Auditory manifestations in HIV-infected children at a state hospital in South Africa

Abstract Objective To determine the prevalence and risk factors for developing ear disease and hearing loss (HL) in children living with HIV/AIDS (CLWHA). Methods This was a cross-sectional survey where participants underwent an otoscopic examination and an otoacoustic emissions screening (<6-years-old) or smartphone-based pure tone audiometry (>6-years-old) test. Prevalence data were analyzed using descriptive statistics while multivariate logistic regression identified the risk factors for developing ear disease/HL. Results Forty-one participants aged 3–12-years-old (22 males and 19 females) took part in this study. Twenty participants (48.7%) presented with ear disease including otitis media (n = 9, 22%), cerumen impaction (n = 10, 23%), and tympanic membrane perforation (n = 1, 2.4%). HL was observed in 13 participants (32%). Lower CD4 count, longer duration of HIV infection, shorter duration on ART treatment, and concomitant tuberculosis (TB) infection were (p < .05) all associated with ear diseases. Conclusion A high prevalence of ear disease and HL was found in CLWHA, which indicated the need for ear and hearing screening to be incorporated into 3-monthly consultations with CLWHA; to enable early detection and intervention and prevent the associated negative impacts. A multidisciplinary team approach to the management of CLWHA, specifically the inclusion of audiologists, and the use of mHealth in resource-constrained settings is highly recommended.