Community-based ototoxicity monitoring for drug-resistant tuberculosis in South Africa : an evaluation study

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Authors

Stevenson, Lucia Jane
Biagio-de Jager, Leigh
Graham, Marien Alet
Swanepoel, De Wet

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Publisher

MDPI Publishing

Abstract

In response to the drug-resistant tuberculosis (DRTB) ototoxicity burden in South Africa, ototoxicity monitoring has been decentralised, with community health workers (CHWs) acting as facilitators. This study describes a community-based ototoxicity monitoring programme (OMP) for patients with DRTB. Findings are compared to the recommended guidelines for ototoxicity monitoring, the OMP protocol and published studies. This was a retrospective study of longitudinal ototoxicity monitoring of 831 patients with DRTB, using data collected at community-based clinics in the City of Cape Town between 2013 and 2017. Approximately half (46.8%) of the patients had an initial assessment conducted in accordance with the OMP protocol recommendations, and follow-up rates (79.5%) were higher than those of a similar DRTB programme. However, patients in this study were not monitored within the timeframes or with the regularity recommended by the guidelines or the OMP protocol. Extended high-frequency pure-tone audiometry (27.5%) was underutilised by testers and data recording was inconsistent (e.g., 37.7% of patient gender was not recorded by testers). Community-based OMP using CHWs to facilitate monitoring showed improvement over previous hospital-based reports, with more accessible services and higher follow-up rates. However, to improve OMP outcomes, OMP managers should reassess current protocols and data recording practices.

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Keywords

Community-based services, Decentralised services, Tuberculosis (TB), Hearing loss, Audiometry, South Africa (SA), Drug-resistant tuberculosis (DR-TB), Community health worker (CHW), Ototoxicity monitoring programme (OMP)

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Citation

Stevenson, L.J.; Biagio-de Jager, L.; Graham, M.A.; Swanepoel, D.W. Community-Based Ototoxicity Monitoring for Drug-Resistant Tuberculosis in South Africa: An Evaluation Study. IInternational Journal of Environmental Research and Public Health 2021, 18, 11342. https://DOI.org/10.3390/ijerph182111342.