Author(s)

Mireille A. Mpwate¹, Eddy M. Mbambu¹, Christian N. Matanda¹, Gabriel M. Lema¹, Michel K. Kaswa², Murielle L. Aloni², Nicole M. Anshambi³, Fabrice M. Matuta³, Luc L. Lukasu⁴, Dominique M. Mupepe⁵, Serge K. Mpwate⁶, Pierre Z. Akilimali⁷, Zacharie M. Kashongwe⁸, Richard N. Matanda^1*

¹Department of Otorhinolaryngology, University Clinics of Kinshasa, Kinshasa 11, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
²National Tuberculosis Control Program in the Democratic Republic of Congo, Kinshasa, Democratic Republic of Congo.
³Provincial Coordination for the Fight against Tuberculosis, Kinshasa, Democratic Republic of Congo.
⁴Multidrug-Resistant Tuberculosis Unit, “Centre d’Excellence Damien”, Damien Foundation, Kinshasa, Democratic Republic of Congo.
⁵Division of Cardiology, Department of Internal Medicine, University Clinics of Kinshasa, Kinshasa 11, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
⁶Department of Anatomy-Pathology, University Clinics of Kinshasa, Kinshasa 11, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
⁷Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
⁸Pneumology Unit, Department of Internal Medicine, University Clinics of Kinshasa, Kinshasa 11, University of Kinshasa, Kinshasa, Democratic Republic of Congo.

Context: Multidrug-resistant tuberculosis (MDR-TB) remains a major public health problem in developing countries such as the Democratic Republic of Congo (DRC), which continues to face the emergence of MDR-TB cases. Because of the ototoxic effects of AGs, the World Health Organization (WHO) has recommended the introduction of the bedaquiline regimen. However, very few data are available regarding the susceptibility of bedaquiline to induce hearing loss, hence the present study set out to compare the AG-based regimen and the bedaquiline-based regimen in the occurrence of hearing loss in MDR-TB patients. Methods: This is a prospective multicenter cohort study that included 335 MDR-TB patients, performed in Kinshasa (DRC) during the period from January 2020 to January 2021. Sociodemographic, clinical, biological and audiometric data were analyzed using Stata 17. Repeated-measures analysis of variance was used to compare changes in the degree of hearing loss over time between the two groups of patients on AG and bedaquiline regimens. The double-difference method was estimated using regression with fixed-effects. A p value < 0.05 was considered the threshold for statistical significance. Results: The degree of hearing loss was similar between the two groups at the first month [AGs (28 dB) vs BDQ (30 dB); p = 0.298]. At six months, the mean degree of hearing loss was significantly greater in the aminoglycoside regimen group [AGs (60.5 dB) vs BDQ (44 dB); p < 0.001]. The double difference was significant, with a greater increase in hearing loss in the AGs group (diff-in-diff 18.3; p < 0.001). After adjustment for age and serum albumin, the group receiving the AG-based regimen had a 2-point greater worsening than those with bedaquiline at the sixth month (diff-in-diff 19.8; p < 0.001). Conclusion: Hearing loss is frequent with both treatment regimens, but more marked with the Aminoglycoside-based regimen. Thus, bedaquiline should also benefit for audiometric monitoring in future MDR-TB patients.

Multidrug-Resistant Tuberculosis, Aminoglycosides, Bedaquiline, Hearing Loss

Mpwate, M. , Mbambu, E. , Matanda, C. , Lema, G. , Kaswa, M. , Aloni, M. , Anshambi, N. , Matuta, F. , Lukasu, L. , Mupepe, D. , Mpwate, S. , Akilimali, P. , Kashongwe, Z. and Matanda, R. (2023) Sensorineural Hearing Loss in Multidrug-Resistant Tuberculosis Patients in Kinshasa (Democratic Republic of Congo): Prospective Cohort Study of Therapeutic Regimen with Aminoglycoside versus Bedaquiline. Journal of Tuberculosis Research, 11, 109-119. doi: 10.4236/jtr.2023.113011.