Hypertension Associated With Hearing Loss and Tinnitus Among Hypertensive Adults at a Tertiary Hospital in South Africa.

Introduction: Hypertension is one of the leading causes of morbidity and mortality worldwide, and has been associated with target organ damage. Effects of hypertension on the auditory system are varied and requires further investigation. This study aimed to investigate the association between hypertension and auditory deficits (hearing loss and tinnitus). Methods: This study employed a cross-sectional study including 106 (54.7% female) hypertensive adults aged 18-55 years, and 92 (52.2% female) non-hypertensive sex- and age-matched adults residing in South Africa. A data extraction sheet was used to obtain hypertension information from participants' medical files, and to subjectively obtain tinnitus status and characteristics among participants. Participants' hearing sensitivity-including extended high frequencies (EHF)-were measured using a diagnostic audiometer. The χ2 test determined the difference in auditory deficit prevalence between the study groups. Logistic regression was used to identify predictor variables associated with auditory deficits in the hypertensive group. Results: A hearing loss prevalence of 37.4% among hypertensive adults compared to 14.1% among the non-hypertensive group (P = 0.000, χ2 = 14.00) was found. The EHF pure-tone average among the hypertensive group was 44.1 ± 19.2 dB HL, and 20.0 ± 18.3 dB HL among the control group. Bilateral mild sensorineural hearing loss was the most common type of hearing loss among hypertensive adults. A higher prevalence of tinnitus (41.5%) was found in the hypertensive group compared to the control group (22.8%) (P = 0.008, χ2 = 7.09). In this study, 30.3% of hypertensive adults had tinnitus without hearing loss compared to 17.7% non-hypertensive adults. Factors associated with hearing loss included being between 50 and 55 years [adjusted Odds Ratio (AOR) = 3.35; 95% Confidence Interval (CI): 1.32-8.50; P = 0.011], having grade 2 hypertension (AOR = 4.18; 95% CI: 1.02-17.10; P = 0.048), and being on antihypertensive medication (AOR = 3.18; 95% CI: 1.02-9.87; P = 0.045). Tinnitus was associated with grade 3 hypertension (AOR = 3.90; 95% CI: 1.12-12.64; P = 0.033). Conclusions: Our study showed that hypertensive adults had a higher proportion of hearing loss and tinnitus compared to non-hypertensive adults. Findings suggest an association between hypertension and auditory deficits, demonstrating a need for integration of hearing healthcare services for hypertension management.

An insight into the implementation of the global action plan on antimicrobial resistance in the WHO African region: A roadmap for action.

INTRODUCTION: The Global Action Plan (GAP) on antimicrobial resistance (AMR) delivers a 'One Health' strategy for the development of the national action plan. It encourages the optimal use of antimicrobials and strengthens the evidence base through surveillance and research. METHODS: This study evaluated the current status of implementation of the GAP on AMR in World Health Organization (WHO) African countries via a retrospective, cross-sectional analysis of routinely collected data on AMR. A SWOT analysis was used to identify the strengths, weaknesses, opportunities and threats involved in the GAP implementation. A roadmap for action was proposed. RESULTS: The overall mean GAP performance score across all the countries that were assessed was 32% ± SD12 (95% CI 27-36%). The mean thematic scores were 59% ± 12 (53-65%) for multi-sector and One Health collaboration; 50% ± 22 (42-58%) for developing national AMR action plans; 38% ± 12 (33-42%) for awareness and training; 18% ± 13 (13-23%) for surveillance; 33% ± 13 (29-38%) for infection prevention and control; and 28% ± 23 (20-37%) for optimal use of antimicrobial medicines in human, animal and plant health. The difference in GAP performance scores between African sub-regions and between income categories was not statistically significant (P > 0.05). While seven countries exhibited strengths in two themes, 25 countries exhibited weaknesses across all themes. Six threats and six opportunities were identified to inform a practical roadmap for AMR action. CONCLUSION: The findings from this study indicate that the overall GAP implementation on AMR in the WHO African region is inadequate. Some thematic GAP scores appeared to be relatively good, but on closer inspection, individual indicators revealed a lack of progress and implementation, requiring action.

Veterinary growth promoters in cattle feedlot runoff: estrogenic activity and potential effects on the rat male reproductive system.

The contribution of veterinary growth promoters (VGP) to the environmental burden of endocrine-disrupting chemicals (EDCs) is largely unknown. At cattle feedlots, the excrement of cattle may contain VGPs, which can contaminate aquatic systems and pose reproductive health risks. The study identifies VGPs used at cattle feedlots in South Africa and confirms associated estrogenic activity in feedlot runoff water. Using a rat model, we investigate the potential reproductive health effects and thyroid function of an environmentally relevant mixture of VGPs. Collected water samples had low levels of selected VGPs, and estrogenic activity was detected in the T47D-KBluc bioassay. Rats exposed to VGP had significant adverse effects on male reproductive health, including shortened anogenital distance, lowered sperm counts, disorganized seminiferous tubules, and thyroid parameters. In conclusion, VGP can contribute to complex environmental EDC mixtures and may adversely affect the reproductive and thyroid health of both humans and wildlife. The varied topography of individual cattle feedlots will govern the rate and extent of effluent runoff, thus continuous monitoring of VGPs in aquatic systems surrounding cattle feedlots is necessary.