The prevalence of hearing loss in HIV-infected South African adolescents on antiretroviral therapy

Banga, Agatha Tafadzwa

The prevalence of hearing loss in HIV-infected South African adolescents on antiretroviral therapy

Master Thesis

2017

Publisher

University of Cape Town

Department

Centre for Infectious Disease Epidemiology and Research (CIDER)

Faculty

Faculty of Health Sciences

Abstract

Objective: To investigate hearing loss among perinatally HIV-infected (PHIV+) adolescents on antiretroviral therapy (ART), and HIV-non-infected (HIV-) adolescents in Cape Town, South Africa. Methods: A cross-sectional analysis was carried out to describe the prevalence, nature and predictors (demographic, past medical history, clinical findings) of hearing loss in adolescents between 9 and 14 years of age. Screening pure-tone air-conduction (AC) thresholds above 30 decibels (dB) were considered to be indicative of debilitating hearing loss. Statistical analysis included univariate analysis and multivariate logistic regression. Results: The cross-sectional analysis included data from 540 participants; consisting 273 males (51%), 267 females, 432 PHIV+ and 108 HIV-, with a median age of 12 years. Hearing impairment was observed in 19% of all the adolescents in the study. Multivariate analysis showed the following predictors for any hearing loss: an unmarried primary caregiver (odds ratio (OR) 0.59; 95% confidence interval (CI), 0.39;0.91, p = 0.015), being female (OR 1.67; 95% CI, 1.12;2.51; p = 0.013) and reports of being troubled by ear pain or discharge in the last month (OR 2.54; 95% CI, 1.55;4.17; p = <0.001) after adjustment. Univariate analysis showed an association between hearing loss and a longer duration on ART among PHIV+ adolescents (OR 1.80, 95%CI 1.17;2.75, p = 0.007). Conclusion: The prevalence of hearing loss appears to be comparable between PHIV+ and HIVadolescents in Cape Town. In low resource settings, a history of ear pain or discharge within the last month may be used as a screening tool for a hearing assessment, and guide referral for formal hearing tests.