Hearing impairment and ear diseases among children of school entry age in rural South India

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Abstract

Objective: To find out the prevalence and causes of hearing impairment among children of school-entry age, in rural areas of coastal south India. Methods: The study adopted the World Health Organization (WHO) guidelines viz., ‘The Prevalence of Ear and Hearing Disorders Protocol’. A total of 855 children studying in the first year of school were examined using a Portable Pure Tone Audiometer and an Otoscope. Children with hearing impairment were re-examined to find out the type of hearing impairment. Mothers of all children were interviewed in their homes, in order to obtain details of socio-economic status, family history and history of consanguinity. Results: Hearing impairment was detected in 102 children (11.9%) and impacted wax was found to be the most common cause of hearing impairment (86.3%). On re-testing, it was predominantly conductive hearing impairment (81.6%) observed among 74 of these children. The prevalence of hearing impairment was significantly lower among children belonging to high socio-economic status (P=0.0036). Conclusions: Hearing impairment and preventable ear diseases were found to be important health problems among children of school-entry age group in this region. Regular screening of children of school-entry age will ensure that children begin their school-life without this disability.

Introduction

Hearing impairment in children is a major public health problem in developing countries. It is unfortunate that hearing impairment obstructs their overall development. The World Health Organization (WHO) suggests that, in developing countries, children should be screened at school entry using a simple audiometer and that the external ear be inspected for the presence of discharge, to study the extent of the problem in the community [1].

Numerous studies have been carried out to find out the prevalence of hearing impairment in children. A study carried out in Finland [2] reports a prevalence of 2.5% whereas a study from a developing country like Kenya reveals a prevalence rate of 5.6% [3]. Studies carried out in India report prevalence rates ranging from 5.5% in Punjab [4] to 21.6% in Lucknow [5].

The present study was conducted with the aim of finding out the prevalence and causes of hearing impairment among children of school entry age, in rural areas by adopting the WHO Protocol [6].

Section snippets

Background information

The study was carried out in schools situated in the Rural Field Practice Area of the Department of Community Medicine, Kasturba Medical College (KMC), Manipal, South India. The field practice area covers a population of about 44 000 spread out in twelve coastal villages of Udupi Taluk (a subdivision of Udupi District, Karnataka State). The population in these villages is homogeneous in terms of occupation, socio-economic status, literacy, food habits and health related beliefs and practices.

Results

A total of 33 schools were visited and 880 children examined. Among these, 25 children were uncooperative and hence excluded from the study. Thus, a total of 855 children were included in the study. Of the total 855 children examined, 102 had hearing impairment i.e., a prevalence of 11.9%. The distribution of children according to age and sex is shown in Table 1. Most of the children (79.9%) were 5 years old and a majority were boys (52.6%). Prevalence of hearing impairment was slightly higher

Discussion

This study shows that hearing impairment and preventable ear diseases are important health problems among children of school entry age in rural areas. A study of hearing impairment among school going children in the same district [9], revealed a prevalence of 8.8%. Reports of studies carried out in rural areas of India [5], [10], [11] and of developing countries like Malaysia and Tanzania [12], [13] show that the prevalence of hearing impairment among rural school children varies from 5.5 to

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