Audiological testing for ototoxicity monitoring in adults with tuberculosis in state hospitals in Gauteng, South Africa

Background: Ototoxicity monitoring during treatment of medical conditions, where the medications used are known to be toxic to the ear, is an important scope of practice of the audiologist; and, is an important clinical service aimed at enhancing patients' quality of life. Aim: The aim of the current study was to determine audiological testing practices for ototoxicity monitoring in adults with tuberculosis in State Hospitals in Gauteng, South Africa. Specific objectives included establishing if ototoxicity (cochleotoxicity) monitoring occurs; determining the timing as well as frequency of monitoring; and, establishing what management protocols are followed once ototoxicity is established. Methodology: A retrospective data record review design was adopted where hospital records from tuberculosis treatment units were reviewed. A total of 191 participant files comprised the research sample. Data obtained was analysed using descriptive statistics. Results: Findings indicated that out of 5 hospitals recruited, only one had an ototoxicity monitoring programme in place. At this programme only 66% of participants were enrolled in an ototoxicity monitoring program in which baseline audiological measures were only conducted one month post treatment in 41% of the samples monitored. The majority of those monitored had repeat measures conducted once monthly. No clear and systematic medical management of ototoxicity, once identified, was found in the current sample. A small number of participants' medication was adjusted as an intervention measure. Conclusion: Findings demonstrate the need for systematic and integrated ototoxicity monitoring programs in tuberculosis treatment centres in South Africa; as well as highlight the need for the development of evidence-based management protocols for ototoxicity within state hospitals in this South African context.