Reversible Audiometric Threshold Changes in Children with Uncomplicated Malaria

Background. Plasmodium falciparum malaria, as well as certain antimalarial drugs, is associated with hearing impairment in adults. There is little information, however, on the extent, if any, of this effect in children, and the evidence linking artemisinin combination therapies (ACTs) with hearing i...

Full description

Bibliographic Details
Published in:Journal of Tropical Medicine
Main Authors: George O. Adjei, Bamenla Q. Goka, Emmanuel Kitcher, Onike P. Rodrigues, Ebenezer Badoe, Jorgen A. L. Kurtzhals
Format: Article in Journal/Newspaper
Language:English
Published: Wiley 2013
Subjects:
Online Access:https://doi.org/10.1155/2013/360540
https://doaj.org/article/3e275cad6bd04115a30490d0dca1511c
Description
Summary:Background. Plasmodium falciparum malaria, as well as certain antimalarial drugs, is associated with hearing impairment in adults. There is little information, however, on the extent, if any, of this effect in children, and the evidence linking artemisinin combination therapies (ACTs) with hearing is inconclusive. Methods. Audiometry was conducted in children with uncomplicated malaria treated with artesunate-amodiaquine (n=37), artemether-lumefantrine (n=35), or amodiaquine (n=8) in Accra, Ghana. Audiometry was repeated 3, 7, and 28 days later and after 9 months. Audiometric thresholds were compared with those of a control group of children (n=57) from the same area. Findings. During the acute stage, hearing threshold levels of treated children were significantly elevated compared with controls (P<0.001). The threshold elevations persisted up to 28 days, but no differences in hearing thresholds were evident between treated children and controls after 9 months. The hearing thresholds of children treated with the two ACT regimens were comparable but lower than those of amodiaquine-treated children during acute illness. Interpretation. Malaria is the likely cause of the elevated hearing threshold levels during the acute illness, a finding that has implications for learning and development in areas of intense transmission, as well as for evaluating potential ototoxicity of new antimalarial drugs.