Deafness and sickle cell disease: three case reports and review of the literature

Aetiologies of profound bilateral sensorineural hearing loss among children in Ekiti State, South Western Nigeria

Introduction

a strong need exists for the knowledge of aetiologies of diseases as this will guide the clinicians on the strategies for their treatment and prevention. In this study, we determined the aetiologies of profound bilateral sensorineural hearing loss (pbSNHL) with a view to provide the relevant data needed for preventive and therapeutic intervention among children in Ekiti State, South Western Nigeria.

Methods

medical records of children with pbSNHL seen over a ten-year period were analysed.

Results

in all, records of 142 children with pbSNHL were analysed. The results showed spectrum of aetiologies that were similar to those reported decades ago with the 'unknown' assuming a recurring decimal. Of the known (acquired) cases, measles takes up the largest 'chunk' with a prevalence of 45.8%. Twenty-eight (32.2%) of those with febrile illnesses had treated their fever with ototoxic antibiotics. Late diagnosis was characteristic of the pbSNHL.

Conclusion

this study shows that there hasn't been any significant shift in the common causes of pbSNHL. Of great concern is the persistence of the 'unknown' causes which assumes a recurring decimal in this and previous studies. Also worrisome is the high prevalence of measles-induced pbSNHL despite the availability of anti-measles vaccine. We therefore suggest effective immunization against measles and other vaccine-preventable causes of pbSNHL. The need for intensive research on the unknown causes of pbSNHL is hereby stressed. Also recommended is routine hearing assessment for survivors of febrile conditions so as to detect, if any, hearing loss promptly.

Geriatric assessment for older adults with sickle cell disease: protocol for a prospective cohort pilot study

Background

The life expectancy for people with sickle cell disease (SCD) has improved tremendously over the last 50 years. This population experiences hemolysis and vaso-occlusion in multiple organs that lead to complications such as cardiopulmonary disease, strokes, and avascular necrosis. These complications can limit mobility and aerobic endurance, similar to limitations that often occur in geriatric populations. These sickle-cell and age-related events lead to frequent hospitalization, which further increases the risk of functional decline. We have few tools to measure functional decline in people with SCD. The purpose of this paper is to describe a protocol to evaluate the feasibility of sickle cell disease geriatric assessment (SCD-GA).

Methods/design

We will enroll 40 adults with SCD (20 age 18–49.99 years and 20 age ≥ 50 years) in a prospective cohort study to assess the feasibility of SCD-GA. The SCD-GA includes validated measures from the oncology geriatric assessment enriched with additional physical and cognitive measures. The SCD-GA will be performed at the first study visit, at 10 to 20 days after hospitalization, and at 12 months (exit visit). With input from a multidisciplinary team of sickle cell specialists, geriatricians, and experts in physical function and physical activity, we selected assessments across 7 domains: functional status (11 measures), comorbid medical conditions (1 measure), psychological state (1 measure), social support (2 measures), weight status (2 measures), cognition (3 measures), and medications (1 measure). We will measure the proportion completing the assessment with feasibility as the primary outcome. Secondary outcomes include the proportion consenting and completing all study visits, duration of the assessment, acceptability, and adverse events.

Discussion

We present the protocol and rationale for selection of the measures included in SCD-GA. We also outline the methods to determine feasibility and subsequently to optimize the SCD-GA in preparation for a larger multicenter validation study of the SCD-GA.

Otological burdens of Nigerian children with sickle cell disease

INTRODUCTION/OBJECTIVE

Sickle cell disease (SCD) is associated with episodic illnesses, multi-systemic affectations and end-organs damages. Otolaryngological related complications are not unexpected. Studies on the overall Otolaryngological pathologies in children with SCD relative to their non-SCD counterparts are scanty in Nigeria. We hypothesized that children with SCD are likely to have more otological burdens than their non-SCD counterparts. Thus, we embarked on this study to describe and compare the overall ear diseases burdens seen in children with sickle cell disease relative to their non-SCD counterparts.

METHODOLOGY

A cross-sectional study of otologic diseases among children with SCD and their non-SCD counterparts attending the paediatrics and otolaryngological clinics of a Nigerian tertiary institution was conducted.

RESULTS

Overall, 80 (47.62%) of the 168 ears of SCD patients compared to 37 (22.02%) of the 168 ears of their non-SCD counterparts were affected by diseases (p < 0.0001). The diseases were Wax, Otitis Media with Effusion, Suppurative Otitis Media, Otosclerosis and Sensorineural Hearing Loss (SNHL). There was a significant difference in the prevalence of SNHL and solitary otosclerosis between the SCD patients and their non-SCD counterparts (P < 0.05) respectively. Both the Haemoglobin concentration and HbF did not discriminate between the SCD participants with or without SNHL (P > 0.05).

CONCLUSION

This study showed that otological burdens are more prevalent in children with SCD than the non-SCD population. The microbiological peculiarity of suppurative otitis media (SOM) among participants stresses the need for concerted efforts at preventing SOM in SCD children. There is need for special Otolaryngological care for SCD children.

Hearing loss among adults with sickle cell disease in an endemic region: a prospective case-control study

BACKGROUND

Sickle cell disease (SCD) is a common disease in the Eastern province of Saudi Arabia. One of the underreported complications of sickle cell disease is sensorineural hearing loss (SNHL).

OBJECTIVES

The aim of this study was to estimate the prevalence of SNHL in patients with sickle cell disease by comparison with a control group from hematological diseases, and to consider the possible options that might minimize the occurrence of SNHL.

DESIGN

Prospective case-control study.

SETTING

Outpatient clinics in the Eastern province over a 9-month duration from July 2014 to March 2015.

PATIENTS AND METHODS

Cases were selected consecutively and controls were matched for age and sex. Means for pure tone audiometry measurements and hearing thresholds were compared.

MAIN OUTCOME MEASURE(S)

SNHL in patients with sickle cell disease.

RESULTS

Nine patients (22.5%) had hearing loss using pure tone audiometry. The mean of pure tone averages in the patient group was 21.1 on the right side and 21.5 on the left side, while the control group average was 15.4 on the right side and 15.2 on the left side. Comparison of the means of the hearing thresholds on each side for both groups showed statistically significant differences in all frequencies.

CONCLUSIONS

Hearing loss is a common complication in patients with SCD. Annual hearing assessment is highly recommended to discover this complication as early as possible.

LIMITATIONS

Relatively small sample size. The study was in a single outpatient clinic. Recall bias in the number of hospital admissions in the last ten years.