Nature and extent of hearing loss in HIV-infected children: A scoping review.

INTRODUCTION: Antiretroviral therapy (ART) has had a major impact on life expectancy from HIV as many people now live with it as a chronic disease. Chronic HIV has been associated with a range of comorbid disabilities and health conditions, one of which is hearing loss. Undiagnosed and untreated hearing loss, particularly in children, has been linked to poorer spoken language skills, with subsequent effects on academic performance. METHODS: This systematic scoping review aimed to summarize the available peer-reviewed literature on hearing loss in HIV-infected children, specifically to describe its extent and nature. The review followed the framework proposed by Arksey and O'Malley. Key search terms included hearing loss (and synonyms), child (and synonyms), and HIV. Electronic databases (EBSCOhost Research Platform, PubMed, Web of Science and Scopus databases) were searched for any relevant articles published from January 1, 2000 to June 30, 2019. Reference lists of included articles were pearled for additional relevant articles not already identified. Each stage of the selection process was conducted independently by two authors. The results were then collated by a third author who also resolved any discrepancies. Extracted data included sample descriptors, audiologic tests, hearing loss prevalence, hearing loss descripts, and factors associated with hearing loss. RESULTS: Seventeen articles were included; 10 from Africa, four from South America, two from North America and the remaining article from Asia. Although most of the articles reported on pure tone audiometry, the samples as well as the cut-off criteria for normal hearing were heterogenous. Prevalence of hearing loss varied across articles (from 6% to 84%). Conductive hearing loss occurred more frequently than sensorineural or mixed hearing loss. ART use and ear infection were reported as significant in three of five articles that reported on significant associates of HIV-related hearing loss. CONCLUSION: There was a modest volume of research from a limited number of countries. Heterogeneity in sampling and audiometric methods precluded a clear understanding of potential associations between chronic HIV-related hearing loss and contributing factors.

Children with HIV: A scoping review of auditory processing skills.

INTRODUCTION: Auditory processing disorders can negatively affect academic performance in children. They can result from a number of aetiologies, including the human immunodeficiency virus (HIV). Although studies in paediatrics are limited, research suggests that HIV-infected children display poorer auditory processing skills than uninfected children. METHODS: The aims of this study were to scan the peer-reviewed literature on auditory processing skills in HIV-infected children, to describe how auditory processing was tested, how auditory processing skills were reported, and to identify gaps in current evidence. This systematic scoping review was conducted using a modified version of Arksey and O'Malley's framework. Key words comprised 'HIV', 'auditory processing', 'hearing' and 'child'. Electronic databases were searched for relevant articles published from 1 January 2000 to 30 April 2018, and reference lists of included studies were pearled. Two researchers reviewed the articles and extracted data on sample descriptors, auditory processing testing procedures, and auditory processing skills. A third author collated the results and resolved discrepancies. The American Speech-Language-Hearing Association description of auditory processing skills framed the analysis. RESULTS: Five articles were included in this review (three from Brazil, one each from Mexico and Tanzania). Samples, and methods of testing were heterogeneous. Three studies reported on localization abilities, while gap detection thresholds, performance on dichotic tasks and speech discrimination scores were reported in one article each. No one study tested all areas of auditory processing skills and there was limited information about the auditory processing skills required for learning. CONCLUSION: This review highlighted the current sparse evidence-base for auditory processing in HIV-infected children. It identified the need to standardise testing procedures, measures of auditory processing skills, and sample selection.

Core psychopathology of treatment-seeking patients with binge-eating disorder: a network analysis investigation.

BACKGROUND: Mental disorders may emerge as the result of interactions between observable symptoms. Such interactions can be analyzed using network analysis. Several recent studies have used network analysis to examine eating disorders, indicating a core role of overvaluation of weight and shape. However, no studies to date have applied network models to binge-eating disorder (BED), the most prevalent eating disorder. METHODS: We constructed a cross-sectional graphical LASSO network in a sample of 788 individuals with BED. Symptoms were assessed using the Eating Disorders Examination Interview. We identified core symptoms of BED using expected influence centrality. RESULTS: Overvaluation of shape emerged as the symptom with the highest centrality. Dissatisfaction with weight and overvaluation of weight also emerged as highly central symptoms. On the other hand, behavioral symptoms such as binge eating, eating in secret, and dietary restraint/restriction were less central. The network was stable, allowing for reliable interpretations (centrality stability coefficient = 0.74). CONCLUSIONS: Overvaluation of shape and weight emerged as core symptoms of BED. This trend is consistent with past network analyses of eating disorders more broadly, as well as literature that suggests a primary role of shape and weight concerns in BED. Although DSM-5 diagnostic criteria for BED does not currently include a cognitive criterion related to body image or shape/weight overvaluation, our results provide support for including shape/weight overvaluation as a diagnostic specifier.

Hearing assessment data in HIV-infected and uninfected children of Cape Town, South Africa.

Researchers are showing that the rate of hearing loss in children with perinatal HIV infection (PHIV) is higher than in HIV-unexposed, uninfected children. These data, however, have been collected mostly in the USA; extensive hearing data from low- and middle-income countries are lacking. The purpose of this study was to collect audiometric data in PHIV and HIV-uninfected children living in Cape Town, South Africa. Questionnaire data along with distortion product otoacoustic emissions (DPOAEs) and pure-tone testing were completed. Hearing loss was determined using the pure-tone thresholds defined as a pure-tone average (PTA) of 500, 1000, 2000, and 4000 Hz of >15 dB HL in the poorer ear. All data were compared between PHIV and HIV-uninfected children. Sixty-one (37 PHIV and 24 HIV-uninfected) children had hearing data. HIV status was not significantly associated with DPOAEs. The rate of conductive hearing loss was 11.5%; five PHIV and two HIV-uninfected children. The rate of any hearing loss was higher in PHIV children, but this difference was not statistically significant. PHIV children had a significantly higher mean PTA in the poorer ear than HIV-uninfected children. Conductive type of hearing loss was more common than sensorineural hearing loss. The underlying cause of hearing loss in the present study therefore remains unclear. Future research should include an examination of auditory neural function in an effort to determine the possible reason for differences in hearing.

Voice rehabilitation after laryngectomy with the Provox voice prosthesis in South Africa.

A study was undertaken to determine whether the Provox voice prosthesis provides good voice rehabilitation following a total laryngectomy in the urban, suburban and rural populations served by a tertiary referral hospital in South Africa. Between 1995 and 1999, a cohort of 128 patients at Tygerberg Hospital was rehabilitated with the Provox voice prosthesis after laryngectomy. In 104 patients primary placement of the prosthesis was done at the time of the laryngectomy. Mean device life and adverse events were determined. Voice quality was assessed subjectively in 104 patients and objectively in 26 patients. The mean device life was 303 days and adverse events occurred in 16 patients. Subjectively, 77 of 104 patients had a good voice, and objectively 22 of 26 patients had good voice intelligibility. The Provox voice prosthesis provides good voice rehabilitation following total laryngectomy, with minimal complications, in the population served by Tygerberg Hospital.