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Hearing impairment and ear pathology in Nepal

Published online by Cambridge University Press:  29 June 2007

Paul Little ,
Alison Bridges ,
Rajendra Guragain ,
Del Friedman ,
Rakesh Prasad  and
Neil Weir
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Abstract

A stratified random cluster sample of 15,845 subjects was performed in two regions of Nepal to determine the prevalence and main causes of hearing impairment (the most common disability) and the prevalence of ear disease. Subjects reporting current ear pain, or ear discharge, or hearing impairment on direct questioning by a Nepali health worker (primary screening failed), had otoscopy and audiometry (using the Liverpool Field Audiometer) performed, and a questionnaire administered relating to past history. In every fifth house subjects who passed the primary screening (1,716 subjects) were examined to assess the false negative rate of screening. An estimated 16.6 per cent of the study population have hearing impairment (either ear worse than 30 dB hearing threshold level (HTL) 1.0–4.0 kHz, or 50 dB HTL 0.5 kHz), and 7.4 per cent ear drum pathology, equivalent to respectively 2.71 and 1.48 million people extrapolated to the whole of Nepal. Most hearing impairment in the school age group (55.2 per cent) is associated with otitis media or its sequelae. Probably at least 14 per cent of sensorineural deafness is preventable (7 per cent infectious disease, 3.9 per cent trauma, 0.8 per cent noise exposure, 1 per cent cretinism, and 1 per cent abnormal pregnancy or labour). Most individuals reporting current ear pathology (61 per cent) had never attended a health post, and of those receiving ear drop treatment, 84 per cent still had serious pathology. Of subjects who reported ear drop treatment at any time, 31 per cent still had serious pathology. The use of traditional remedies was prevalent.

In conclusion this study shows high prevalences of hearing impairment and ear drum pathology. To reduce hearing impairment in Nepal, particularly in the school age group, a priority should be the effective treatment of otitis media.

Keywords

DeafnessEar diseasesData collectionNepal
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 107 , Issue 5 , May 1993 , pp. 395 - 400
Copyright
Copyright © JLO (1984) Limited 1993

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Footnotes

This study was performed by the Britain-Nepal Otology Service (BRINOS) in collaboration with the ENT Department at Tribhuvan University Teaching Hospital (TUTH). The Hearing Impairment Research Group, Department of International Community Health, Liverpool School of Tropical Medicine, and Community Medicine Department of TUTH acted as advisors for the study. Some of the methods and a summary of the results were presented at the Section of Otology of the Royal Society of Medicine (6 March 1992).

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