due to barriers like battery costs, embarrassment, and fear of theft.
03Most participants were unaware of the ototoxic side effects of their treatment before starting, leading to confusion when hearing loss began.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Very small sample size (n=6) limits generalisability to other populations or contexts. Findings are specific to the South African LMIC context and the unique burden of MDR-TB, so they may not apply to hearing loss from other causes or in high-income settings. The study did not separate the impact of hearing loss from the concurrent trauma of poverty, orphanhood, and TB stigma. Data collection occurred in 2013, and MDR-TB treatment regimens have since changed, potentially altering the risk profile.
Declared interests
The authors declare that no financial support was received for the research, authorship, and/or publication of this article.
The easy way to misread this
Do not conclude that hearing aids are ineffective or that patients simply refuse them. In this study, hearing aids were provided but unusable due to systemic barriers like cost and stigma. The failure lies in the lack of pre-treatment counselling about permanent ototoxicity and the absence of a holistic rehabilitation plan that addresses these social and economic realities.