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Severe malaria in children leads to a significant impairment of transitory otoacoustic emissions - a prospective multicenter cohort study

BACKGROUND: Severe malaria may influence inner ear function, although this possibility has not been examined prospectively. In a retrospective analysis, hearing impairment was found in 9 of 23 patients with cerebral malaria. An objective method to quickly evaluate the function of the inner ear are t...

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Autores principales: Schmutzhard, Joachim, Lackner, Peter, Helbok, Raimund, Hurth, Helene Verena, Aregger, Fabian Cedric, Muigg, Veronika, Kegele, Josua, Bunk, Sebastian, Oberhammer, Lukas, Fischer, Natalie, Pinggera, Leyla, Otieno, Allan, Ogutu, Bernards, Agbenyega, Tsiri, Ansong, Daniel, Adegnika, Ayola A., Issifou, Saadou, Zorowka, Patrick, Krishna, Sanjeev, Mordmüller, Benjamin, Schmutzhard, Erich, Kremsner, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457990/
https://www.ncbi.nlm.nih.gov/pubmed/26021376
http://dx.doi.org/10.1186/s12916-015-0366-8
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author Schmutzhard, Joachim
Lackner, Peter
Helbok, Raimund
Hurth, Helene Verena
Aregger, Fabian Cedric
Muigg, Veronika
Kegele, Josua
Bunk, Sebastian
Oberhammer, Lukas
Fischer, Natalie
Pinggera, Leyla
Otieno, Allan
Ogutu, Bernards
Agbenyega, Tsiri
Ansong, Daniel
Adegnika, Ayola A.
Issifou, Saadou
Zorowka, Patrick
Krishna, Sanjeev
Mordmüller, Benjamin
Schmutzhard, Erich
Kremsner, Peter
author_facet Schmutzhard, Joachim
Lackner, Peter
Helbok, Raimund
Hurth, Helene Verena
Aregger, Fabian Cedric
Muigg, Veronika
Kegele, Josua
Bunk, Sebastian
Oberhammer, Lukas
Fischer, Natalie
Pinggera, Leyla
Otieno, Allan
Ogutu, Bernards
Agbenyega, Tsiri
Ansong, Daniel
Adegnika, Ayola A.
Issifou, Saadou
Zorowka, Patrick
Krishna, Sanjeev
Mordmüller, Benjamin
Schmutzhard, Erich
Kremsner, Peter
author_sort Schmutzhard, Joachim
collection PubMed
description BACKGROUND: Severe malaria may influence inner ear function, although this possibility has not been examined prospectively. In a retrospective analysis, hearing impairment was found in 9 of 23 patients with cerebral malaria. An objective method to quickly evaluate the function of the inner ear are the otoacoustic emissions. Negative transient otoacoustic emissions are associated with a threshold shift of 20 dB and above. METHODS: This prospective multicenter study analyses otoacoustic emissions in patients with severe malaria up to the age of 10 years. In three study sites (Ghana, Gabon, Kenya) 144 patients with severe malaria and 108 control children were included. All malaria patients were treated with parental artesunate. RESULTS: In the control group, 92.6 % (n = 108, 95 % confidence interval 86.19–6.2 %) passed otoacoustic emission screening. In malaria patients, 58.5 % (n = 94, malaria vs controls p < 0.001, 95 % confidence interval 48.4–67.9 %) passed otoacoustic emission screening at the baseline measurement. The value increased to 65.2 % (n = 66, p < 0.001, 95 % confidence interval 53.1–75.5 %) at follow up 14–28 days after diagnosis of malaria. The study population was divided into severe non-cerebral malaria and severe malaria with neurological symptoms (cerebral malaria). Whereas otoacoustic emissions in severe malaria improved to a passing percentage of 72.9 % (n = 48, 95 % confidence interval 59–83.4 %) at follow-up, the patients with cerebral malaria showed a drop in the passing percentage to 33 % (n = 18) 3–7 days after diagnosis. This shows a significant impairment in the cerebral malaria group (p = 0.012 at days 3–7, 95 % confidence interval 16.3–56.3 %; p = 0.031 at day 14–28, 95 % confidence interval 24.5–66.3 %). CONCLUSION: The presented data show that 40 % of children have involvement of the inner ear early in severe malaria. In children, audiological screening after severe malaria infection is not currently recommended, but is worth investigating in larger studies.
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spelling pubmed-44579902015-06-07 Severe malaria in children leads to a significant impairment of transitory otoacoustic emissions - a prospective multicenter cohort study Schmutzhard, Joachim Lackner, Peter Helbok, Raimund Hurth, Helene Verena Aregger, Fabian Cedric Muigg, Veronika Kegele, Josua Bunk, Sebastian Oberhammer, Lukas Fischer, Natalie Pinggera, Leyla Otieno, Allan Ogutu, Bernards Agbenyega, Tsiri Ansong, Daniel Adegnika, Ayola A. Issifou, Saadou Zorowka, Patrick Krishna, Sanjeev Mordmüller, Benjamin Schmutzhard, Erich Kremsner, Peter BMC Med Research Article BACKGROUND: Severe malaria may influence inner ear function, although this possibility has not been examined prospectively. In a retrospective analysis, hearing impairment was found in 9 of 23 patients with cerebral malaria. An objective method to quickly evaluate the function of the inner ear are the otoacoustic emissions. Negative transient otoacoustic emissions are associated with a threshold shift of 20 dB and above. METHODS: This prospective multicenter study analyses otoacoustic emissions in patients with severe malaria up to the age of 10 years. In three study sites (Ghana, Gabon, Kenya) 144 patients with severe malaria and 108 control children were included. All malaria patients were treated with parental artesunate. RESULTS: In the control group, 92.6 % (n = 108, 95 % confidence interval 86.19–6.2 %) passed otoacoustic emission screening. In malaria patients, 58.5 % (n = 94, malaria vs controls p < 0.001, 95 % confidence interval 48.4–67.9 %) passed otoacoustic emission screening at the baseline measurement. The value increased to 65.2 % (n = 66, p < 0.001, 95 % confidence interval 53.1–75.5 %) at follow up 14–28 days after diagnosis of malaria. The study population was divided into severe non-cerebral malaria and severe malaria with neurological symptoms (cerebral malaria). Whereas otoacoustic emissions in severe malaria improved to a passing percentage of 72.9 % (n = 48, 95 % confidence interval 59–83.4 %) at follow-up, the patients with cerebral malaria showed a drop in the passing percentage to 33 % (n = 18) 3–7 days after diagnosis. This shows a significant impairment in the cerebral malaria group (p = 0.012 at days 3–7, 95 % confidence interval 16.3–56.3 %; p = 0.031 at day 14–28, 95 % confidence interval 24.5–66.3 %). CONCLUSION: The presented data show that 40 % of children have involvement of the inner ear early in severe malaria. In children, audiological screening after severe malaria infection is not currently recommended, but is worth investigating in larger studies. BioMed Central 2015-05-28 /pmc/articles/PMC4457990/ /pubmed/26021376 http://dx.doi.org/10.1186/s12916-015-0366-8 Text en © Schmutzhard et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Schmutzhard, Joachim
Lackner, Peter
Helbok, Raimund
Hurth, Helene Verena
Aregger, Fabian Cedric
Muigg, Veronika
Kegele, Josua
Bunk, Sebastian
Oberhammer, Lukas
Fischer, Natalie
Pinggera, Leyla
Otieno, Allan
Ogutu, Bernards
Agbenyega, Tsiri
Ansong, Daniel
Adegnika, Ayola A.
Issifou, Saadou
Zorowka, Patrick
Krishna, Sanjeev
Mordmüller, Benjamin
Schmutzhard, Erich
Kremsner, Peter
Severe malaria in children leads to a significant impairment of transitory otoacoustic emissions - a prospective multicenter cohort study
title Severe malaria in children leads to a significant impairment of transitory otoacoustic emissions - a prospective multicenter cohort study
title_full Severe malaria in children leads to a significant impairment of transitory otoacoustic emissions - a prospective multicenter cohort study
title_fullStr Severe malaria in children leads to a significant impairment of transitory otoacoustic emissions - a prospective multicenter cohort study
title_full_unstemmed Severe malaria in children leads to a significant impairment of transitory otoacoustic emissions - a prospective multicenter cohort study
title_short Severe malaria in children leads to a significant impairment of transitory otoacoustic emissions - a prospective multicenter cohort study
title_sort severe malaria in children leads to a significant impairment of transitory otoacoustic emissions - a prospective multicenter cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457990/
https://www.ncbi.nlm.nih.gov/pubmed/26021376
http://dx.doi.org/10.1186/s12916-015-0366-8
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