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Audiology

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Browsing Audiology by Author "Paken, Jessica."

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    Audiological practices employed by audiologists in the management of adult patients with multi-drug resistant tuberculosis in South Africa.
    (2015) Govender, Melesha.; Paken, Jessica.
    Aminoglycosides, such as amikacin and kanamycin, are part of the treatment for Multi-Drug Resistant Tuberculosis; however, it is ototoxic and the need for audiological monitoring is, therefore, emphasised. However, there are currently no explicit guidelines for monitoring ototoxicity in the South African context. Consequently, there is no standardised method for monitoring ototoxicity; however, audiologists are providing the service. Often adaptations to international protocols make them contextually relevant. Therefore, this study aims to describe the audiological practices employed by audiologists in the management of adult patients with MDR-TB in South Africa. A descriptive survey design was used. A questionnaire was developed and included the following aspects such as: identification and criteria used for patients with MDR-TB, baseline practices, monitoring procedures and post treatment management. Ninety-three audiologists contributed data for this study. Descriptive statistics and inferential statistics were used in the analysis of data. Results revealed that 80% of audiologists are aware of international guidelines, 93% reportedly provide pre-treatment counselling; while, 87% of audiologists conduct baseline assessments prior to the administration of MDR-TB treatment. Furthermore, 19% of audiologists conduct HFA and indicated that there is a lack of high frequency audiometers due is to financial constraints. The following were cited as reasons for the modification to the international guidelines: lack of specialised equipment, time constraints and large caseloads, as well as, understaffed departments. In addition, 74% of the audiologists are able to conduct periodic assessments monthly, while 72% of audiologists conduct a full audiological assessment after the cessation of MDR-TB treatment and 96% of audiologists conduct post treatment counselling. The findings of this study may, thus, inform policy by allowing for evidence-based ototoxicity monitoring protocols in South Africa.
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    An audiological profile of school aged children with HIV/AIDS at an antiretroviral clinic in KwaZulu-Natal.
    Peter, Vuyelwa Zandile.; Joseph, Lavanithum.; Paken, Jessica.
    There is limited research on hearing loss in the paediatric population infected with HIV/AIDS in South Africa. There is a need to establish an audiological profile in HIV infected children, as the prevalence of hearing loss is not known and there is limited published research available. This information will assist the audiologist to ascertain the extent of the disorder, establish a profile of hearing loss using hearing loss type, degree, configuration and symmetry, and dictate the necessary audiological and medical management strategies required. The aim of the study was to determine the audiological profile of school age children with HIV/AIDS at an antiretroviral clinic in KwaZulu-Natal. The study had the following objectives: To describe the prevalence and nature of hearing loss in terms of degree, type, configuration and symetry. To determine whether children with a hearing loss have received medical management and the type of treatment receive and to determine whether children with a hearing loss have received audiological management for their hearing loss and the nature of these interventions. This was achieved through a non-experimental descriptive exploratory design. The research was carried out at the Philani Family Clinic which is an ARV clinic at King Edward VIII hospital in KwaZulu-Natal, South Africa. Convenience sampling was used to recruit 30 participants aged between 6-12 years. Seventeen (60%) participants were males and 13 (40%) were females. The participants underwent diagnostic audiological evaluation, which included a case history questionnaire, medical record review, otoscopic examination, immittance audiometry, pure tone audiometry, speech audiometry, Distortion Product Otoacoustic emissions (DPOAE) and a neurological Auditory Brainstem Response (ABR) test. The results revealed, abnormal otoscopic findings in the right ear of 17 (57%) participants and the left ear of 19 (63%) participants. Tympanometry results revealed abnormal tympanograms in the right ear of 13 (43%) participants and the left ear of 12 (40%) participants. Ipsilateral acoustic reflex thresholds were abnormal in the right ear of 8 (27%) participants and in the left ear of 7 (24%) participants. Contra lateral acoustic reflex thresholds were abnormal in the right ear of 13 (44%) participants and in the left ear of 12 (40%) participants. Of the 28 participants assessed for pure tone audiometry, 15 (54%) presented with normal hearing in the right ear and 13 (46%) presented with normal hearing in the left ear. Conductive hearing loss was the most prevalent type of hearing loss, followed by sensorineural hearing loss and mixed hearing loss. Good SRT-PTA correlation was obtained in majority of the participants, indicating good test reliability. Only 18 participants underwent DPOAE testing and pass results were obtained in the right ear of 15 (50%) participants and the left ear of 12 (40%) participants. The ABR results revealed auditory dysfunction suggestive of neural dysnchrony. Seventeen (43%) participants reported a history of ear infections with 15 (50%) participants reporting having receiving medical attention for ear infections. Three (10%) participants were fitted with hearing aids. Fourteen (46%) participants reported to have repeated a school grade. Fifteen (50%) participants reported not coping academically. Study limitations included time constraints to conduct a more in depth protocol. A small sample size limited generalisation to the entire population under study. The study concluded that there was a prevalence of 53% hearing loss among children with HIV/AIDS. Therefore, the prevalence of hearing loss requires the expertise of the audiologist in the multi-disciplinary team, to both monitor and manage hearing loss and thereby improve quality of life of children with compromised immune systems . “It is always seems impossible until it is done” Nelson Mandela
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    The psychosocial impact of hearing loss on the quality of adults with multi drug-resistant tuberculosis.
    (2020) Thusi, Amanda Bernice.; Paken, Jessica.
    Aminoglycosides used in the treatment of Multi Drug-Resistant Tuberculosis (MDR-TB) is an ototoxic agent, known to result in hearing loss. Hearing loss has been reported to have far-reaching psychological, physical, and social consequences, while the diagnosis of MDR-TB has negative impacts such as stigma, and financial implications. The effects of an acquired hearing loss with an MDR-TB diagnosis may, therefore, have an increased adverse impact on the overall Quality of life of an individual; however, there is minimal research in the area. A Qualitative Phenomenological research study was conducted on 10 participants, with a confirmed diagnosis of MDR-TB, and hearing loss. The researcher used a semi-structured questionnaire to collect data during face-to-face, audio-recorded interviews. Thematic analysis of results revealed that hearing loss in patients diagnosed with MDR-TB has a significant adverse impact on the patients‟ Quality of life. All participants were unable to return their „normal‟ lives, i.e., life before the diagnosis of MDR-TB and hearing loss. Stigma, discrimination, psychological distress, adverse changes in family status and family relationships, financial constraints, and social challenges were some of the common issues reported by participants. Unemployment posed a significant challenge, resulting in participants having no economic stability due to MDR-TB, which was then worsened by the hearing loss; consequently, generating a great deal of stress. Participants reported feelings of worthlessness, a loss of identity, lack of motivation, feelings of embarrassment, and loss of independence. Cultural and ethnic factors also appeared to have influenced the participant‟s willingness to seek assistance for the psychosocial challenges they had been experiencing. Consequently, there is a significant irreversible social, psychological, and economic impact of hearing loss that has a direct impact on the Quality of life of MDR-TB patients and their families, which are likely to persist even after MDR-TB has been cured. There is a need for improved treatment methods that are less toxic to hearing together with psychosocial intervention strategies that equip patients diagnosed with MDR-TB and hearing loss to alleviate the adverse effects they experience. Without such interventions, the fight against the psychosocial impact of hearing loss in MDR-TB patients remains incomplete.