加蓬儿童严重疟疾患者的耳声发射测试的长期随访研究。

A long-term follow-up study on otoacoustic emissions testing in paediatric patients with severe malaria in Gabon.

机构信息

Department of Otorhinolaryngology, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.

Department of Internal Medicine, Medical University Innsbruck, Innsbruck, Austria.

出版信息

Malar J. 2019 Jun 24;18(1):212. doi: 10.1186/s12936-019-2840-9.

DOI:10.1186/s12936-019-2840-9

PMID:31234890

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6591898/

Abstract

BACKGROUND

In a previous study, severe and cerebral malaria have been connected with acute cochlear malfunction in children, demonstrated by a decrease of transitory evoked otoacoustic emissions (TEOAEs) reproducibility. This study aims to determine whether cochlear malfunction persists for 4 years after recovery from severe malaria in a subset of the previous study's collective. Follow-up TEOAEs were performed on site (CERMEL, Hôpital Albert Schweitzer, Lambaréné, Gabon) or at the participants' homes; 33 out of 90 participants included in the initial investigation by Schmutzhard et al. could be retrieved and were re-examined, 31/33 could be included. Of the 57 missing participants, 51 could not be contacted, 1 had moved away, 4 refused to cooperate, and 1 had died.

METHODS

As in the initial investigation, participants of this prospective follow-up study were subjected to TEOAE examination on both ears separately. A wave correlation rate of > 60% on both ears was considered a "pass"; if one ear failed to pass, the examination was considered a "fail". The results were compared to the primary control group. Additionally, a questionnaire has been applied focusing on subsequent malaria infections between the primary inclusion and follow-up and subjective impairment of hearing and/or understanding.

RESULTS

The cohort's mean age was 9 years, 14 children were female, 18 male. 31 had been originally admitted with severe, one with cerebral malaria. 83.8% of participants (n = 26) presented with a TEOAE correlation rate of > 60% on both ears (the cut-off for good cochlear function); in the control group, 92.2% (n = 83) had passed TEOAE examination on both ears. Recurrent severe malaria was associated with a worse TEOAE correlation rate. Age at infection and gender had no influence on the outcome.

CONCLUSIONS

Cochlear malfunction seems to be persistent after 4 years in more than 16% of children hospitalized for malaria. In a healthy control group, this proportion was 7.8%. Yet, the severity of the initial TEOAE-decrease did not predict a worse outcome.

摘要

背景

在之前的研究中，严重和脑型疟疾与儿童急性耳蜗功能障碍有关，表现为瞬态诱发耳声发射（TEOAEs）可重复性降低。本研究旨在确定在 Schmutzhard 等人之前研究的一个子集中，从严重疟疾中恢复 4 年后，耳蜗功能障碍是否仍然存在。在现场（CERMEL，Lambaréné 的 Albert Schweitzer 医院，加蓬）或参与者家中进行后续 TEOAE 检查；最初 Schmutzhard 等人进行的研究中纳入的 90 名参与者中有 33 名可以找到并重新检查，其中 31 名可以纳入。在 57 名缺失的参与者中，51 名无法联系，1 名已搬离，4 名拒绝合作，1 名死亡。

方法

如同最初的研究一样，本前瞻性随访研究的参与者分别对双耳进行 TEOAE 检查。双耳的波相关性率>60%被认为是“通过”；如果一只耳朵未通过，则检查被认为是“失败”。将结果与原始对照组进行比较。此外，还应用了一份问卷，重点关注原发性纳入和随访之间的后续疟疾感染以及听力和/或理解的主观损害。

结果

队列的平均年龄为 9 岁，14 名儿童为女性，18 名男性。31 名最初因严重疟疾入院，1 名因脑型疟疾入院。83.8%（n=26）的参与者双耳 TEOAE 相关性率>60%（良好耳蜗功能的截止值）；对照组中，83 名（n=83）双耳 TEOAE 检查均通过。复发性严重疟疾与较差的 TEOAE 相关性相关。感染时的年龄和性别对结果没有影响。