Surdez(n=644)GraudePerdadeaudiçãoTipodeSurdez
Moderada(41-60dB)
Ligeira(26-40dB)
Severa(61-80dB)
Profunda(≥81dB)
2012-2014
SurdezNeurosensorial
SurdezdeCondução
SurdezMista
Normal
UnilateralHL
Normal
180
44
16 19 17 40
0 50 100 150 200
Controlo
Surdez
Unilateral
Surdez
Bilateral
GRUPOCASO/CONTROLOPORGRAUDESURDEZ
Normal Ligeira Moderada Severa Profunda
250
Hz
500
Hz
1000
Hz
2000
Hz
4000
Hz
LeftEar(dB) 20.36 19.78 19.36 14.01 13.18
RightEar(dB) 19.96 20.57 19.97 14.27 13.66
0102030405060708090100
dB
CurvaAudiométrica–grupocontrolo
250
Hz
500
Hz
1000
Hz
2000
Hz
4000
Hz
LeftEar(dB) 55.49 60.8 61.6 61.81 63.41
RightEar(dB) 56.76 60.75 62.71 59.26 61.7
0102030405060708090
100
dB
CurvaAudiométrica–grupocaso
AUDIOGRAMATONAL–MÉDIAS
WT wB(376A)
Var
wA+(376G)
wA-(202A+376G)
wHeterozygousgroup*
G6PD202G>A(n=298) G6PD376A>G(n=298)
VarianteG6PD(n=298)
27
Table2-Binary Logistic Regressi betwee independent variables a HL without
a with ris factors a interactions
Cases
129(43.3%)
Controls
169(56.7%)
P-
valueCrudeOR(95%CI) P-value AdjustedOR(95%CI)
GenderGroup
Female
Male
54(41.9%)
75(58.1%)
80(47.3%)
89(52.7%)
0.347
Reference
0.801[0.505-1.272]
0.024
Reference
0.312[0.113-0.860]
Agegroup
[2-14]:
[15-35]:
67(51.9%)
62(48.1%)
77(45.6%)
92(54.4%)
0.275
Reference
0.774[0.489-1.226]
0.130
Reference
2.047[0.809-5.181]
Malaria
infection
No:
Yes:
86(66.7%)
39(30.2%)
98(58%)
66(40.2%)
0.114
Reference
1.485[0.909-2.425]
0.053
Reference
2.885[0.987-8.435]
HbS
AA:
AS:
SS:
106(82.2%)
21(16.3%)
2(1.6%)
133(78.7%)
35(20.7%)
1(0.6%)
0.475
0.352
0.455
Reference
0.753[0.414-1.369]
2.509[0.224-28.051]
0.768
0.939
0.523
Reference
0.931[0.266-3.403]
2.470[0.154-39.633]
G6PDvariants
B
Non-B
66(51.2%)
63(48.8%)
86(50.9%)
83(49.1%)
0.962
Reference
0.989[0.625-1.564]
0.884
Reference
1.079[0.388-3.004]
RubellaIgG
Neg:
Pos:
36(27.9%)
93(72.1%)
64(37.4%)
107(62.6%)
0.111
Reference
1.497[0.912-2.458]
0.023
Reference
1.986[1.100-3.585]
Malaria
infection&Age
groups
0.084 0.0001
No&[2-14] Reference Reference
0.658[0.409-1.059] 0.123[0.039-0.385]
Malaria
infection&
Gender
0.168 0.046
No&Fem Reference Reference
1.448[0.856-2.451] 3.001[1.021-8.817]
G6PDvariants
&Gender
0.672 0.258
No&Fem Reference Reference
1.141[0.620-2.101] 1.804[0.649-5.014]
G6PDvariants
&Malaria
infection
0.844 0.459
B&No Reference Reference
1.051[0.639-1.729] 0.669[0.230-1.942]
G6PDvariants
&HbS*
0.436 0.643
B&HbAA Reference Reference
0.749[0.362-1.550] 0.738[0.204-2.668]
HbS*&Malaria
infection
0.960
0.506
HbAA&No Reference Reference
0.982[0.481-2.005] 1.264[0.634-2.522]
HL:Normalhearing 0 ReferenceCategoryisaresponsevariable;independentvariables:GenderGroup(0 Female,1
Male),agegroups(0 [2-14]years,1 [15-35]years),historyofMalariainfection(0 no,1 yes),ImmunityRubella(0
Negative,1 Positive),HbS(0 HbAAwildtype,1-HbAStrait,2 HbSShomozygotic),G6PDvariants(0 G6PDB,1
G6PDA/G6PDA-/202G>A)andHbS*(0 HbAA,1 HbAS/HbSS)
27
Table2-Binary Logistic Regressi betwee independent variables a HL without
a with ris factors a interactions
Cases
129(43.3%)
Controls
169(56.7%)
P-
valueCrudeOR(95%CI) P-value AdjustedOR(95%CI)
GenderGroup
Female
Male
54(41.9%)
75(58.1%)
80(47.3%)
89(52.7%)
0.347
Reference
0.801[0.505-1.272]
0.024
Reference
0.312[0.113-0.860]
Agegroup
[2-14]:
[15-35]:
67(51.9%)
62(48.1%)
77(45.6%)
92(54.4%)
0.275
Reference
0.774[0.489-1.226]
0.130
Reference
2.047[0.809-5.181]
Malaria
infection
No:
Yes:
86(66.7%)
39(30.2%)
98(58%)
66(40.2%)
0.114
Reference
1.485[0.909-2.425]
0.053
Reference
2.885[0.987-8.435]
HbS
AA:
AS:
SS:
106(82.2%)
21(16.3%)
2(1.6%)
133(78.7%)
35(20.7%)
1(0.6%)
0.475
0.352
0.455
Reference
0.753[0.414-1.369]
2.509[0.224-28.051]
0.768
0.939
0.523
Reference
0.931[0.266-3.403]
2.470[0.154-39.633]
G6PDvariants
B
Non-B
66(51.2%)
63(48.8%)
86(50.9%)
83(49.1%)
0.962
Reference
0.989[0.625-1.564]
0.884
Reference
1.079[0.388-3.004]
RubellaIgG
Neg:
Pos:
36(27.9%)
93(72.1%)
64(37.4%)
107(62.6%)
0.111
Reference
1.497[0.912-2.458]
0.023
Reference
1.986[1.100-3.585]
Malaria
infection&Age
groups
0.084 0.0001
No&[2-14] Reference Reference
0.658[0.409-1.059] 0.123[0.039-0.385]
Malaria
infection&
Gender
0.168 0.046
No&Fem Reference Reference
1.448[0.856-2.451] 3.001[1.021-8.817]
G6PDvariants
&Gender
0.672 0.258
No&Fem Reference Reference
1.141[0.620-2.101] 1.804[0.649-5.014]
G6PDvariants
&Malaria
infection
0.844 0.459
B&No Reference Reference
1.051[0.639-1.729] 0.669[0.230-1.942]
G6PDvariants
&HbS*
0.436 0.643
B&HbAA Reference Reference
0.749[0.362-1.550] 0.738[0.204-2.668]
HbS*&Malaria
infection
0.960
0.506
HbAA&No Reference Reference
0.982[0.481-2.005] 1.264[0.634-2.522]
HL:Normalhearing–0–ReferenceCategoryisaresponsevariable;independentvariables:GenderGroup(0–Female,1
–Male),agegroups(0–[2-14]years,1–[15-35]years),historyofMalariainfection(0–no,1–yes),ImmunityRubella(0
–Negative,1–Positive),HbS(0–HbAAwildtype,1-HbAStrait,2–HbSShomozygotic),G6PDvariants(0–G6PDB,1–
G6PDA/G6PDA-/202G>A)andHbS*(0–HbAA,1–HbAS/HbSS)
Ogéneromasculinotemmenorriscodedesenvolversurdezemrelaçãoaogénerofeminino.Provavelmenteporqueosexo
femininotemmaisanemia.
REGRESSÃOLOGÍSTICABINÁRIAMÚLTIPLASENTRETODOSOSFACTORESDERISCOESURDEZ
ARubéolaéumadoençaevitávelquepodelevarasurdez
(períodogestacional).Representaumriscoelevado– duplicao
riscodesurdez
27
Table2-Binary Logistic Regressi betwee independent variables a HL without
a with ris factors a interactions
Cases
129(43.3%)
Controls
169(56.7%)
P-
valueCrudeOR(95%CI) P-value AdjustedOR(95%CI)
GenderGroup
Female
Male
54(41.9%)
75(58.1%)
80(47.3%)
89(52.7%)
0.347
Reference
0.801[0.505-1.272]
0.024
Reference
0.312[0.113-0.860]
Agegroup
[2-14]:
[15-35]:
67(51.9%)
62(48.1%)
77(45.6%)
92(54.4%)
0.275
Reference
0.774[0.489-1.226]
0.130
Reference
2.047[0.809-5.181]
Malaria
infection
No:
Yes:
86(66.7%)
39(30.2%)
98(58%)
66(40.2%)
0.114
Reference
1.485[0.909-2.425]
0.053
Reference
2.885[0.987-8.435]
HbS
AA:
AS:
SS:
106(82.2%)
21(16.3%)
2(1.6%)
133(78.7%)
35(20.7%)
1(0.6%)
0.475
0.352
0.455
Reference
0.753[0.414-1.369]
2.509[0.224-28.051]
0.768
0.939
0.523
Reference
0.931[0.266-3.403]
2.470[0.154-39.633]
G6PDvariants
B
Non-B
66(51.2%)
63(48.8%)
86(50.9%)
83(49.1%)
0.962
Reference
0.989[0.625-1.564]
0.884
Reference
1.079[0.388-3.004]
RubellaIgG
Neg:
Pos:
36(27.9%)
93(72.1%)
64(37.4%)
107(62.6%)
0.111
Reference
1.497[0.912-2.458]
0.023
Reference
1.986[1.100-3.585]
Malaria
infection&Age
groups
0.084 0.0001
No&[2-14] Reference Reference
0.658[0.409-1.059] 0.123[0.039-0.385]
Malaria
infection&
Gender
0.168 0.046
No&Fem Reference Reference
1.448[0.856-2.451] 3.001[1.021-8.817]
G6PDvariants
&Gender
0.672 0.258
No&Fem Reference Reference
1.141[0.620-2.101] 1.804[0.649-5.014]
G6PDvariants
&Malaria
infection
0.844 0.459
B&No Reference Reference
1.051[0.639-1.729] 0.669[0.230-1.942]
G6PDvariants
&HbS*
0.436 0.643
B&HbAA Reference Reference
0.749[0.362-1.550] 0.738[0.204-2.668]
HbS*&Malaria
infection
0.960
0.506
HbAA&No Reference Reference
0.982[0.481-2.005] 1.264[0.634-2.522]
HL:Normalhearing–0–ReferenceCategoryisaresponsevariable;independentvariables:GenderGroup(0–Female,1
–Male),agegroups(0–[2-14]years,1–[15-35]years),historyofMalariainfection(0–no,1–yes),ImmunityRubella(0
Negative,1 Positive),HbS(0 HbAAwildtype,1-HbAStrait,2 HbSShomozygotic),G6PDvariants(0 G6PDB,1
G6PDA/G6PDA-/202G>A)andHbS*(0 HbAA,1 HbAS/HbSS)
27
Table2-Binary Logistic Regressi betwee independent variables a HL without
a with ris factors a interactions
Cases
129(43.3%)
Controls
169(56.7%)
P-
valueCrudeOR(95%CI) P-value AdjustedOR(95%CI)
GenderGroup
Female
Male
54(41.9%)
75(58.1%)
80(47.3%)
89(52.7%)
0.347
Reference
0.801[0.505-1.272]
0.024
Reference
0.312[0.113-0.860]
Agegroup
[2-14]:
[15-35]:
67(51.9%)
62(48.1%)
77(45.6%)
92(54.4%)
0.275
Reference
0.774[0.489-1.226]
0.130
Reference
2.047[0.809-5.181]
Malaria
infection
No:
Yes:
86(66.7%)
39(30.2%)
98(58%)
66(40.2%)
0.114
Reference
1.485[0.909-2.425]
0.053
Reference
2.885[0.987-8.435]
HbS
AA:
AS:
SS:
106(82.2%)
21(16.3%)
2(1.6%)
133(78.7%)
35(20.7%)
1(0.6%)
0.475
0.352
0.455
Reference
0.753[0.414-1.369]
2.509[0.224-28.051]
0.768
0.939
0.523
Reference
0.931[0.266-3.403]
2.470[0.154-39.633]
G6PDvariants
B
Non-B
66(51.2%)
63(48.8%)
86(50.9%)
83(49.1%)
0.962
Reference
0.989[0.625-1.564]
0.884
Reference
1.079[0.388-3.004]
RubellaIgG
Neg:
Pos:
36(27.9%)
93(72.1%)
64(37.4%)
107(62.6%)
0.111
Reference
1.497[0.912-2.458]
0.023
Reference
1.986[1.100-3.585]
Malaria
infection&Age
groups
0.084 0.0001
No&[2-14] Reference Reference
0.658[0.409-1.059] 0.123[0.039-0.385]
Malaria
infection&
Gender
0.168 0.046
No&Fem Reference Reference
1.448[0.856-2.451] 3.001[1.021-8.817]
G6PDvariants
&Gender
0.672 0.258
No&Fem Reference Reference
1.141[0.620-2.101] 1.804[0.649-5.014]
G6PDvariants
&Malaria
infection
0.844 0.459
B&No Reference Reference
1.051[0.639-1.729] 0.669[0.230-1.942]
G6PDvariants
&HbS*
0.436 0.643
B&HbAA Reference Reference
0.749[0.362-1.550] 0.738[0.204-2.668]
HbS*&Malaria
infection
0.960
0.506
HbAA&No Reference Reference
0.982[0.481-2.005] 1.264[0.634-2.522]
HL:Normalhearing 0 ReferenceCategoryisaresponsevariable;independentvariables:GenderGroup(0 Female,1
Male),agegroups(0 [2-14]years,1 [15-35]years),historyofMalariainfection(0 no,1 yes),ImmunityRubella(0
Negative,1 Positive),HbS(0 HbAAwildtype,1-HbAStrait,2 HbSShomozygotic),G6PDvariants(0 G6PDB,1
G6PDA/G6PDA-/202G>A)andHbS*(0 HbAA,1 HbAS/HbSS)
AinfeçãoporMalárianogrupomaisvelhoéprotectorparaasurdez,provavelmenteporqueaimaturidade
imunológicaeefeitodaototoxicidadenosmaisnovos
AinfeçãoporMalárianogéneromasculinotemumriscoelevadoparaasurdez(3vezes),provavelmentedevidoà
maiorexposiçãoaPFalciparumoueventualmenteuma
anemiahemolíticamaisagressivanogéneromasculino
quenofeminino.
REGRESSÃOLOGÍSTICABINÁRIAMÚLTIPLASENTRETODOSOSFACTORESDERISCOESURDEZ
27
Table2-Binary Logistic Regressi betwee independent variables a HL without
a with ris factors a interactions
Cases
129(43.3%)
Controls
169(56.7%)
P-
valueCrudeOR(95%CI) P-value AdjustedOR(95%CI)
GenderGroup
Female
Male
54(41.9%)
75(58.1%)
80(47.3%)
89(52.7%)
0.347
Reference
0.801[0.505-1.272]
0.024
Reference
0.312[0.113-0.860]
Agegroup
[2-14]:
[15-35]:
67(51.9%)
62(48.1%)
77(45.6%)
92(54.4%)
0.275
Reference
0.774[0.489-1.226]
0.130
Reference
2.047[0.809-5.181]
Malaria
infection
No:
Yes:
86(66.7%)
39(30.2%)
98(58%)
66(40.2%)
0.114
Reference
1.485[0.909-2.425]
0.053
Reference
2.885[0.987-8.435]
HbS
AA:
AS:
SS:
106(82.2%)
21(16.3%)
2(1.6%)
133(78.7%)
35(20.7%)
1(0.6%)
0.475
0.352
0.455
Reference
0.753[0.414-1.369]
2.509[0.224-28.051]
0.768
0.939
0.523
Reference
0.931[0.266-3.403]
2.470[0.154-39.633]
G6PDvariants
B
Non-B
66(51.2%)
63(48.8%)
86(50.9%)
83(49.1%)
0.962
Reference
0.989[0.625-1.564]
0.884
Reference
1.079[0.388-3.004]
RubellaIgG
Neg:
Pos:
36(27.9%)
93(72.1%)
64(37.4%)
107(62.6%)
0.111
Reference
1.497[0.912-2.458]
0.023
Reference
1.986[1.100-3.585]
Malaria
infection&Age
groups
0.084 0.0001
No&[2-14] Reference Reference
0.658[0.409-1.059] 0.123[0.039-0.385]
Malaria
infection&
Gender
0.168 0.046
No&Fem Reference Reference
1.448[0.856-2.451] 3.001[1.021-8.817]
G6PDvariants
&Gender
0.672 0.258
No&Fem Reference Reference
1.141[0.620-2.101] 1.804[0.649-5.014]
G6PDvariants
&Malaria
infection
0.844 0.459
B&No Reference Reference
1.051[0.639-1.729] 0.669[0.230-1.942]
G6PDvariants
&HbS*
0.436 0.643
B&HbAA Reference Reference
0.749[0.362-1.550] 0.738[0.204-2.668]
HbS*&Malaria
infection
0.960
0.506
HbAA&No Reference Reference
0.982[0.481-2.005] 1.264[0.634-2.522]
HL:Normalhearing 0 ReferenceCategoryisaresponsevariable;independentvariables:GenderGroup(0 Female,1
Male),agegroups(0 [2-14]years,1 [15-35]years),historyofMalariainfection(0 no,1 yes),ImmunityRubella(0
Negative,1 Positive),HbS(0 HbAAwildtype,1-HbAStrait,2 HbSShomozygotic),G6PDvariants(0 G6PDB,1
G6PDA/G6PDA-/202G>A)andHbS*(0 HbAA,1 HbAS/HbSS)
HbSéumahemoglobinopatiaquehabitualmenteestá
associadaaproteçãoàmalária.OtraçodeHbSsugerealgumaproteçãoparaasurdez,enquantoqueadoençaHbSpareceaumentaroriscoparaasurdez,quase2,5vezes.
HistóriadeMaláriasugereumaumentoderiscopróximo
de3vezes.
Maláriapodelevaraanemiahemolíticaelibertaçãode
mediadoresinflamatóriosquepodeminduzirasurdez.
Tambématerapêuticaantipalúdicapodedarorigema
surdez.
27
Table2-Binary Logistic Regressi betwee independent variables a HL without
a with ris factors a interactions
Cases
129(43.3%)
Controls
169(56.7%)
P-
valueCrudeOR(95%CI) P-value AdjustedOR(95%CI)
GenderGroup
Female
Male
54(41.9%)
75(58.1%)
80(47.3%)
89(52.7%)
0.347
Reference
0.801[0.505-1.272]
0.024
Reference
0.312[0.113-0.860]
Agegroup
[2-14]:
[15-35]:
67(51.9%)
62(48.1%)
77(45.6%)
92(54.4%)
0.275
Reference
0.774[0.489-1.226]
0.130
Reference
2.047[0.809-5.181]
Malaria
infection
No:
Yes:
86(66.7%)
39(30.2%)
98(58%)
66(40.2%)
0.114
Reference
1.485[0.909-2.425]
0.053
Reference
2.885[0.987-8.435]
HbS
AA:
AS:
SS:
106(82.2%)
21(16.3%)
2(1.6%)
133(78.7%)
35(20.7%)
1(0.6%)
0.475
0.352
0.455
Reference
0.753[0.414-1.369]
2.509[0.224-28.051]
0.768
0.939
0.523
Reference
0.931[0.266-3.403]
2.470[0.154-39.633]
G6PDvariants
B
Non-B
66(51.2%)
63(48.8%)
86(50.9%)
83(49.1%)
0.962
Reference
0.989[0.625-1.564]
0.884
Reference
1.079[0.388-3.004]
RubellaIgG
Neg:
Pos:
36(27.9%)
93(72.1%)
64(37.4%)
107(62.6%)
0.111
Reference
1.497[0.912-2.458]
0.023
Reference
1.986[1.100-3.585]
Malaria
infection&Age
groups
0.084 0.0001
No&[2-14] Reference Reference
0.658[0.409-1.059] 0.123[0.039-0.385]
Malaria
infection&
Gender
0.168 0.046
No&Fem Reference Reference
1.448[0.856-2.451] 3.001[1.021-8.817]
G6PDvariants
&Gender
0.672 0.258
No&Fem Reference Reference
1.141[0.620-2.101] 1.804[0.649-5.014]
G6PDvariants
&Malaria
infection
0.844 0.459
B&No Reference Reference
1.051[0.639-1.729] 0.669[0.230-1.942]
G6PDvariants
&HbS*
0.436 0.643
B&HbAA Reference Reference
0.749[0.362-1.550] 0.738[0.204-2.668]
HbS*&Malaria
infection
0.960
0.506
HbAA&No Reference Reference
0.982[0.481-2.005] 1.264[0.634-2.522]
HL:Normalhearing–0–ReferenceCategoryisaresponsevariable;independentvariables:GenderGroup(0–Female,1
–Male),agegroups(0–[2-14]years,1–[15-35]years),historyofMalariainfection(0–no,1–yes),ImmunityRubella(0
–Negative,1–Positive),HbS(0–HbAAwildtype,1-HbAStrait,2–HbSShomozygotic),G6PDvariants(0–G6PDB,1–
G6PDA/G6PDA-/202G>A)andHbS*(0–HbAA,1–HbAS/HbSS)
REGRESSÃOLOGÍSTICABINÁRIAMÚLTIPLASENTRETODOSOSFACTORESDERISCOESURDEZ
27
Table2-Binary Logistic Regressi betwee independent variables a HL without
a with ris factors a interactions
Cases
129(43.3%)
Controls
169(56.7%)
P-
valueCrudeOR(95%CI) P-value AdjustedOR(95%CI)
GenderGroup
Female
Male
54(41.9%)
75(58.1%)
80(47.3%)
89(52.7%)
0.347
Reference
0.801[0.505-1.272]
0.024
Reference
0.312[0.113-0.860]
Agegroup
[2-14]:
[15-35]:
67(51.9%)
62(48.1%)
77(45.6%)
92(54.4%)
0.275
Reference
0.774[0.489-1.226]
0.130
Reference
2.047[0.809-5.181]
Malaria
infection
No:
Yes:
86(66.7%)
39(30.2%)
98(58%)
66(40.2%)
0.114
Reference
1.485[0.909-2.425]
0.053
Reference
2.885[0.987-8.435]
HbS
AA:
AS:
SS:
106(82.2%)
21(16.3%)
2(1.6%)
133(78.7%)
35(20.7%)
1(0.6%)
0.475
0.352
0.455
Reference
0.753[0.414-1.369]
2.509[0.224-28.051]
0.768
0.939
0.523
Reference
0.931[0.266-3.403]
2.470[0.154-39.633]
G6PDvariants
B
Non-B
66(51.2%)
63(48.8%)
86(50.9%)
83(49.1%)
0.962
Reference
0.989[0.625-1.564]
0.884
Reference
1.079[0.388-3.004]
RubellaIgG
Neg:
Pos:
36(27.9%)
93(72.1%)
64(37.4%)
107(62.6%)
0.111
Reference
1.497[0.912-2.458]
0.023
Reference
1.986[1.100-3.585]
Malaria
infection&Age
groups
0.084 0.0001
No&[2-14] Reference Reference
0.658[0.409-1.059] 0.123[0.039-0.385]
Malaria
infection&
Gender
0.168 0.046
No&Fem Reference Reference
1.448[0.856-2.451] 3.001[1.021-8.817]
G6PDvariants
&Gender
0.672 0.258
No&Fem Reference Reference
1.141[0.620-2.101] 1.804[0.649-5.014]
G6PDvariants
&Malaria
infection
0.844 0.459
B&No Reference Reference
1.051[0.639-1.729] 0.669[0.230-1.942]
G6PDvariants
&HbS*
0.436 0.643
B&HbAA Reference Reference
0.749[0.362-1.550] 0.738[0.204-2.668]
HbS*&Malaria
infection
0.960
0.506
HbAA&No Reference Reference
0.982[0.481-2.005] 1.264[0.634-2.522]
HL:Normalhearing–0–ReferenceCategoryisaresponsevariable;independentvariables:GenderGroup(0–Female,1
–Male),agegroups(0–[2-14]years,1–[15-35]years),historyofMalariainfection(0–no,1–yes),ImmunityRubella(0
Negative,1 Positive),HbS(0 HbAAwildtype,1-HbAStrait,2 HbSShomozygotic),G6PDvariants(0 G6PDB,1
G6PDA/G6PDA-/202G>A)andHbS*(0 HbAA,1 HbAS/HbSS)
27
Table2-Binary Logistic Regressi betwee independent variables a HL without
a with ris factors a interactions
Cases
129(43.3%)
Controls
169(56.7%)
P-
valueCrudeOR(95%CI) P-value AdjustedOR(95%CI)
GenderGroup
Female
Male
54(41.9%)
75(58.1%)
80(47.3%)
89(52.7%)
0.347
Reference
0.801[0.505-1.272]
0.024
Reference
0.312[0.113-0.860]
Agegroup
[2-14]:
[15-35]:
67(51.9%)
62(48.1%)
77(45.6%)
92(54.4%)
0.275
Reference
0.774[0.489-1.226]
0.130
Reference
2.047[0.809-5.181]
Malaria
infection
No:
Yes:
86(66.7%)
39(30.2%)
98(58%)
66(40.2%)
0.114
Reference
1.485[0.909-2.425]
0.053
Reference
2.885[0.987-8.435]
HbS
AA:
AS:
SS:
106(82.2%)
21(16.3%)
2(1.6%)
133(78.7%)
35(20.7%)
1(0.6%)
0.475
0.352
0.455
Reference
0.753[0.414-1.369]
2.509[0.224-28.051]
0.768
0.939
0.523
Reference
0.931[0.266-3.403]
2.470[0.154-39.633]
G6PDvariants
B
Non-B
66(51.2%)
63(48.8%)
86(50.9%)
83(49.1%)
0.962
Reference
0.989[0.625-1.564]
0.884
Reference
1.079[0.388-3.004]
RubellaIgG
Neg:
Pos:
36(27.9%)
93(72.1%)
64(37.4%)
107(62.6%)
0.111
Reference
1.497[0.912-2.458]
0.023
Reference
1.986[1.100-3.585]
Malaria
infection&Age
groups
0.084 0.0001
No&[2-14] Reference Reference
0.658[0.409-1.059] 0.123[0.039-0.385]
Malaria
infection&
Gender
0.168 0.046
No&Fem Reference Reference
1.448[0.856-2.451] 3.001[1.021-8.817]
G6PDvariants
&Gender
0.672 0.258
No&Fem Reference Reference
1.141[0.620-2.101] 1.804[0.649-5.014]
G6PDvariants
&Malaria
infection
0.844 0.459
B&No Reference Reference
1.051[0.639-1.729] 0.669[0.230-1.942]
G6PDvariants
&HbS*
0.436 0.643
B&HbAA Reference Reference
0.749[0.362-1.550] 0.738[0.204-2.668]
HbS*&Malaria
infection
0.960
0.506
HbAA&No Reference Reference
0.982[0.481-2.005] 1.264[0.634-2.522]
HL:Normalhearing 0 ReferenceCategoryisaresponsevariable;independentvariables:GenderGroup(0 Female,1
Male),agegroups(0 [2-14]years,1 [15-35]years),historyofMalariainfection(0 no,1 yes),ImmunityRubella(0
Negative,1 Positive),HbS(0 HbAAwildtype,1-HbAStrait,2 HbSShomozygotic),G6PDvariants(0 G6PDB,1
G6PDA/G6PDA-/202G>A)andHbS*(0 HbAA,1 HbAS/HbSS)
REGRESSÃOLOGÍSTICABINÁRIAMÚLTIPLASENTRETODOSOSFACTORESDERISCOESURDEZ
QuemtemavarianteG6PDdefeédogéneromasculino,sugereumaumentoderiscoparaasurdez.G6PDdefémaisprevalentecomodoençanogéneromasculinoporqueéhemizigótica,apresentandomaioranemia
hemolítica,comelevadoriscoparaasurdez.QuemtemavarianteG6PDnão-Betemmalária,sugereumadiminuiçãoderiscoparaasurdez.G6PDdeftemum
efeitoprotectorparaamaláriasevera,nestaamostrater
G6PDvariantenão-BactuacomoprotectorparaasurdezG6PDdefeHbSsugereumefeitoprotectornodesenvolvimentodemaláriasevera.Nestaamostrater
G6PDvariantenão-BeHbSestãoaactuarcomo
protectoresparaasurdezQuemtemHbSemalária,sugereumriscoaumentadodetersurdez.HbStemumefeitoprotectorparao
desenvolvimentodemaláriasevera,mastambémtem
ummecanismoquepodeinduzirsurdeznestaamostra,
aumentadoorisco.
OUTROSPROJETOS
• EducaçãoparaaSaúde
• AdaptaçãodePróteses
Auditivas
• TerapiadaFala
• STP:Desenvolvimentode
LínguaGestual
• RastreioAuditivoNeonatal
• ImplementaçãodaVacinada
Rubéola
• TelemedicinaORL
• Treinomédicoespecializado
emORL,emespecialpara
médicosdeSTP
• EducaçãoparaaSaúde
• AdaptaçãodePróteses
Auditivas
• TerapiadaFala
• STP:Desenvolvimentode
LínguaGestual
• RastreioAuditivoNeonatal
• ImplementaçãodaVacinada
Rubéola
• TelemedicinaORL
• Treinomédicoespecializado
emORL,emespecialpara
médicosdeSTP
OUTROSPROJETOS
• EducaçãoparaaSaúde
• AdaptaçãodePróteses
Auditivas
• TerapiadaFala
• STP:Desenvolvimentode
LínguaGestual
• RastreioAuditivoNeonatal
• ImplementaçãodaVacinada
Rubéola
• TelemedicinaORL
• Treinomédicoespecializado
emORL,emespecialpara
médicosdeSTP
CONSIDERAÇÕESFINAIS
OUTROSPROJETOS
• EducaçãoparaaSaúde
• AdaptaçãodePróteses
Auditivas
• TerapiadaFala
• STP:Desenvolvimentode
LínguaGestual
• RastreioAuditivoNeonatal
• ImplementaçãodaVacinada
Rubéola
• TelemedicinaORL
• Treinomédicoespecializado
emORL,emespecialpara
médicosdeSTP
CONSIDERAÇÕESFINAIS
OUTROSPROJETOS
• EducaçãoparaaSaúde
• AdaptaçãodePróteses
Auditivas
• TerapiadaFala
• STP:Desenvolvimentode
LínguaGestual
• RastreioAuditivoNeonatal
• ImplementaçãodaVacinada
Rubéola
• TelemedicinaORL
• Treinomédicoespecializado
emORL,emespecialpara
médicosdeSTP
CONSIDERAÇÕESFINAIS
OUTROSPROJETOS
• EducaçãoparaaSaúde
• AdaptaçãodePróteses
Auditivas
• TerapiadaFala
• STP:Desenvolvimentode
LínguaGestual
• RastreioAuditivoNeonatal
• ImplementaçãodaVacinada
Rubéola
• TelemedicinaORL
• Treinomédicoespecializado
emORL,emespecialpara
médicosdeSTP
CONSIDERAÇÕESFINAIS
OUTROSPROJETOS
• EducaçãoparaaSaúde
• AdaptaçãodePróteses
Auditivas
• TerapiadaFala
• STP:Desenvolvimentode
LínguaGestual
• RastreioAuditivoNeonatal
• ImplementaçãodaVacinada
Rubéola
• TelemedicinaORL
• Treinomédicoespecializado
emORL,emespecialpara
médicosdeSTP
CONSIDERAÇÕESFINAIS
OUTROSPROJETOS
• EducaçãoparaaSaúde
• AdaptaçãodePróteses
Auditivas
• TerapiadaFala
• STP:Desenvolvimentode
LínguaGestual
• RastreioAuditivoNeonatal
• ImplementaçãodaVacinada
Rubéola
• TelemedicinaORL
• Treinomédicoespecializado
emORL,emespecialpara
médicosdeSTP
CONSIDERAÇÕESFINAIS
OUTROSPROJETOS
PerspectivasCirúrgicas
• Follow-updosprojectos
• TreinomédicoespecializadodeORLamédicosgeneralistasdeSTP
• Identificaçãoprecocedesurdez,follow-upeidentificaçãodeoutrosfactoresderisco
• RastreiodeG6PDemSTP
PerspectivasFuturas–G6PDDefeLinguagemOral
Normouvinte
SemOralidadeComOralidade
G6PDVar
ìG6PDA+
ìG6PDA-
PerspectivasFuturas–G6PDDef– Surdez-Hipertensão
G6PDVar
ì Susceptibilidadeàs
infeções
ìHemólise
íOxidoNítrico
ì SurdezNS ìHipertensão
ììMasc
ìFeminino
OxidoNitrico(NO)– Efeitovasodilatadorarteriolar
ArtCoclear
PerspectivasFuturas– Toxoplasmose
Amostra
HipoacusiaNeurosensorialNormouvintebil
IgGToxoplasmose
ìIgGToxop
Equipamultidisciplinar
Familiares/Educadores
TerapêutadaFala
Reabilitaçãoauditiva
Audiologistas
Médicos
Psicólogos