Prevalence and types of hearing impairment in patients attending the HIV/AIDS clinics at mulago hospital.

Abstract

BACKGROUND: HIV/AIDS is a major cause of morbidity and mortality in Uganda. Hearing impairment is one form of morbidity seen in HIV Positive patients affecting quality of life and productivity. The incidence of otologic symptoms are reported to be high as 56% and complaints of hearing loss in 21-40% of patients. Various degrees of hearing impairment are seen in 29-39% of HIV infected patients in various studies. The prevalence of hearing impairment among HIV positive patients in uganda has not yet been documented. A cross sectional descriptive study was designed to determine the prevalence and types of hearing of hearing impairment in patients attending the HIV/AIDS clinics at Mulago hospital. A total of 388 HIV serologically positive patients (aged 13 to 50 years) attending the infectious disease (medical out-patient) and TASO HIV/AIDS clinics at mulago hospital were seen between November 2001 and February 2002. Basic demographic information, medical history and detailed otological complaints were ontained from the patient. An otological examination, pure tone audiometry and tympanometry were carried out on each patient. Otological symptoms were present in about 1/3 of patients with the commonest being hearing loss (32%), tinnitus (21%) and aural fullness/blockage (19%). These results were similar to other studies. The overall prevalence of hearing imairment among the HIV/AIDS patients seen was 30.7%. About 19.8% had mild, 5.6% moderate, 3.6% severe and 1.5% profound hearing impirment. Only 12.3% of patients however had hearing impairment in both ears. The prevalence of hearing impairment in the better and worse ears was 12.8% and 31% respectively. Most patients with hearing imairment had accrss board type of hearing loss. A significant number (15.2%) had isolated high frequecy loss, another 7.5% high frequency and 6.4% low frequency slope. Sensorineural hearing loss was seen in 20.9% and conductive hearing loss in 5.8% of patients. About 4% of patients had mixed hearing loss. The common causes of conductive hearing loss were acute otitis media in 3.2%, CSOM 2.8% and eustachian tube dysfunction tube dysfunction in 2.4% of patients. Hearing impairment and other audiogram changes were noted to be a common finding among HIV positive patients and require further study.