Ototoxic hearing loss from antimalarials: a systematic narrative review

Lauren K. Dillard*, Amanda M. Fullerton, Catherine M. McMahon

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

5 Citations (Scopus)


Background: Drugs used in curative and prophylactic antimalarial treatment may be ototoxic and lead to permanent hearing loss, but there is no consensus regarding prevalence and permanence of ototoxic hearing loss caused by antimalarials. The purpose of this systematic narrative review was to synthesize current evidence on antimalarial ototoxicity in human populations. Method: Studies published between 2005 and 2018 that reported prevalence of post-treatment hearing loss in individuals treated for malaria were included. Results: Twenty-two studies including data from 21 countries were included. Primary themes of the included studies were to evaluate drug safety and/or efficacy (n = 13) or ototoxic effects of drugs (n = 9). Hearing data were measured objectively in 9 studies. Five studies focused on quinine (or derivates), 10 focused on artemisinin combination therapies, and 7 considered multiple drug combinations. There is a paucity of evidence that thoroughly reports potentially permanent ototoxic effects of antimalarials. Conclusions: Antimalarial drugs may be ototoxic in some cases. More research in human populations is needed to describe ototoxicity of current antimalarials and of future drugs that will be used/developed in response to antimalarial resistance. It is recommended that randomized trials evaluating drug safety objectively measure and report ototoxic hearing loss as an adverse event.

Original languageEnglish
Article number102117
Pages (from-to)1-11
Number of pages11
JournalTravel Medicine and Infectious Disease
Publication statusPublished - Sept 2021


  • malaria
  • deafness
  • adverse drug event


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