The occurrence of auditory dysfunction in children with TB receiving ototoxic medication at a TB hospital in South Africa

Ghafari, Nazanin; Rogers, Christine; Petersen, Lucretia; Singh, Shajila

doi:10.1016/j.ijporl.2015.04.040

Cited by 11 publications

(10 citation statements)

References 14 publications

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“…1 The use of aminoglycosides, which are broad-spectrum antibiotics used in the treatment of life-threatening acute infections, accounts for the majority of ototoxicity in children, with incidence as high as 40 per cent in children receiving treatment for tuberculosis. 61 Again, rates of hearing loss associated with ototoxicity are expected to be higher in low-and middle-income countries, where access to other effective antibiotics is expensive or restricted, and the monitoring of safe dosages is not always feasible.…”

Section: Epidemiologymentioning

confidence: 99%

“…In children, the WHO estimate that the use of ototoxic drugs during pregnancy and in neonates accounts for 4 per cent of childhood hearing losses 1 . The use of aminoglycosides, which are broad-spectrum antibiotics used in the treatment of life-threatening acute infections, accounts for the majority of ototoxicity in children, with incidence as high as 40 per cent in children receiving treatment for tuberculosis 61 …”

Section: Ototoxicitymentioning

confidence: 99%

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Global burden of hearing impairment and ear disease

et al. 2018

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Section: Epidemiologymentioning

confidence: 99%

Section: Ototoxicitymentioning

confidence: 99%

Global burden of hearing impairment and ear disease

et al. 2018

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“…More severe adverse events included hearing loss with aminoglycosides, psychosis with cycloserine, allergic reaction with meropenem and severe linezolid adverse events (peripheral neuropathy and optic neuritis). Hearing loss with aminoglycosides has been largely described [32] , [33] . Aminoglycosides must be replaced by novel therapeutic tuberculosis drugs.…”

Section: Discussionmentioning

confidence: 99%

Challenge to treat pre-extensively drug-resistant tuberculosis in a low-income country: A report of 12 cases

Kashongwe

Mawete

Anshambi³

et al. 2020

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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Setting: Democratic Republic of the Congo is a high-burden TB country. Its capital, Kinshasa, reports annually about one-third of all MDR-TB cases in the country; thus, pre-XDRTB management is warranted. Objectives To describe the main challenges in treating pre- XDR TB in this low resources setting and possible solutions. Method This is a retrospective study of all pre-XDR TB patients diagnosed in Kinshasa in 2018. A personalized regimen was applied according to the clinical profile, drug availability, and the Drug susceptibility testing (DST). Treatment was administered by hospitalization during the intensive phase and in ambulatory care in the continuation phase except in emergencies. Monthly follow up included evaluating clinical and bacteriological features, renal and liver functions, QT interval on ECG, and audiometry for those under aminoglycosides. Results Among the 236 MDR-TB patients identified in 2018, 14 had pre-XDR. Two died before treatment initiation. Of the remaining 12. 75% were male, 50% were aged 25–44 years, 66.7% had previous anti-tuberculosis treatment, 75% had a body mass index < 18.5 kg/m 2 , and 1 patient was HIV positive. On radiography, all the patients had cavities. The median time from the diagnosis to treatment initiation was 48.5 days (range: 14–105). A favorable outcome occurred in 10 cases (83.3%), one patient died, and anotherwas lost to follow up. Nine (75%) patients reported adverse reactions, which were mild or moderate in 6 cases and severe in 2 cases. The severe reactions were psychosis (1 case) and ototoxicity (1 case). Conclusion: Successful pre-XDRTB treatment using the new strategy is possible even in a low-income country. The main challenges are diagnosis access, drug availability and follow-up laboratory facilities. These can be included in a global policy review by the NTP to ensure the sustainability of the strategies implemented.

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“…5 Concurring with results from the Seddon et al 5 study, a 2015 study on children with TB found that 48% of children taking potentially ototoxic medication had a hearing loss. 29 However, it is acknowledged that a baseline assessment was not carried out, so the hearing status prior to receiving the ototoxic medication was not known. The study reiterated the need for ototoxicity monitoring, as well as recommending monitoring of the middle ear as irregularity was observed.…”

Section: Audiologymentioning

confidence: 99%

Ototoxicity: A review of South African studies

2021

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Background: Ototoxicity is damage to cells in the inner ear after administering a toxic drug, with a resultant hearing loss. Drugs used to treat illnesses such as cancer, tuberculosis, human immuno-deficiency virus (HIV) and infections are potentially ototoxic. South Africa has one of the highest rates of HIV and tuberculosis, and thus a potentially greater degree of the population is being affected by hearing loss from the medications used to treat these illnesses.Methods: To determine the current status of research in ototoxicity, a systematic literature review was carried out to determine the focus areas of South African studies for the period 1989–2019. From the database search engines used (Science Direct, Ebscohost and Proquest), a total of 33 relevant articles were identified, including the themes of pharmacology, audiology and knowledge.Results: Studies were conducted in the three most resourced provinces in South Africa. Findings indicate that there is a need for educating doctors regarding ototoxicity and a delineation of the role of the audiologist in monitoring and management of ototoxic hearing loss. There is a resultant need for audiology training on the pharmacology of ototoxic medication, otoprotective strategies and adherence to recommended guidelines. This has implications for university audiology training programmes and curriculum planning. The need for development of South Africa-specific audiology guidelines was highlighted.Conclusion: Whilst it is noted that there is a lack of resources for effective implementation of ototoxicity-monitoring protocols, it is also noted that there are measures and otoprotective strategies that can be put in place without additional resources.

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The occurrence of auditory dysfunction in children with TB receiving ototoxic medication at a TB hospital in South Africa

Cited by 11 publications

References 14 publications

Global burden of hearing impairment and ear disease

Global burden of hearing impairment and ear disease

Challenge to treat pre-extensively drug-resistant tuberculosis in a low-income country: A report of 12 cases

Ototoxicity: A review of South African studies

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