Study of streptomycin-induced ototoxicity: protocol for a longitudinal study.

Area of Science:

• Ototoxicology
• Genetics
• Public Health

Background:

• Aminoglycosides, like streptomycin, can cause hearing loss (ototoxicity), particularly in individuals with specific mitochondrial gene mutations.
• Unregulated aminoglycoside use in developing nations exacerbates hearing impairment burdens, yet data for policy changes is scarce.
• Streptomycin is crucial for tuberculosis retreatment, making its ototoxicity a significant concern for patient adherence and public health.

Purpose of the Study:

• To determine the incidence and predictors of streptomycin-induced ototoxicity in tuberculosis retreatment patients.
• To identify mitochondrial gene mutations associated with aminoglycoside ototoxicity in an African population.
• To provide data for informing public health policies on aminoglycoside use and optimizing tuberculosis treatment adherence.

Main Methods:

• Longitudinal recruitment of tuberculosis retreatment patients from Directly Observed Treatment, Short-course centers.
• Comprehensive audiologic assessments pre- and post-treatment, with early ototoxicity detection via American Speech and Hearing Association criteria.
• Genetic analysis for mitochondrial gene mutations and statistical analysis including Kaplan-Meier curves and Cox proportional hazards tests.

Main Results:

• Analysis of ototoxicity incidence and associated risk factors, including genotype status.
• Identification of specific mitochondrial gene mutations linked to streptomycin ototoxicity in the study cohort.
• Quantification of the impact of ototoxicity on tuberculosis treatment adherence.

Conclusions:

• The study provides crucial data on the burden and predictors of aminoglycoside-induced ototoxicity in tuberculosis patients.
• Findings will guide public health strategies for regulating aminoglycoside use and managing drug-induced ototoxicity.
• Results will enhance pre-treatment counseling, potentially improving tuberculosis treatment adherence and outcomes.