Community-Based Ototoxicity Monitoring for Drug-Resistant Tuberculosis in South Africa: An Evaluation Study

Lucia Jane Stevenson, Leigh Biagio- de Jager, Marien Alet Graham and Swanepoel De Wet
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Lucia Jane Stevenson: Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Corner of Lynnwood and University Roads, Hatfield, Pretoria 0002, South Africa
Leigh Biagio- de Jager: Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Corner of Lynnwood and University Roads, Hatfield, Pretoria 0002, South Africa
Marien Alet Graham: Department of Science, Mathematics and Technology Education, Faculty of Education, University of Pretoria, Corner of George Storrar Dr and Leyds St., Groenkloof, Pretoria 0002, South Africa
Swanepoel De Wet: Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Corner of Lynnwood and University Roads, Hatfield, Pretoria 0002, South Africa

IJERPH, 2021, vol. 18, issue 21, 1-14

Abstract: In response to the drug-resistant tuberculosis (DRTB) ototoxicity burden in South Africa, ototoxicity monitoring has been decentralised, with community health workers (CHWs) acting as facilitators. This study describes a community-based ototoxicity monitoring programme (OMP) for patients with DRTB. Findings are compared to the recommended guidelines for ototoxicity monitoring, the OMP protocol and published studies. This was a retrospective study of longitudinal ototoxicity monitoring of 831 patients with DRTB, using data collected at community-based clinics in the City of Cape Town between 2013 and 2017. Approximately half (46.8%) of the patients had an initial assessment conducted in accordance with the OMP protocol recommendations, and follow-up rates (79.5%) were higher than those of a similar DRTB programme. However, patients in this study were not monitored within the timeframes or with the regularity recommended by the guidelines or the OMP protocol. Extended high-frequency pure-tone audiometry (27.5%) was underutilised by testers and data recording was inconsistent (e.g., 37.7% of patient gender was not recorded by testers). Community-based OMP using CHWs to facilitate monitoring showed improvement over previous hospital-based reports, with more accessible services and higher follow-up rates. However, to improve OMP outcomes, OMP managers should reassess current protocols and data recording practices.

Keywords: community-based services; community health workers; decentralised services; drug-resistant tuberculosis; tuberculosis; hearing loss; ototoxicity monitoring; audiometry; South Africa (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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