Department of Otorhinolaryngology, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
Department of Internal Medicine, Medical University Innsbruck, Innsbruck, Austria.
Malar J. 2019 Jun 24;18(1):212. doi: 10.1186/s12936-019-2840-9.
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.
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.
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.
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.
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。
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。
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。
在因疟疾住院的儿童中，超过 16%的儿童在 4 年后耳蜗功能障碍仍然存在。在健康对照组中，这一比例为 7.8%。然而，初始 TEOAE 降低的严重程度并不能预测更差的结果。
