Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-28T06:20:58.356Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access Rights & Permissions [Opens in a new window]

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

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).

References

Bridges, A. M., Little, P. S., Guragain, R., Prasad, R., Weir, N. (1992) The Liverpool Field Audiometer in a developing country. The Journal of Audiological Medicine, 1: 81–88Google Scholar
Brobby, G. W. (1988) Causes of congenital and acquired total sensorineural hearing loss in Ghanaian children. Tropical Doctor, 18: 30–32Google Scholar
Browning, G. G. (1986) In: Clinical Otology and Audiology. Butterworths.Google Scholar
Clifford, P. (1968) Causes of deafness in Africa. In: Report on the first seminar on deafness to be held in Africa, 1968. Commonwealth Society for the Deaf. Nairobi, Kenya, p. 54–58Google Scholar
Couldrey, E. (1968) Speech and hearing problems in Africa. In: Report on the first seminar on deafness to be held in Africa, 1968. Commonwealth Society for the Deaf. Nairobi, Kenya, p. 58–72Google Scholar
Davis, A. C. (1989) The prevalence of hearing impairment and reported hearing disability among adults in Great Britain. International Journal of Epidemiology, 18 (4): 911–917Google Scholar
Eason, R. J., Harding, E., Nicholson, D., Pada, J., Gathercole, J. (1986) Chronic suppurative otitis media in the Solomon Islands: a prospective, microbiological, audiometric and therapeutic survey. New Zealand Medical Journal, 99, 812–815Google ScholarPubMed
Ensign, P. R., Urbanich, E. M, Moran, M. (1960) Prophylaxis for otitis media in an Indian population. American Journal of Public Health, 50: 195–199CrossRefGoogle Scholar
Farid, H., Girgis, I. H. (1966) Causes and prevention of deafness in Egyptian children at school age. Journal of Egyptian Medical Association, 49: 293–301Google ScholarPubMed
Gray, R. F. (1989) Causes of deafness in schools of the deaf in Madras. International Journal of Pediatic Otorhinolaryngology, 18 (2): 97–106CrossRefGoogle ScholarPubMed
Hatchuel, W., Beron, A. (1965) Hearing loss in children: an investigation into the incidence of hearing defects among children attending a South African primary school, South African Medical Journal, 39: 130–136Google ScholarPubMed
Hinchcliffe, R. (1981) Clinical tests of auditory function in the adult and the school child. In: Audiology and Audiological Medicine. (Beagley, H. A., ed.) Oxford University Press, p. 319–364Google Scholar
Hinchcliffe, R., Miall, W. E. (1965) Deafness in Jamaica (a pilot survey of a sample rural population), West Indian Medical Journal, 14: 241–246Google Scholar
Holborow, C., Martinson, F., Anger, N. (1982) A study of deafness in West Africa, International Journal of Pedialric Otorhinolaryngology, 4: 107–132CrossRefGoogle ScholarPubMed
Kakar, P. K. (1975) Sensorineural deafness and its prevention. In: Problems of Deafness in the Newer World, Proceedings of a Seminar convened by the Commonwealth Society for the Deaf, September 1974, The Commonwealth Foundation, Occasional paper no. XXXIV: 105–106Google Scholar
Kapur, Y. P. (1967) Study of the aetiology and pattern of deafness in a School for the Deaf in Madras, In: Proceedings of Congress the World Federation of Deaf, Warsaw.Google Scholar
Lewis, A. N., Coman, W., McCafferty, G., Shaw, E. (1977) The prevalence of ear disease in Queensland Aboriginals, Journal of the Otolaryngology Society of Australia, 4 (2): 112–126Google Scholar
McPherson, B., Holborow, C. (1985) A study of deafness in West Africa, the Gambian hearing health project, International Journal of Pediatric Otorhinolaryngology, 10: 115–135Google Scholar
McPherson, B., Knox, E. (1992) Test-retest variability using the Liverpool screening audiometer in a field environment, British Journal of Audiology, 26: 139–141CrossRefGoogle Scholar
Noh, K. T, Kim, C. S. (1985) The changing pattern of otitis media in Korea, International Journal of Pediatric Otorhinolaryngology, 9 (1): 77–87Google Scholar
Prasad, L. (1981) International Year of the Disabled Survey of Disability in Nepal.Google Scholar
Prescott, C. A., Kibel, M. A. (1990) Ear and hearing disorders in rural Grade 2 school children in the western Cape, South African Medical Journal, 79 (2): 90–93Google Scholar
Roland, P. E. (1960) Otological problems in Uganda, Journal of Laryngology, 74: 678–684Google Scholar
White, E. (1988) National Sample of the Prevalence of Hearing Impairment in Children in Swaziland. Hearing Impairment Research Project, Department of International Community Health, Liverpool School of Tropical Medicine.Google Scholar
Wilson, J. (1985) Deafness in developing countries: approaches to a global program of prevention, Archives Otolaryngology, 111: 2–9CrossRefGoogle ScholarPubMed