title: The risk of hearing loss in a population with a high prevalence of chronic suppurative otitis media.
abstract: BACKGROUND
  Chronic suppurative otitis media (CSOM) affects 65-330 million people in the developing part of the world and develops in early childhood. Knowledge of the long-term effects on hearing is scarce. Hearing loss (HL) can cause reduced ability to communicate, impair language development and academic skills.
  
  
  OBJECTIVE
  To estimate the prevalence of HL in a population with a high-risk of CSOM and to identify the risk of permanent hearing loss from CSOM.
  
  
  METHODS
  Ten and 15 years follow-up of two Greenlandic population-based children cohorts. Participants underwent otologic examination and audiometric evaluation. HL was defined using both the American Speech-Language-Hearing Association's (ASHA) and the World Health Organizations's (WHO) definition. Risk factors for HL were analyzed, using binomial logistic regression analysis.
  
  
  RESULTS
  A total of 438 individuals aged 11-24 years participated. Using the ASHA definition of HL the prevalence was 50% (95% CI 45.3-54.7). Using the WHO definition of HL the prevalence was 2.5% (95% CI 1.1-3.98). CSOM was the main cause of HL. Co-existing CSOM (OR 16.7, 95% CI 8.29-33.65), spontaneous healing from CSOM (OR 3.75, 95% CI 1.62-8.67), and male gender (OR 2.2, 95% CI 1.28-3.78) were associated with HL. Ninety-one percent of children with CSOM developed a permanent hearing loss >15dBHL.
  
  
  CONCLUSIONS
  CSOM was strongly associated with permanent hearing loss. CSOM was the main reason for HL in this population. The WHO definition of hearing loss is likely to underestimate the burden of hearing loss among children and adolescents in developing countries with a high prevalence of CSOM.
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Rigshospitalet, University Hospital of Copenhagen, Denmark. ramon@dadlnet.dk
authors.forename: Ramon Gordon
authors.initials: RG
authors.lastname: Jensen
authors.forename: Anders
authors.initials: A
authors.lastname: Koch
authors.forename: Preben
authors.initials: P
authors.lastname: Homøe
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000704:Analysis of Variance; D001299:Audiometry / Q000379:methods; D001301:Audiometry, Pure-Tone; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006116:Greenland / Q000453:epidemiology; D034381:Hearing Loss / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010035:Otitis Media, Suppurative / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D014944:World Health Organization; D055815:Young Adult
keywords: Adolescent; Children; Chronic suppurative otitis media; Developing countries; Epidemiology; Hearing loss; Risk factors