The prevalence of hearing impairment in the 6 weeks - 5 years HIV/AIDS-positive patients attending Paediatric Infectious Disease Clinic at Mulago Hospital

Abstract

Introduction In Uganda, it is estimated that between 39,000 and 200,000 children (0-14) years of age are living with HIV (UNAIDS, 2006). In children with HIV/AIDS, hearing impairment is one form of disability that greatly interferes with language development, that in turn affects communication hence leading to poor performance of these children, and this has far reaching social and economic implications. Hearing impairment is stressing to the children and the caretakers. With increasing availability of free anti-retroviral therapy, children with HIV/AIDS are expected to live much longer. Therefore efforts must be made to reduce the disability resulting from hearing impairment, among HIV infected children. Objectives The main objective of this study was to determine the prevalence, types and severity of hearing loss in HIV positive pediatric patients between 6 weeks -5 years of age attending PIDC. Methods This was a descriptive cross sectional study on 374 HIV/AIDS pediatric patients between 6weeks-5 years of age attending the PIDC Mulago between the months of July 2008 to April 2009. Systematic sampling procedure was used to reach each participant under ethical considerations. An audiological and electrophysiological assessment was carried out to determine degrees and types of hearing impairment among the study population. This was done using an ABR machine of the VIVOSONIC VIVOLINK type. The data was cleaned, coded and entered in the computer in the view section of EPI Info version 3.2.2, which was exported to SPSS for data analysis. Results A total of 370 children were recruited. The median age of these children was 36 months with a mean of 38 months, while the range was 6-60 months. The ratio of male to female was 1:1.The WHO HIV staging for the participants with hearing loss as per stage was: Stage 1; 12/27 (44.4%) , Stage 2; 31/158 (19.6%), Stage 3; 65/172 (33.8) and Stage 4; 13/13 (100%). The prevalence of hearing loss in the 6 weeks to 5 years HIV/AIDS positive patients was found to be 121/370 (33.0%). Of the 121 with hearing impairment, the majority 77 (64.0 %) of those children had sensorineural hearing loss while 44(36.0 %) had conductive hearing loss. All those with conductive hearing loss had moderate impairments (41-60 dBHL) while those with SNHL, 44% had mild (26-40 dBHL), 14% had moderate and 6% had severe (61-80 dBHL) degrees of hearing loss. Conclusions • The prevalence hearing loss in the 6 weeks to 5 years was found to be 33%. • Sensorineural hearing loss was the most prevalent at a rate of 64% followed by conductive hearing loss at rate of 36%. • Sensorineural hearing impairments occurred at high frequencies;- 44% had mild SNHL , 50% of the patients had a moderate hearing impairment while 6% had severe SNHL.