Vestibulo-otologic Events in Drug-resistant Tuberculosis Patients on Medications

Aims: This study aims to document the onset, types and factors associated with vestibulo-otologic (VO) events among patients on treatment for drug resistant Tuberculosis (DRTb).

Study Design: This is a prospective study of patients with drug resistant Tuberculosis who were admitted for the intensive phase of treatment with injectable medications.

Place and Duration of Study: The study was carried out at drug resistant Tuberculosis (DRTb) centre, Sacred Heart Hospital, Lantoro, Abeokuta, Nigeria between October 2013 and December 2014.

Methodology: Patients with complaints referable to VO effects of medications were recruited into the study. Clinical evaluation included the type, onset and duration of the vestibular or otologic events. Further information were retrieved from the patients case note records which included age, sex, retroviral status, weight on admission and height, from where the body mass index (BMI) was calculated. Data analyses were performed using SPSS version 20.

Results: A total of 121 patients comprising of 80 male and 41 female patients. Modal age group distribution for all patients was the group 21-40 years (72.7%), while the mean age ±SD was 32.9±13.7 years. The duration of treatment ranged from 12 to 20 weeks, mean ±SD= 14±3.4 weeks. VO events occurred in 40.5%, vestibular events alone were in 27.3% while otologic events alone occurred in 33.1%. The VO events were noticed between 6-19 weeks of treatment (mean ±SD= 11.1±4.7 weeks). Dizziness/imbalance were the most common vestibular while tinnitus was the most common otologic event. Among the patients with VO events, 13/46=28.3%, had repeat pure tone audiometry, and 7 (15.2%) met audiometric criteria for ototoxicity.

Conclusion: Vestibulo-otologic events were common among DRTb patients in Nigeria. The major complaints started around 11 weeks on medication. Factors associated with the VO events were female gender, being underweight and retroviral positive.