Predictors of hearing loss in school entrants in a developing country.
BACKGROUND
Hearing loss is a prevalent and significant disability that impairs functional development and educational attainment of school children in developing countries. Lack of a simple and practical screening protocol often deters routine and systematic hearing screening at school entry.


OBJECTIVE
To identify predictors of hearing loss for a practical screening model in school-aged children.


METHODS
Community-based, retrospective case-control study of school entrants in an inner city.


METHODS
Results from the audiologic and non-audiologic examination of 50 hearing impaired children in randomly selected mainstream schools were compared with those of a control group of 150 normal hearing children, matched for age and sex from the same population. The non-audiologic evaluation consisted of medical history, general physical examination, anthropometry, motor skills, intelligence and visual acuity while the audiologic assessment consisted of otoscopy, audiometry and tympanometry.


METHODS
Multiple logistic regression analysis of significant variables derived from univariate analysis incorporating student t-test and chi-square.


RESULTS
Besides parental literacy (OR:0.3; 95% CI:0.16-0.68), non-audiologic variables showed no association with hearing loss. In contrast, most audiologic indicators, enlarged nasal turbinate (OR:3.3; 95% CI:0.98-11.31), debris or foreign bodies in the ear canal (OR:5.4; 95% CI:1.0-36.03), impacted cerumen (OR:6.2; 95% CI:2.12-14.33), dull tympanic membrane (OR:2.2; 95% CI:1.10-4.46), perforated ear drum (OR:24.3; 95% CI:2.93-1100.17) and otitis media with effusion OME (OR:14.2; 95% CI:6.22-33.09), were associated with hearing loss. However, only parental literacy (OR:0.3; 95% CI:0.16-0.69), impacted cerumen (OR:4.0; 95% CI:1.66-9.43) and OME (OR:11.0; 95% CI:4.74-25.62) emerged as predictors.


CONCLUSIONS
Selective screening based on the identification of impacted cerumen and OME will facilitate the detection of a significant proportion of hearing impaired school entrants.
Olusanya
B O
BO
Institute of Child Health, LUTH, Lagos. b.olusanya@ich.ucl.ac.uk
Okolo
A A
AA
Aderemi
A A
AA
D016022:Case-Control Studies; D002571:Cerumen; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D004522:Educational Status; D005260:Female; D034381:Hearing Loss / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D008403:Mass Screening; D009549:Nigeria / Q000453:epidemiology; D010034:Otitis Media with Effusion / Q000453:epidemiology; D010290:Parents; D012189:Retrospective Studies; D012307:Risk Factors