Auditory manifestations in HIV-infected children at a state hospital in South Africa

Abstract

Objective

To determine the prevalence and risk factors for developing ear disease and hearing loss (HL) in children living with HIV/AIDS (CLWHA).

Methods

This was a cross-sectional survey where participants underwent an otoscopic examination and an otoacoustic emissions screening (<6-years-old) or smartphone-based pure tone audiometry (>6-years-old) test. Prevalence data were analyzed using descriptive statistics while multivariate logistic regression identified the risk factors for developing ear disease/HL.

Results

Forty-one participants aged 3–12-years-old (22 males and 19 females) took part in this study. Twenty participants (48.7%) presented with ear disease including otitis media (n = 9, 22%), cerumen impaction (n = 10, 23%), and tympanic membrane perforation (n = 1, 2.4%). HL was observed in 13 participants (32%). Lower CD4 count, longer duration of HIV infection, shorter duration on ART treatment, and concomitant tuberculosis (TB) infection were (p < .05) all associated with ear diseases.

Conclusion

A high prevalence of ear disease and HL was found in CLWHA, which indicated the need for ear and hearing screening to be incorporated into 3-monthly consultations with CLWHA; to enable early detection and intervention and prevent the associated negative impacts. A multidisciplinary team approach to the management of CLWHA, specifically the inclusion of audiologists, and the use of mHealth in resource-constrained settings is highly recommended.

Keywords:

• Paediatric HIV
• ear disease
• hearing loss
• rural health
• smartphone-based audiometry

Acknowledgements

A portion of this data was presented at the University of Fort Hare’s Govan Mbeki Virtual Research Conference titled ‘Unlocking Covid-19 for sustainable development’. The authors would like to thank the children and their families for their participation in this study, along with Dr. B. Makhongwana, for her assistance in ensuring access to, and referring, participants to this study during data collection. In addition, the authors thank Carrin Martin for assisting with language editing for this manuscript.

Disclosure statement

The authors declare no competing interests.