Hearing impairment in HIV-infected and HIV/TB-coinfected individuals in Tanzania

坦桑尼亚艾滋病毒感染者和艾滋病毒/结核病合并感染者的听力障碍

• 批准号: 8020050
• 负责人: JAY C BUCKEY
• 金额: $ 51.3万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-02-01 至 2015-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8020050
• 关键词: Acquired Immunodeficiency Syndrome; Adult; Affect; African; Allied Health Sciences; Anti-Retroviral Agents; Antitubercular Agents; Audiometry; Auditory; Auditory Brainstem Responses; Child; Childhood; Clinic; Collaborations; Communication impairment; Computers; Cross-Sectional Studies; Data; Defect; Detection; Developed Countries; Development; Devices; Diagnosis; Disease; Ear; Early Diagnosis; Environment; Equipment; Etiology; Evaluation; Face; Frequencies; Funding; Government; Guidelines; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; Health; Hearing; Hearing Aids; Hearing Tests; Hearing problem; High Prevalence; Incidence; Individual; International; Lead; Life; Longitudinal Studies; Measurement; Monitor; Nature; Noise; Patients; Peripheral; Pharmaceutical Preparations; Prevalence; Prevalence Study; Process; Prospective Studies; Provider; Public Health; Questionnaires; Relative (related person); Research; Resources; Risk Factors; Role; Screening procedure; Services; Severities; Study Subject; Symptoms; System; Tanzania; Test Result; Testing; Therapeutic Agents; Time; Treatment Protocols; Tuberculosis; Tympanometry; United States National Aeronautics and Space Administration; United States National Institutes of Health; Universities; base; cohort; hearing impairment; high risk; improved; laptop; medical schools; middle ear; otoacoustic emission; prospective; secondary infection; therapy duration; tuberculosis treatment

DESCRIPTION (provided by applicant): Limited data suggest that HIV infection and its treatment are associated with hearing loss. Several factors can affect hearing in those infected with HIV including HIV itself, secondary infections, and medications. The relative contribution of these factors is not known. We will bring together four established Dartmouth/Tanzanian resources to study hearing loss among both HIV-infected adults and children in Tanzania: 1) the DarDar Health Study, an ongoing NIH-funded study of HIV-associated tuberculosis involving Dartmouth Medical School (DMS) and the Muhimbili University of Health and Allied Sciences (MUHAS), which will provide a large cohort of HIV-infected adult study subjects, 2) the MUHAS ENT service, which routinely diagnoses and treats HIV-infected individuals with hearing loss, 3) the DarDar pediatric clinic, a DMS/MUHAS collaboration to diagnose and treat HIV-positive children, which follows a growing cohort of HIV-positive and HIV-affected children and 4) a laptop computer- based, hearing-testing system developed by DMS in collaboration with the National Aeronautics and Space Administration for use on the International Space Station, which will be used as the field testing apparatus. This battery-powered, laptop-based device incorporates Bikisy-like tracking audiometry, distortion-product otoacoustic emission testing, probe placement verification, in-ear noise level measurement, and a gap detection test. It is ideally suited for assessing hearing loss in resource-limited environments. A computer-based, Kiswahili questionnaire that covers hearing symptoms and noise exposure will be added to the system to provide a robust system for performing complete hearing evaluations efficiently. Using this system we will determine the frequency of abnormal central and peripheral hearing test results in both adults and children by performing a cross-sectional prevalence study in Tanzania among HIV-positive subjects receiving and not receiving anti-retroviral therapy (ART), HIV-positive subjects with and without prior treatment for TB, and HIV-negative controls. We will also assess the incidence of new hearing loss and the quantitative contributions of HIV severity, ART duration and specific TB treatment regimens to hearing loss in a longitudinal study among HIV-positive and HIV-negative subjects. African-made hearing aids with solar battery chargers will be provided to those subjects with significant hearing loss that would benefit from hearing augmentation. Collectively, these studies will: (1) provide the first comprehensive data on hearing loss among HIV-positive adults and children living in a resource poor setting, (2) provide information on the prevalence, incidence and nature (central vs. peripheral) of the hearing loss in HIV-positive subjects, (3) determine associations between hearing loss, ART and TB treatment, and (4) permit the development of guidelines for monitoring high-risk subjects and intervening with appropriate treatment and hearing augmentation.

描述（由申请人提供）：有限的数据表明，HIV感染及其治疗与听力损失有关。几个因素可能会影响感染HIV感染的患者的听力，包括HIV本身，继发感染和药物。这些因素的相对贡献尚不清楚。我们将汇集四项已建立的达特茅斯/坦桑尼亚资源，以研究坦桑尼亚的HIV感染的成年人和儿童的听力损失：1）Dardar Health研究，一项正在进行的NIH基金会研究的HIV相关结核病研究，涉及DARTMOUTH医学院（DMS）和Muhimbili University和Muhimbili University sciess（Muhimbili Scip）艾滋病毒感染的成人研究受试者，2）穆哈斯的服务，该服务常规诊断并治疗感染了听力损失的艾滋病毒感染者，3）DARDAR儿科诊所，DMS/MUHAS协作以诊断和治疗HIV阳性儿童，以HIV和HIV阳性的儿童的成长为基于HIV阳性和HIV的儿童，并在hiv阳性和HIV的群体中逐渐受到培训，并在hiv阳性的儿童中及其培训，并在hiv阳性的儿童中进行了良好的培训，并在4）中培养了一个计算机和4）。在国际空间站使用国家航空航天局，将用作现场测试设备。这款电池供电的基于笔记本电脑的设备结合了类似骑自行车的跟踪测量法，失真产品耳声发射测试，探针放置验证，入耳噪声水平测量和间隙检测测试。它非常适合评估资源有限环境中的听力损失。将涵盖听力症状和噪音暴露的基于计算机的基斯瓦希里语问卷将被添加到系统中，以提供有效执行完整听力评估的强大系统。使用该系统，我们将通过在接受抗逆转录病毒疗法（ART）的HIV阳性受试者中进行坦桑尼亚的横断面患病率研究（ART），对HIV阳性受试者，对TB和HIV对照组进行抗HIV阳性受试者，并未接受抗逆转录病毒疗法（ART），并没有接受抗逆转录病毒疗法（ART），并没有接受抗逆转录病毒疗法（ART）。在HIV阳性和HIV阴性受试者的一项纵向研究中，我们还将评估新听力损失的发生率以及HIV严重程度，ART持续时间和特定结核病治疗方案对听力损失的定量贡献。将提供带有太阳能电池充电器的非洲制造的助听器，并向那些巨大的听力损失的受试者提供，这将使听力增强受益。总的来说，这些研究将：（1）提供有关艾滋病毒阳性的成年人和生活在资源较差的儿童中听力损失的第一个全面数据，（2）提供有关HIV阳性受试者的听力损失的流行，发病率和自然（中心与周围）的信息，（3）允许对听力损失的治疗以及（4）允许及格的研究，以及（4）允许使用指南，（4）允许使用指导，4）增强。