Lassa fever-induced hearing loss: The neglected disability of hemorrhagic fever

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Abstract

Objective:

Lassa fever (LF), a hemorrhagic fever endemic to West Africa, has an incidence of approximately 500,000 cases per year. This study evaluated hearing loss and other sequelae following LF.

Methods:

This case–control study enrolled laboratory-confirmed LF survivors, non-LF febrile controls and matched-community controls with no history of LF or recent hospitalization for a febrile illness. Study participants completed a symptom questionnaire. Pure-tone audiometry was completed by a subset of participants.

Results:

A total of 147 subjects aged 3–66 years (mean, 23.3) were enrolled. LF survivors were significantly more likely to report balance difficulties (55% vs. 20%, p < 0.001), hair loss (32% vs. 7%, p < 0.001), difficulty speaking (19% vs. 1%, p < 0.001), social isolation (50% vs. 0%, p < 0.001), and hearing loss (17% vs. 1%, p = 0.002) in comparison with matched-community controls. Similar trends were noted in comparison with febrile controls, although these findings were non-significant. Fifty subjects completed audiometry. Audiometry found that LF survivors had significantly more bilateral hearing loss in comparison with matched-community controls (30% vs. 4%, p = 0.029).

Conclusion:

This study characterized the sequelae of LF and highlighted the need for increased access to hearing care in West Africa.

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Most cited references 54

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Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Spencer L James, Degu Abate, Kalkidan Hassen Abate … (2020)

Summary Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1–4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0–8·4) while the total sum of global YLDs increased from 562 million (421–723) to 853 million (642–1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6–9·2) for males and 6·5% (5·4–7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782–3252] per 100 000 in males vs s1400 [1279–1524] per 100 000 in females), transport injuries (3322 [3082–3583] vs 2336 [2154–2535]), and self-harm and interpersonal violence (3265 [2943–3630] vs 5643 [5057–6302]). Interpretation Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury. Funding Bill & Melinda Gates Foundation.

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The impact of hearing loss on quality of life in older adults.

Dayna S Dalton, Karen J Cruickshanks, Barbara E K Klein … (2003)

The authors investigate the impact of hearing loss on quality of life in a large population of older adults. Data are from the 5-year follow-up Epidemiology of Hearing Loss Study, a population-based longitudinal study of age-related hearing impairment conducted in Beaver Dam, WI. Participants (N = 2,688) were 53-97 years old (mean = 69 years) and 42% were male. Difficulties with communication were assessed by using the Hearing Handicap for the Elderly-Screening version (HHIE-S), with additional questions regarding communication difficulties in specific situations. Health-related quality of life was assessed by using measures of activities of daily living (ADLs), instrumental ADLs (IADLs) and the Short Form 36 Health Survey (SF-36). Hearing loss measured by audiometry was categorized on the basis of the pure-tone average of hearing thresholds at 0.5, 1, 2, and 4 kHz. Of participants, 28% had a mild hearing loss and 24% had a moderate to severe hearing loss. Severity of hearing loss was significantly associated with having a hearing handicap and with self-reported communication difficulties. Individuals with moderate to severe hearing loss were more likely than individuals without hearing loss to have impaired ADLs and IADLs. Severity of hearing loss was significantly associated with decreased function in both the Mental Component Summary score and the Physical Component Summary score of the SF-36 as well as with six of the eight individual domain scores. Severity of hearing loss is associated with reduced quality of life in older adults.

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Hearing Loss and Cognition: The Role of Hearing Aids, Social Isolation and Depression

Piers Dawes, Richard Emsley, Karen Cruickshanks … (2015)

Hearing loss is associated with poor cognitive performance and incident dementia and may contribute to cognitive decline. Treating hearing loss with hearing aids may ameliorate cognitive decline. The purpose of this study was to test whether use of hearing aids was associated with better cognitive performance, and if this relationship was mediated via social isolation and/or depression. Structural equation modelling of associations between hearing loss, cognitive performance, social isolation, depression and hearing aid use was carried out with a subsample of the UK Biobank data set (n = 164,770) of UK adults aged 40 to 69 years who completed a hearing test. Age, sex, general health and socioeconomic status were controlled for as potential confounders. Hearing aid use was associated with better cognition, independently of social isolation and depression. This finding was consistent with the hypothesis that hearing aids may improve cognitive performance, although if hearing aids do have a positive effect on cognition it is not likely to be via reduction of the adverse effects of hearing loss on social isolation or depression. We suggest that any positive effects of hearing aid use on cognition may be via improvement in audibility or associated increases in self-efficacy. Alternatively, positive associations between hearing aid use and cognition may be accounted for by more cognitively able people seeking and using hearing aids. Further research is required to determine the direction of association, if there is any direct causal relationship between hearing aid use and better cognition, and whether hearing aid use results in reduction in rates of cognitive decline measured longitudinally.

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Author and article information

Journal

Journal ID (nlm-journal-id): 9610933

Journal ID (pubmed-jr-id): 20844

Journal ID (nlm-ta): Int J Infect Dis

Journal ID (iso-abbrev): Int J Infect Dis

Title: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

ISSN (Print): 1201-9712

ISSN (Electronic): 1878-3511

Publication date Nihms-submitted: 1 January 2021

Publication date (Electronic): 11 August 2020

Publication date (Print): November 2020

Publication date PMC-release: 14 January 2021

Volume: 100

Pages: 82-87

Affiliations

[a ]Tulane University School of Medicine, New Orleans, LA, USA

[b ]Division of Rheumatology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA

[c ]Kenema Government Hospital, Kenema, Sierra Leone

[d ]Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA

[e ]Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA

[f ]Duke Global Health Institute, Durham, NC, USA

[g ]Center for Health Policy and Inequalities Research, Duke University, Durham, NC, USA

[h ]Tulane Viral Hemorrhagic Fever Research Program, Kenema Government Hospital, Kenema, Sierra Leone

Author notes

[* ]Corresponding author at: Tulane University School of Medicine, 1430 Tulane Ave, Box 840, New Orleans, LA 70112, USA. sficenec@ 123456tulane.edu (S.C. Ficenec).

Article

Manuscript ID: NIHMS1647229

DOI: 10.1016/j.ijid.2020.08.021

PMC ID: 7807889

PubMed ID: 32795603

SO-VID: 9633d430-d5b7-4e52-8317-0646e490aab3

License:

This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Lassa fever-induced hearing loss: The neglected disability of hemorrhagic fever

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Abstract

Objective:

Methods:

Results:

Conclusion:

Related collections

Hearing Loss and Restoration

Most cited references 54

Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

The impact of hearing loss on quality of life in older adults.

Hearing Loss and Cognition: The Role of Hearing Aids, Social Isolation and Depression

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Cited by 11

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