An audiological profile of school aged children with HIV/AIDS at an antiretroviral clinic in KwaZulu-Natal.

Abstract

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