Hearing loss in children treated for multidrug-resistant tuberculosis

J Infect. 2013 Apr;66(4):320-9. doi: 10.1016/j.jinf.2012.09.002. Epub 2012 Sep 6.

Abstract

Objective: The aminoglycosides and polypeptides are vital drugs for the management of multidrug-resistant (MDR) tuberculosis (TB). Both classes of drug cause hearing loss. We aimed to determine the extent of hearing loss in children treated for MDR-TB.

Methods: In this retrospective study, children (<15 years) admitted to Brooklyn Chest Hospital, Cape Town, South Africa, from January 2009 until December 2010, were included if treated for MDR-TB with injectable drugs. Hearing was assessed and classified using audiometry and otoacoustic emissions.

Results: Ninety-four children were included (median age: 43 months). Of 93 tested, 28 (30%) were HIV-infected. Twenty-three (24%) children had hearing loss. Culture-confirmed, as opposed to presumed, diagnosis of TB was a risk factor for hearing loss (OR: 4.12; 95% CI: 1.13-15.0; p = 0.02). Seven of 11 (64%) children classified as having hearing loss using audiometry had progression of hearing loss after finishing the injectable drug.

Conclusions: Hearing loss is common in children treated for MDR-TB. Alternative drugs are required for the treatment of paediatric MDR-TB.

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy*
  • AIDS-Related Opportunistic Infections / microbiology
  • Antitubercular Agents / adverse effects*
  • Antitubercular Agents / therapeutic use
  • Audiometry / methods
  • Child
  • Child, Preschool
  • Female
  • HIV Infections / complications
  • Hearing Loss / chemically induced*
  • Hearing Loss / diagnosis
  • Hearing Loss / epidemiology*
  • Humans
  • Infant
  • Male
  • Mycobacterium tuberculosis / drug effects*
  • Otoacoustic Emissions, Spontaneous
  • South Africa / epidemiology
  • Tuberculosis / drug therapy*
  • Tuberculosis / microbiology
  • Tuberculosis / pathology
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Tuberculosis, Pulmonary / drug therapy*
  • Tuberculosis, Pulmonary / microbiology

Substances

  • Antitubercular Agents