A cross-sectional investigation on the hearing findings of leprosy patients in Maluku, rural Indonesia

Background: Leprosy, a neglected tropical illness caused by Mycobacterium leprae, has a substantial socioeconomic and psychological impact in Indonesia, which ranks third in global prevalence. Despite well-documented dermatological and neurological effects, auditory problems of leprosy, such as hearing loss, remain largely unknown. The purpose of this study is to look at the spectrum of hearing impairment in leprosy patients in Maluku, Indonesia's highest leprosy burden area, and to identify critical variables that may lead to hearing loss in these individuals.Methods: A cross-sectional study of 98 leprosy patients was carried out in Maluku, Indonesia. Audiological evaluations included otoacoustic emissions to measure cochlear function and pure tone audiometry to test hearing sensitivity. Bivariate analyses were used to compare group characteristics, with statistical significance defined at p<0.05. The study followed STROBE principles for transparent reporting.Results: Among 98 patients (196 ears) evaluated, 26% had hearing loss, primarily sensorineural (71.7%) and of mild severity (76.5%). The median age of participants was 32 years, and older patients (>40 years) had considerably higher hearing thresholds (p<0.001). Leprosy reactions were associated with higher hearing thresholds at 4000 Hz (p=0.015), and corticosteroid therapy was linked to better hearing outcomes in individuals with reactions.Conclusion: This study reveals a significant prevalence of sensorineural hearing loss among leprosy patients in Maluku, which is strongly associated with age and leprosy responses. Corticosteroid medication appears to have a protective effect on hearing function, highlighting the importance of regular auditory examinations and focused therapies to enhance patient outcomes in this population.