Practices employed by audiologists in the management of adult patients with multidrug-resistant tuberculosis in South Africa

Introduction: Aminoglycosides used for treating multidrug-resistant (MDR) tuberculosis are ototoxic, leading to a need for audiological monitoring. While audiologists monitor ototoxicity, currently there are no guidelines on monitoring in the South African context. Therefore, the findings of this st...

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Main Authors: M. Govender, J. Paken
Format: Article
Language:English
Published: AOSIS 2015-11-01
Series:South African Family Practice
Subjects:
Online Access:https://safpj.co.za/index.php/safpj/article/view/4279
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author M. Govender
J. Paken
author_facet M. Govender
J. Paken
author_sort M. Govender
collection DOAJ
description Introduction: Aminoglycosides used for treating multidrug-resistant (MDR) tuberculosis are ototoxic, leading to a need for audiological monitoring. While audiologists monitor ototoxicity, currently there are no guidelines on monitoring in the South African context. Therefore, the findings of this study might help to motivate the establishment of a more in-depth ototoxicity monitoring policy, which facilitates uniformity among audiologists managing patients with MDR tuberculosis. Therefore, the study aimed to describe the audiological practices employed by audiologists in the management of adult patients with MDR tuberculosis in South Africa. Method: A descriptive survey design was used. A questionnaire was developed and included elements of the American Speech-Language and Hearing Association (1994) guidelines for monitoring ototoxicity. Ninety-three audiologists contributed data to this study. Descriptive statistics were used in the analysis of the data. Results: Sixty-eight percent (%) of the respondents were aware of the international guidelines, 93% provided pre-treatment counselling and 87% conducted a baseline assessment. Nineteen per cent of the respondents conducted high-frequency audiometry, while 74% carried out a monthly evaluation, 72% performed a full audiological assessment after the cessation of the MDR tuberculosis treatment, and 96% conducted post-treatment counselling. Modifications to the international guidelines include not conducting speech and immittance audiometry, as well as testing certain frequencies. The reasons for these modifications include limited specialised equipment, time constraints, large caseloads and understaffed departments. Conclusion: There are no explicit guidelines on ototoxicity monitoring in South Africa. Consequently, audiologists are having to modify the international guidelines. Thus, there is no consistency in managing patients with MDR tuberculosis. This highlights the need for South Africa to develop context-relevant ototoxicity monitoring guidelines to appropriately manage patients with MDR tuberculosis.
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spelling doaj-art-df4ddc550c814fec8369794b0f0950b02025-08-20T03:47:07ZengAOSISSouth African Family Practice2078-61902078-62042015-11-0157610.4102/safp.v57i6.42793574Practices employed by audiologists in the management of adult patients with multidrug-resistant tuberculosis in South AfricaM. Govender0J. Paken1Audiology, Department of Health, KwaZulu-NatalDiscipline of Audiology, University of KwaZulu-Natal, WestvilleIntroduction: Aminoglycosides used for treating multidrug-resistant (MDR) tuberculosis are ototoxic, leading to a need for audiological monitoring. While audiologists monitor ototoxicity, currently there are no guidelines on monitoring in the South African context. Therefore, the findings of this study might help to motivate the establishment of a more in-depth ototoxicity monitoring policy, which facilitates uniformity among audiologists managing patients with MDR tuberculosis. Therefore, the study aimed to describe the audiological practices employed by audiologists in the management of adult patients with MDR tuberculosis in South Africa. Method: A descriptive survey design was used. A questionnaire was developed and included elements of the American Speech-Language and Hearing Association (1994) guidelines for monitoring ototoxicity. Ninety-three audiologists contributed data to this study. Descriptive statistics were used in the analysis of the data. Results: Sixty-eight percent (%) of the respondents were aware of the international guidelines, 93% provided pre-treatment counselling and 87% conducted a baseline assessment. Nineteen per cent of the respondents conducted high-frequency audiometry, while 74% carried out a monthly evaluation, 72% performed a full audiological assessment after the cessation of the MDR tuberculosis treatment, and 96% conducted post-treatment counselling. Modifications to the international guidelines include not conducting speech and immittance audiometry, as well as testing certain frequencies. The reasons for these modifications include limited specialised equipment, time constraints, large caseloads and understaffed departments. Conclusion: There are no explicit guidelines on ototoxicity monitoring in South Africa. Consequently, audiologists are having to modify the international guidelines. Thus, there is no consistency in managing patients with MDR tuberculosis. This highlights the need for South Africa to develop context-relevant ototoxicity monitoring guidelines to appropriately manage patients with MDR tuberculosis.https://safpj.co.za/index.php/safpj/article/view/4279aminoglycosidesaudiologisthigh-frequency audiometryototoxicity
spellingShingle M. Govender
J. Paken
Practices employed by audiologists in the management of adult patients with multidrug-resistant tuberculosis in South Africa
South African Family Practice
aminoglycosides
audiologist
high-frequency audiometry
ototoxicity
title Practices employed by audiologists in the management of adult patients with multidrug-resistant tuberculosis in South Africa
title_full Practices employed by audiologists in the management of adult patients with multidrug-resistant tuberculosis in South Africa
title_fullStr Practices employed by audiologists in the management of adult patients with multidrug-resistant tuberculosis in South Africa
title_full_unstemmed Practices employed by audiologists in the management of adult patients with multidrug-resistant tuberculosis in South Africa
title_short Practices employed by audiologists in the management of adult patients with multidrug-resistant tuberculosis in South Africa
title_sort practices employed by audiologists in the management of adult patients with multidrug resistant tuberculosis in south africa
topic aminoglycosides
audiologist
high-frequency audiometry
ototoxicity
url https://safpj.co.za/index.php/safpj/article/view/4279
work_keys_str_mv AT mgovender practicesemployedbyaudiologistsinthemanagementofadultpatientswithmultidrugresistanttuberculosisinsouthafrica
AT jpaken practicesemployedbyaudiologistsinthemanagementofadultpatientswithmultidrugresistanttuberculosisinsouthafrica