TITLE:
Sensorineural Hearing Loss in Multidrug-Resistant Tuberculosis Patients in Kinshasa (Democratic Republic of Congo): Prospective Cohort Study of Therapeutic Regimen with Aminoglycoside versus Bedaquiline
AUTHORS:
Mireille A. Mpwate, Eddy M. Mbambu, Christian N. Matanda, Gabriel M. Lema, Michel K. Kaswa, Murielle L. Aloni, Nicole M. Anshambi, Fabrice M. Matuta, Luc L. Lukasu, Dominique M. Mupepe, Serge K. Mpwate, Pierre Z. Akilimali, Zacharie M. Kashongwe, Richard N. Matanda
KEYWORDS:
Multidrug-Resistant Tuberculosis, Aminoglycosides, Bedaquiline, Hearing Loss
JOURNAL NAME:
Journal of Tuberculosis Research,
Vol.11 No.3,
August
14,
2023
ABSTRACT: Context: Multidrug-resistant tuberculosis (MDR-TB) remains a major public health
problem in developing countries such as the Democratic Republic of Congo (DRC),
which continues to face the emergence of MDR-TB cases. Because of the ototoxic
effects of AGs, the World Health Organization (WHO) has recommended the
introduction of the bedaquiline regimen. However, very few data are available
regarding the susceptibility of bedaquiline to induce hearing loss, hence the
present study set out to compare the AG-based regimen and the bedaquiline-based
regimen in the occurrence of hearing loss in MDR-TB patients. Methods: This is a prospective multicenter cohort study that included 335 MDR-TB
patients, performed in Kinshasa (DRC) during the period from January 2020 to
January 2021. Sociodemographic, clinical, biological and audiometric data were
analyzed using Stata 17. Repeated-measures analysis of variance was used to
compare changes in the degree of hearing loss over time between the two groups
of patients on AG and bedaquiline regimens. The double-difference method was
estimated using regression with fixed-effects. A p value Results: The
degree of hearing loss was similar between the two groups at the first month
[AGs (28 dB) vs
BDQ (30 dB); p
= 0.298]. At six months, the mean degree of hearing loss was significantly
greater in the aminoglycoside regimen group [AGs (60.5 dB) vs BDQ (44 dB); p Conclusion: Hearing loss is frequent with both treatment
regimens, but more marked with the Aminoglycoside-based regimen. Thus,
bedaquiline should also benefit for audiometric monitoring in future MDR-TB
patients.