Hearing Disorders among HIV Positive Children at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

Background: Use of antiretroviral drugs (ART) has changed the epidemiology of HIV disease, making it a chronic illness and with many people developing long term sequelae of the disease such as hearing loss. This study compared hearing disorders, its types and severity among children with and without HIV disease.

Methods: This was a hospital based comparative cross-sectional study carried out among eligible patients who were HIV positive, aged 6 to 15 years recruited via systematic sampling method and matched by age and sex with HIV negative controls. An interviewer-administered questionnaire was used to extract the sociodemographic characteristics of the subjects, patients/caregivers awareness of hearing impairment and to document the otoscopic, Pure tone audiometry (PTA) and tympanometry findings performed on the patients. CD4 count was done for all the study participants while all HIV positive patients were graded for severity using WHO clinical Staging. Obtained data was analysed using the statistical package for social sciences (SPSS) version 22. A p-value of less than 0.05 was considered statistically significant.

Results: A total of 400 children aged 6 years to 15 years were recruited for the study out of which 200 were HIV positive (cases), while 200 were HIV negative (controls). Otitis media with effusion, otitis media and perforated tympanic membrane were the predominant tympanometry and otoscopic findings. Seventy-three (36.5%) of the HIV positive patients had hearing loss compared to 19(9.5%) of HIV negative patients and this was statistically significant (X2 = 41.1; p = 0.0001). Majority (95.9%) of persons with hearing loss had the conductive type and of mild degree 53 (72.6%). Only 3(4.1%) caregivers of the HIV positive children and 1 (5.6%) caregiver of the HIV negative children were aware of the hearing impairment in their children but none had complained to their primary health caregivers.

Conclusion: This study has established a higher rate of hearing loss, of the conductive type and of mild degree among HIV positive patient. It is necessary to assess and monitor the hearing in HIV positive children by conducting interval PTA testing and Tympanometry to ensure timely intervention since parental awareness is poor.