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Community-Based Ototoxicity Monitoring for Drug-Resistant Tuberculosis in South Africa: An Evaluation Study

Author

Listed:
  • Lucia Jane Stevenson

    (Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Corner of Lynnwood and University Roads, Hatfield, Pretoria 0002, South Africa)

  • Leigh Biagio-de Jager

    (Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Corner of Lynnwood and University Roads, Hatfield, Pretoria 0002, South Africa)

  • Marien Alet Graham

    (Department of Science, Mathematics and Technology Education, Faculty of Education, University of Pretoria, Corner of George Storrar Dr and Leyds St., Groenkloof, Pretoria 0002, South Africa)

  • De Wet Swanepoel

    (Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Corner of Lynnwood and University Roads, Hatfield, Pretoria 0002, South Africa
    Ear Science Institute Australia, Perth, WA 6008, Australia)

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.

Suggested Citation

  • Lucia Jane Stevenson & Leigh Biagio-de Jager & Marien Alet Graham & De Wet Swanepoel, 2021. "Community-Based Ototoxicity Monitoring for Drug-Resistant Tuberculosis in South Africa: An Evaluation Study," IJERPH, MDPI, vol. 18(21), pages 1-14, October.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:21:p:11342-:d:667139
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    References listed on IDEAS

    as
    1. Katijah Khoza-Shangase & Nothando Masondo, 2020. "What Are the Current Audiological Practices for Ototoxicity Assessment and Management in the South African Healthcare Context?," IJERPH, MDPI, vol. 17(7), pages 1-14, April.
    2. Sizulu Moyo & Helen S Cox & Jennifer Hughes & Johnny Daniels & Leigh Synman & Virginia De Azevedo & Amir Shroufi & Vivian Cox & Gilles van Cutsem, 2015. "Loss from Treatment for Drug Resistant Tuberculosis: Risk Factors and Patient Outcomes in a Community-Based Program in Khayelitsha, South Africa," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-13, March.
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