Dosage - a film to raise awareness of aminoglycoside-induced hearing loss - on YouTube
Aminoglycoside antibiotics are widely used to treat infections, such as cellulitis and tuberculosis, as they have low manufacturing costs, therefore they are relatively cheap and so are accessible in economically disadvantaged societies. However, there is little awareness that these drugs are toxic to the inner ear and therefore carry a risk of hearing loss.
Dr Adebolajo Adeyemo is a Senior Medical Research Fellow and Consultant ENT Surgeon at the College of Medicine, University of Ibadan and University College Hospital Ibadan.
In this article he describes his project, supported by the DELTAS Africa Community and Public Engagement (CPE) Seed Fund, which aimed to raise awareness of aminoglycoside-induced hearing loss through the creation of a movie.
The Silent Plague
Hearing loss is the most prevalent chronic disability worldwide. The aminoglycoside family of antibiotics, including streptomycin, gentamycin and amikacin are effective against a range of bacterial infections. The high prevalence of bacterial diseases including tuberculosis and the relatively low cost of aminoglycosides, means these antibiotics are widely used in sub-Saharan Africa.
However, there is limited awareness of the potential risks associated with their use. Aminoglycosides can cause inner ear hair cell death (ototoxicity), which can result in hearing damage. The risk of this varies between aminoglycosides, the susceptibility of individuals and the duration of use of the aminoglycosides.
Without action to change how these antibiotics are used, this may worsen the burden of hearing loss in Africa and impair efforts to curtail deafness in the society.
Project aims
Currently, there are limited efforts to address aminoglycoside-induced hearing loss in Nigeria despite the huge exposure of the country’s population to aminoglycosides. This project therefore sought to investigate how to effectively raise awareness of the potential side effects of aminoglycosides and how the accessibility and dispensing of these drugs can be better managed to reduce the impact of its adverse effect.
Our aims were to make valid and adequate information accessible to the Nigerian society on the impacts of aminoglycosides on hearing, with emphasis on gentamycin. The goal was to engage patients, their families, and the society at large to instigate change to better control the use of these drugs and limit the resulting hearing loss.
Nollywood brings the issue to the public
The Nigerian movie industry, known as Nollywood, is renowned as one of the largest in the world. We set out to use these resources to produce a movie to highlight the risks of hearing loss to communities in Nigeria in a captivating way.
The storyline was developed by interviewing people whose hearing had been affected using these drugs. A 30-min Nollywood drama movie – Dosage – was scripted, casted and produced, with the plot inspired by these real-life stories. The movie included a recorded interview with a real person who suffered hearing loss secondary to aminoglycoside usage and an education session on preventing hearing loss through controlled use of these antibiotics.
A second version of the movie in Yoruba language was also made to make the movie and the message accessible to a wider audience. Yoruba is the main language in southwest Nigeria and is one of the three main languages in Nigeria. It is also spoken in neighbouring West African countries of Togo, Republic of Benin, and Cote d’Ivoire.
Screening the movie and conducting education sessions for at-risk groups
The movie was shown to groups of patients at the University College Hospital in Ibadan. Appropriate information was provided, and questions sought on issues related to aminoglycoside ototoxicity. The knowledge gap of viewers before and after the movie was measured via a questionnaire. CD copies of the movie will also be distributed for use by public health nurses in hospitals across Ibadan, Nigeria.
Using social media and community word-of-mouth to reach wider society
The movie was posted to YouTube so that it can be freely accessed by anyone with internet access. In addition, the movie was promoted by sharing the YouTube link through social media outlets such as WhatsApp and Instagram. Members of the public were encouraged to view the movie and share the link to increase the viewership of the movie and help to reach out to the society.
In addition to the use of social media, individuals who saw the movie promoted it to their family and friends through word-of-mouth. This can be an effective method of sharing the message in communities as individuals receive reviews from people that they have strong relationships with, and so they trust that the movie will also be valuable to them and thus are likely to engage.
Impact
This project has helped to successfully push aminoglycoside-induced ototoxicity into the public domain in Nigeria. The awareness created by the movie to the inherent hearing related dangers of aminoglycosides has promoted additional discussions and engagement.
The movie was shared with 100 hospital patients. This session enabled us to seed adequate information into the primary target group as well as a secondary group of care givers and relations. It is expected that the information provided will positively influence the actions of the recipients. It is also anticipated that the recipients will pass the information gained to other members of the society. Based on the responses to the questionnaire, it was deduced that several people were not aware of the side effects of aminoglycosides before this project, but seeing the movie increased their awareness. It also generated feedback of personal experiences; many viewers shared their experiences (or of people close to them) of hearing related side effects after using an aminoglycoside antibiotic.
The movie has been viewed many times on YouTube, demonstrating that the use of social media is effective in reaching a wider audience in society. Through online hosting the movie can be accessed at any time by people who desire to acquire knowledge on aminoglycoside-induced hearing loss; the word-of-mouth referral and the self-perpetuating nature of social media will allow the message to be shared well beyond the life span and funding of the project.
We believe this project will help increase constraint on the abuse of aminoglycoside antibiotics and positively impact regulation of over-the-counter sale of aminoglycoside antibiotics.
Learning
Acceptance of the results of scientific research in communities is dependent on effective public engagement, however, this requires innovative approaches to capture the attention of the public. We learnt that a good movie with a compelling story line successfully captured the attention of our target audience, enabling us to conduct engaging and effective public health messaging.
Though the primary target of this project was aminoglycoside-induced ototoxicity, the strategies gained could be deployed to target other health issues.
Since the goal of science is to help humans and the world we live in, it is a worthwhile investment to engage CPE activities in disseminating the outcomes of scientific research.
The movie was produced by Oladipo O’Fresh of Fresh Pro Multimedia studios
This report is part of the DELTAS Africa CPE Seed Fund Programme Hub
This work is licensed under a Creative Commons Attribution 4.0 International License
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