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: 8603154
• 负责人: JAY C BUCKEY
• 金额: $ 47.3万
• 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 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8603154
• 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; 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; screening; 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。有几个因素会影响艾滋病毒感染者的听力，包括艾滋病毒本身、继发感染和药物。这些因素的相对贡献尚不清楚。我们将汇集达特茅斯/坦桑尼亚的四个现有资源来研究坦桑尼亚感染艾滋病毒的成人和儿童的听力损失：1) DarDar 健康研究，这是一项由 NIH 资助、涉及达特茅斯医学院 (DMS) 的艾滋病毒相关结核病持续研究和 Muhimbili 健康与相关科学大学 (MUHAS)，该大学将提供大量 HIV 感染成人研究对象，2) MUHAS ENT服务，定期诊断和治疗患有听力损失的 HIV 感染者，3) DarDar 儿科诊所，DMS/MUHAS 合作诊断和治疗 HIV 阳性儿童，跟踪越来越多的 HIV 阳性和受 HIV 影响的儿童群体4）DMS与美国国家航空航天局合作开发的基于笔记本电脑的听力测试系统，用于国际空间站，作为现场测试设备。这款电池供电、基于笔记本电脑的设备集成了类似 Bikisy 的跟踪测听、失真产物耳声发射测试、探头放置验证、入耳噪声级测量和间隙检测测试。它非常适合在资源有限的环境中评估听力损失。该系统将添加一份涵盖听力症状和噪声暴露的基于计算机的斯瓦希里语调查问卷，以提供一个强大的系统来有效地执行完整的听力评估。使用该系统，我们将通过在坦桑尼亚对接受和未接受抗逆转录病毒治疗（ART）的艾滋病毒阳性受试者、艾滋病毒-既往接受或未接受结核病治疗的阳性受试者，以及艾滋病毒阴性对照。我们还将在 HIV 阳性和 HIV 阴性受试者的纵向研究中评估新发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影响。非洲制造的带有太阳能电池充电器的助听器将提供给那些听力严重受损、可从听力增强中受益的受试者。总的来说，这些研究将：(1) 提供有关生活在资源匮乏环境中的艾滋病毒阳性成人和儿童听力损失的第一份全面数据，(2) 提供有关听力损失的患病率、发病率和性质（中枢性与外周性）的信息HIV 阳性受试者的听力损失，(3) 确定听力损失、ART 和结核病治疗之间的关联，以及 (4) 允许制定监测高危受试者并采取适当治疗和听力增强干预的指南。