Prevalence of hearing loss and associated factors among patients with rheumatic diseases attending Muhimbili national hospital and Muhimbili Orthopedics Institute.

Abstract

ABSTRACT. Background: Hearing loss in patients with rheumatic diseases is common. Studies show the prevalence of hearing loss in rheumatic diseases, ranges from 6-72% depending on the type of rheumatic disease. Data from WHO show the trend of rheumatic diseases is increasing at 3%-6% annually every year, hence the population of people with high risk of hearing loss is also increasing. Despite this fact, there is no data in Tanzania, on the prevalence of hearing loss, but also most studies done in other parts of the world have not assessed the factors contributing to hearing loss in these patients. This study will bring data on the prevalence and associated factors that contribute to hearing loss among RD patients attending rheumatology clinics at Muhimbili National Hospital and Muhimbili Orthopedics Institute. Objective: To determine prevalence and associated factors of hearing loss among patients with rheumatic diseases attending Muhimbili National Hospital and Muhimbili Orthopaedics Institute. Methods: This was a cross-sectional study, in patients with established diagnosis of specific rheumatic disease, at Muhimbili national hospital rheumatology clinic and Muhimbili orthopaedics institute. Patient information including socio-demographics data, and data on hearing thresholds were taken, thereafter hearing loss was categorized into types and severity and recorded in a data sheet. Data was entered and analyzed using Statistical Package for Social Sciences version 25. Categorical variables were summarized using percentages; Numerical variables which are not normally distributed were summarized using median and interquartile ranges. Differences between groups were assessed using the chi-square test. A univariate logistic regression model was used to assess the association between dependent and independent variables. A p-value ≤ 0.05 was considered significant. Results; This study enrolled 88 patients with different rheumatic diseases, 27 with rheumatoid arthritis, 43 with systemic lupus erythematosis and 18 with ankylosing spondylitis. Patients age ranged from 15 to 74 years, the median age was 44 years. Percentage of females was 76.1 while 23.9% were males with female to male ratio of 3.1; 1. Hearing loss was found in 37.5 % (n=33) of patients with 69.7% (n=23) being vi females and 30.3 %( n=10) being males. Sensorineural hearing loss was most prevalent accounting 78.8%, conductive hearing loss proportion was 15.2% and mixed hearing loss was least represented with proportion of 6%. Rheumatoid arthritis patients had the highest proportion of hearing loss 59.3% (n=16), in systemic lupus erythematosus the proportion was 20.9% (n=9) and in ankylosing spondylitis the proportion was 44.4% (n=8).Bilateral hearing loss was common accounting 75.8% and unilateral hearing loss 24.2% of which 15.2% was right sided and 9% was left sided. Regarding severity of hearing loss this study found only mild and moderate forms of hearing loss with proportions of 45.5% and 54.5% respectively .with 75% of patients aged 57 and above having moderate hearing loss. Several factors were found to have statistical significant contribution in hearing loss among rheumatic disease patients these are age (p=0.002), active disease (p=0.001) and longer disease duration (p=0.003). Conclusion. This study found the prevalence of hearing loss among rheumatic patients to be high at 37.5% as other studies in other parts of the world, patients with active disease, advanced age; longer disease duration are at high risk. Bilateral sensorineural hearing loss was predominant of mild to moderate level. Recommendation; Rheumatic diseases patients with risk factors should undergo periodic audiologic evaluation