Stop TB Partnership

Hear to Help: Enabling Early Detection of Hearing Loss Resulting from Anti-Tuberculosis Treatment to Improve the Lives of Our Patients

25 March 2015 - South Africa - South Africa has one of the highest levels of multidrug-resistant tuberculosis (MDR-TB) in the world, affecting 15,400 people in 2012 alone. Current standard of care for the disease involves the use of toxic medicines, which, among other side effects, can also cause hearing loss in about 30% of patients.

Caused by the presence of an aminoglycoside within the standard treatments, hearing loss can be substantially reduced by the simple step of early detection. By closely monitoring people undergoing treatment, patients could be spared the devastating effects of hearing loss, which significantly adds to the burden the disease already places upon them.

Unfortunately, with only 461 audiologists registered by the South African government, demand far outweighs supply and this number is not nearly sufficient to reach and treat the entire population of MDR-TB patients, of which there are over 10,000.

To overcome this, The National Department of Health, is rolling out the KUDUwave audiometer - a lightweight, clinical diagnostic audiometer which enables patients to undergo accurate and comprehensive hearing tests without the need for expensive and complex sound booth equipment or the supervision of a trained audiologist. The introduction of the KUDUwave is also supported by a donation from Janssen. This donation is consistent with the goals of the Janssen Global Public Health (GPH) unit, seeking to create and implement innovative strategies to improve access to medicines, foster collaboration with key global health partners and support public health policies and technical solutions that address critical health needs in highly burdened communities.

"We know that regular testing could significantly reduce the impact of hearing loss for patients," said Dr Norbet Ndjeka, Director of Drug Resistant TB department in the National Department of Health. "However, reaching and assessing the vast number of patients, some of whom are very sick and unable to travel, has posed a significant challenge which we hope this roll-out will position us to overcome."

This initiative could significantly improve patient outcomes, enabling thousands of patients to be regularly monitored for hearing loss and reduce the number of people impacted by this side effect. Furthermore, the design of the audiometer enables the equipment to be transported, facilitating seriously ill patients to be tested at their bed-side. This removes the need for patients to travel and reduces the risk of cross-contamination. The audiometer’s easy mobility also means that it is possible to use on a significantly higher number of patients at a lower cost, thereby greatly impacting the potential implications on the countries’ already stretched health system.

The KUDUwave audiometer, designed by Dr Dirk Koekmoer, is already utilized by several large international health organisations, and it is hoped that its roll out in South Africa will help overcome the current hurdles that have prevented patients from receiving the care they deserve.