1. g Prevalence of Hearing Impairment in School Children Results
Tahir Hussain, Abdullah A. Alghasham, Muhammad Raza
College of Medicine, Qassim University, Qassim
Results
Introduction
Hearing impairment (HI) is a handicap, which can be corrected therapeutically, as well as can be helped with amplification. HI is usually associated with a loss of communication1, in the young children it will also impair the normal development of speech and language2. The poverty of language in school children also affects reading skills and diminished functional status3. Early childhood HI may have a negative effect on educational outcome and employment in adulthood4. Persons with HI are likely to have lower family incomes, less educated and unemployed5. Early identification of HI followed by a timely and effective intervention is necessary to minimize the negative effects of HI on the development of cognition, psychological and verbal communication skills6.
Among 5120 children, 2730 (53.328%) were male and 2390 (46.796%) were females showing male predominance with male to female ratio being 1.4:1. There was no significant difference of HI between males (14.1%) and females (13.01%). Most of the children 4424 (86.4%) were found to have normal hearing i.e. less than 25 dB, and 696 (13.65%) had any degree of hearing loss i.e. hearing threshold more than 25 dB. Among 696 children who had HI, most 616 (12.03%) had mild hearing loss i.e. 26 to 40 dB. 42 (0.82%) children had moderate hearing loss i.e. 41 to 50 dB, 30 (0.59%) had moderate severe hearing loss i.e. 51 to 70 dB while 8 (0.16%) children had severe hearing loss i.e. 71 to 90 dB. No student was found profound deaf. Among the hearing impaired children most of them 614 (88.2%) had conductive hearing loss, 58 (8.3%) had Sensorineural hearing loss and 24 (3.5%) children had mixed type of hearing loss. In those children having conductive type of hearing loss 614 (88.2%), otoscopic examination was done and majority of 376 (61.2%) were found to have impacted wax in one or both ears.78 (12.7%) children had unilateral or bilateral discharging ears suggestive of chronic suppurative otitis media. Other less common findings were fungal infection in 10 (1.6%) and foreign body in 8 (1.3%) children. 122 (19.9%) children had no positive finding on otoscopic examination.
Discussion / Conclusions
In Karachi HI in school children is 13.6%. Impacted wax was found to be the most common problem which can be very easily managed. The next common finding was history of ear discharge and it showed a very significant cause of conductive HI. History of taking ototoxic drugs had HI 10× > the children having no such history. Noise induced sensorineural HI was found 3.37%.
Recommendations
The message that we wish to convey is that neonatal screening, pre-school checkup, intra-school assessment and post-school audiometric evaluation must be a part of national health policy, in line with WHO mandate.
Cousin marriages should be discouraged.
Aminoglycoside antibiotics must be given in absolute indication, taking care of contraindications and for the shortest possible duration.
Reduction in environmental noise, periodic ear examination, removal of impacted wax and early treatment of ear discharge should be the priorities.
This work was part of dissertation submitted to College of Physicians and Surgeons Pakistan in partial fulfillment of requirements of FCPS. (T. Hussain)
Objectives
The main objective was to determine the hearing level in Karachi’s school children between ages 5-15 years and to determine the prevalence of HI in the same cohorts of children with matching variables and also to identify the causes of deafness and hearing impairment in the same cohorts.
Methodology
A survey was conducted between in 170 schools of Karachi. The prevalence of HI in Karachi’s school children between the ages of 5 – 15 years of both genders and studying in normal school was studied. There are million children registered in 2988 schools in Karachi. From each school 30 children from different classes were randomly selected with total of 5120 children. Hearing assessment was carried out using standard procedure with a portable audiometer. The threshold of hearing was measured at 250, 500, 1000, 2000 and 4000Hz, respectively, and data was recorded. Children were labeled as hearing impaired if they did not respond to tone in the range of 25 dB and below, in any frequency tested as per WHO protocol7. Children with HI were subjected to otoscopy. Later on, parents of children having HI were interviewed regarding ear discharge, family history of HI, drug history, noise exposure, and parent’s consanguinity.
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