Auditory Steady-State Response and Hearing Impairment in Survivors of Childhood Bacterial Meningitis in Luanda, Angola

Mariia Karppinen; Emilie Rugemalira; Okko Savonius; Manuel Leite Cruzeiro; Antti Aarnisalo; Topi Jutila; Tuula Pelkonen

doi:10.3390/jcm12082842

Auditory Steady-State Response and Hearing Impairment in Survivors of Childhood Bacterial Meningitis in Luanda, Angola

J Clin Med. 2023 Apr 13;12(8):2842. doi: 10.3390/jcm12082842.

Authors

Mariia Karppinen¹, Emilie Rugemalira², Okko Savonius², Manuel Leite Cruzeiro³, Antti Aarnisalo¹, Topi Jutila¹, Tuula Pelkonen^{2

3}

Affiliations

¹ Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki, Helsinki University Hospital, 00290 HUS Helsinki, Finland.
² Children's Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, 00290 HUS Helsinki, Finland.
³ David Bernardino Children's Hospital, Rua Amilcar Cabral, Maianga, Luanda, Angola.

Abstract

Survivors of childhood bacterial meningitis (BM) often develop hearing impairment (HI). In low- and middle-income countries (LMICs), BM continues to be a significant cause of hearing disability. We assessed hearing among BM survivors using auditory steady-state responses (ASSR), providing frequency-specific estimated audiograms, and examined whether ASSR would provide a greater understanding of BM-induced HI. Survivors from two prospective BM trials (ISRCTN62824827; NCT01540838) from Luanda Children's Hospital were examined in a follow-up visit with a median duration of 26 months after BM. The hearing of 50 BM survivors and 19 control children was evaluated using ASSR and auditory brainstem response (ABR) after interview and neurological and otorhinolaryngological examinations. The median age of survivors was 80 (IQR 86) months. We diagnosed HI (better ear hearing ≥ 26 dB) in 9/50 (18%) children. Five of the fifty survivors (10%) and 14/100 ears (14%) had profound HI (>80 dB). Severe-to-profound HI affected all frequencies steadily, affecting only the ears of BM survivors (18/100 vs. 0/38, p = 0.003). When looking only at the severely or profoundly affected ears, young age, low Glascow coma score, pneumococcal aetiology, and ataxia were associated with a worse hearing outcome.

Keywords: bacterial meningitis; child; deafness; low- and middle-income country; objective audiometry; sensorineural hearing loss; unilateral hearing loss.

Grants and funding

The Eclipse Interacoustics was funded by a grant from the Sigfrid Juselius Foundation funding medical research. Helsinki University research visit grants for PhD students (M.K., E.R., and O.S.) were used for travel to Luanda, Angola. Open access funding was provided by University of Helsinki.