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Salomè S, Malesci R, Delle Cave V, Amitrano A, Gammella R, Fanelli F, Capone E, Capasso L, Fetoni AR, Raimondi F. Congenital toxoplasmosis and audiological outcome: from a case series to a suggestion of patient-based schedule. Front Pediatr 2024; 11:1297208. [PMID: 38239593 PMCID: PMC10794333 DOI: 10.3389/fped.2023.1297208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/11/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Sensorineural hearing loss (SNHL) has been suggested to be possibly related to congenital toxoplasmosis (CT), although its prevalence varies from 0% to 26%. This variance appears to be dependent especially on early timing of treatment. However, the available data are based on outdated studies conducted on small groups of patients that lack homogeneity. Therefore, to establish evidence-based guidelines for audiologic monitoring in CT, we conducted a comprehensive evaluation of a large case series over a long period of time. Patients and methods This is a single-center, retrospective cohort that enrolled all infants and children who were exposed in utero to Toxoplasma gondii and/or congenitally infected between September 1980 and December 2022. They underwent standard serial audiological evaluations to detect possible SNHL at an early stage. The first evaluation was performed during the initial assessment to define the onset of congenital toxoplasmosis, with another evaluation conducted at least at 12 months of life. Results We collected data from 1,712 patients, and 183 (10.7%) were diagnosed with CT. Among these cases, 78 children (42.6%) presented with symptomatic CT at the onset, exhibiting ocular findings (21.1%), clinical cerebral manifestations (6.1%), and/or abnormal findings on neuroimaging (35.5%). Therapy was administrated at the onset in 164 patients (89.6%) with 115 of them starting treatment prior to 2.5 months of age (0-388, median 32.00 ± 92.352 days of life). Only one patient presented with SNHL at the onset, but this was apparently unrelated to CT. The median number of audiological assessments was 2.2 ± 1.543 (2-10). No patients developed any grade of delayed hearing loss, both in treated and untreated groups. The median age at last audiological evaluation was 2.3 ± 2.18 years (1-8), although the median follow-up period was 12.4 years (±6.3), ranging from 1 to 27 years. Conclusions Based on these data, it appears that SNHL may be less frequent in CT than previously assumed. We recommend conducting an audiological assessment at the onset (within the first 2.5 months of life) to comprehensively define the type of CT onset, and then conducting another evaluation within 9 months of life.
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Affiliation(s)
- S. Salomè
- Division of Neonatology, Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy
| | - R. Malesci
- Unit of Audiology, Department of Neurosciences, Reproductive and Odontostomatologic Sciences, University of Naples “Federico II”, Naples, Italy
| | - V. Delle Cave
- Division of Neonatology, Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy
| | - A. Amitrano
- Division of Neonatology, Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy
| | - R. Gammella
- Division of Neonatology, Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy
| | - F. Fanelli
- Division of Neonatology, Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy
| | - E. Capone
- Division of Neonatology, Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy
| | - L. Capasso
- Division of Neonatology, Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy
| | - A. R. Fetoni
- Unit of Audiology, Department of Neurosciences, Reproductive and Odontostomatologic Sciences, University of Naples “Federico II”, Naples, Italy
| | - F. Raimondi
- Division of Neonatology, Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy
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Continisio GI, D’Errico D, Toscano S, Maldonato NM, De Falco R, Nunziata F, Rodio A, Casarella A, Del Vecchio V, Fetoni AR, Malesci R. Parenting Stress in Mothers of Children with Permanent Hearing Impairment. CHILDREN 2023; 10:children10030517. [PMID: 36980075 PMCID: PMC10046956 DOI: 10.3390/children10030517] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023]
Abstract
Permanent childhood hearing impairment (PCHI) represents the most frequent sensory pathology at birth. PCHI has a relevant psychological impact on the life of both the affected children and their families. Thus, the aim of this work is to explore the degree of parental distress felt by mothers of a deaf or hard-of-hearing child, to determine if this stress is associated with variables related to the children’s health (e.g., the severity of hearing loss, presence of other conditions, difficulty with treatment options, difficulty with rehabilitation) or family characteristics such as socio-economic and educational status. The study used the Parenting Stress Index–Short Form (PSI-SF) questionnaire administered to mothers. The results were analyzed in relation to variables such as parents’ education level, number of children, severity of hearing loss, presence of other chronic conditions, presence of cognitive delay, familiarity with hearing loss, time of diagnosis, use of prosthetics, and start in a rehabilitation program. The data indicate a correlation between maternal stress levels and low-educational levels, as well as the presence of congenital infections and cognitive delay. These results highlight the need for a comprehensive physical and psychological approach for hearing-impaired children, as stress factors can affect the adherence to effective rehabilitation.
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Affiliation(s)
- Grazia Isabella Continisio
- Department of Neuroscience, Reproductive Science and Dentistry, Università degli Studi di Napoli Federico II, Via Pansini, 5, 80131 Naples, Italy
| | - Domenico D’Errico
- Section of Audiology, Department of Neuroscience, Reproductive Science and Dentistry, Università degli Studi di Napoli Federico II, Via Pansini, 5, 80131 Naples, Italy
| | - Silvia Toscano
- Section of Pediatrics, Department of Translational Medicine Science, Università degli Studi di Napoli Federico II, Via Pansini, 5, 80131 Naples, Italy
| | - Nelson Mauro Maldonato
- Department of Neuroscience, Reproductive Science and Dentistry, Università degli Studi di Napoli Federico II, Via Pansini, 5, 80131 Naples, Italy
| | - Raffaella De Falco
- Department of Neuroscience, Reproductive Science and Dentistry, Università degli Studi di Napoli Federico II, Via Pansini, 5, 80131 Naples, Italy
| | - Francesco Nunziata
- Section of Pediatrics, Department of Translational Medicine Science, Università degli Studi di Napoli Federico II, Via Pansini, 5, 80131 Naples, Italy
| | - Angelica Rodio
- Section of Audiology, Department of Neuroscience, Reproductive Science and Dentistry, Università degli Studi di Napoli Federico II, Via Pansini, 5, 80131 Naples, Italy
| | - Antonio Casarella
- Section of Audiology, Department of Neuroscience, Reproductive Science and Dentistry, Università degli Studi di Napoli Federico II, Via Pansini, 5, 80131 Naples, Italy
| | - Valeria Del Vecchio
- Section of Audiology, Department of Neuroscience, Reproductive Science and Dentistry, Università degli Studi di Napoli Federico II, Via Pansini, 5, 80131 Naples, Italy
| | - Anna Rita Fetoni
- Department of Neuroscience, Reproductive Science and Dentistry, Università degli Studi di Napoli Federico II, Via Pansini, 5, 80131 Naples, Italy
- Correspondence:
| | - Rita Malesci
- Section of Audiology, Department of Neuroscience, Reproductive Science and Dentistry, Università degli Studi di Napoli Federico II, Via Pansini, 5, 80131 Naples, Italy
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The Absence of Permanent Sensorineural Hearing Loss in a Cohort of Children with SARS-CoV-2 Infection and the Importance of Performing the Audiological “Work-Up”. CHILDREN 2022; 9:children9111681. [DOI: 10.3390/children9111681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/19/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
Abstract
Background: Currently, the novel coronavirus (SARS-CoV-2) causes an acute respiratory illness named COVID-19 and is a controversial risk factor for hearing loss (HL). Herein, we aim to describe the associated symptoms and to evaluate hearing function in the COVID-19 pediatric population. Methods: A retrospective cross-sectional observational study was carried out on 37 children who contracted COVID-19 infection with no previous audio-vestibular disorders. Clinical data on the infections were collected, and an audiological assessment of all affected children was performed by using different diagnostic protocols according to their age. Results: Fever, upper respiratory and gastrointestinal manifestations were common presentations of infection. Audiological function was normal in 30 (81.08%) children, while 7 children showed an increased hearing threshold: 6 (16.21%) had transient conductive hearing loss (CHL) due to middle ear effusion and normalized at the follow-up and 1 had sensorineural hearing loss (SNHL). A single child was affected by bilateral SNHL (2.7%); however, he underwent a complete audiological work-up leading to a diagnosis of genetic HL due to a MYO6 gene mutation which is causative of progressive or late onset SNHL. Conclusions: HL needs to be considered among the manifestations of COVID-19 in children, nevertheless, we found cases of transient CHL. The onset of HL during or following COVID-19 infection does not eliminate the indication for maintaining audiological surveillance and audiological work-ups, including genetic diagnosis, to avoid the risk of mistaking other causes of HL.
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