Hearing-Functioning Problems Across High-Burden Adult Health Conditions in Africa

Hearing-functioning problems contribute substantially to disability and rehabilitation needs globally; however, evidence describing the range and interconnected nature of these problems across African populations remains fragmented. This study aimed to describe hearing-functioning problems associated with high-burden adult health conditions across African populations using data from the Rehab4All database. A secondary exploratory analysis was conducted using data extracted from a large Africa-wide scoping review of functioning problems associated with conditions contributing substantially to years lived with disability (YLD). The parent review systematically searched PubMed, Scopus, Web of Science, EBSCOhost, and SABINET and included English-language studies conducted in African adults. Hearing-functioning problems were classified according to the International Classification of Functioning, Disability and Health (ICF). Descriptive analyses, visual mapping techniques, and exploratory random-effects prevalence meta-analyses were performed. Ninety-seven articles published between 2007 and 2022 were included. Most studies originated from Southern Africa, particularly South Africa. Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), tuberculosis (TB), diabetes mellitus (DM), hearing-loss cohorts, and headache-related conditions contributed most frequently to reported hearing-functioning problems. Hearing loss, tinnitus, and vestibular dysfunction were the most commonly reported problems; however, multidimensional co-occurring auditory and vestibular profiles were frequently identified. Distinct functional patterns emerged across conditions, with TB demonstrating predominantly auditory dysfunction, while HIV/AIDS and DM demonstrated broader auditory-vestibular involvement. Hearing-functioning problems within the African evidence base appear multidimensional, interconnected, and unevenly distributed geographically.