Incidence and audiometric outcomes of hearing loss among tuberculosis patients receiving all-oral treatment regimens: A prospective cohort study in Nigeria

Le résumé fourni par la source

Objectives: The objective of the study is to determine the incidence of hearing loss and evaluate audiometric changes among patients with drug-susceptible TB (DS-TB) and multidrug-resistant TB (MDR-TB) receiving all-oral anti-TB treatment regimens. Tuberculosis (TB) remains a major global health challenge, with Nigeria among the high-burden countries identified by the World Health Organization. Although all-oral treatment regimens have replaced injectable agents to reduce ototoxicity, concerns persist regarding potential auditory toxicity, particularly among patients treated for MDR-TB. Prospective data evaluating hearing outcomes associated with these newer regimens in high-burden settings remain limited. Methods: We conducted a 1-year prospective cohort study involving 98 adults with newly diagnosed TB and 98 matched healthy controls at a tertiary hospital in south-east Nigeria. Pure tone audiometry (PTA) was performed at baseline, 2 months, and 3 months. Hearing loss was defined using the American Speech-Language-Hearing Association ototoxicity criteria. Audiometric thresholds and incidence rates were compared between DS-TB and MDR-TB treatment groups. Multivariable statistical analyses were performed using STATA version 16, with p < 0.05 considered statistically significant. Results: All participants had normal hearing at baseline. After 3 months of treatment, the overall incidence of sensorineural hearing loss (SNHL) was 4.1% (4/98). The incidence was significantly higher among MDR-TB patients (16.7%; 3/18) compared with DS-TB patients (1.3%; 1/80). Hearing loss severity ranged from mild to moderate and was bilateral in all affected cases. Despite this, mean audiometric thresholds did not differ significantly between treatment and control groups ( p > 0.05). Conclusion: All-oral anti-TB regimens were associated with a low overall incidence of hearing loss. However, patients receiving MDR-TB treatment remain at increased risk. These findings support continued audiological monitoring during MDR-TB therapy, even with injectable-free regimens, and highlight the need for larger longitudinal studies to confirm auditory safety.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.