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Daniel R. Seely, MD, MPH; Stephen S. Gloyd, MD, MPH; Arthur D. Omope Wright, MD; Susan J. Norton, PhD

Arch Otolaryngol Head Neck Surg. 1995;121(8):853-858.

Abstract
Objectives
To determine hearing loss prevalence among a group of Third World children, to describe the physical examination and audiometric findings in the hearing-impaired children, and to assess the association of hearing loss with several known risk factors. It was hypothesized that chronic otorrhea would be the risk factor most strongly associated with hearing loss.

Design
Community screening program to identify and evaluate hearing-impaired children. Case-control analysis of hearing loss risk factors. A survey taker, blinded to the children's hearing status, ascertained risk factors.

Setting
Rural community in eastern province of Sierra Leone, West Africa.

Patients
Population-based sample of 2015 children aged 5 to 15 years. Risk factor analysis was performed in 184 children and an equal number of matched controls.

Main Outcome Measure
Hearing loss determined according to World Health Organization, Geneva, Switzerland, definition.

Results
A total of 184 (9.1%) of 2015 children were found to have mild or greater hearing loss. The prevalence of bilateral profound hearing impairment was 4.0 per 1000. We assessed physical examination and audiometric findings. The risk factor most strongly associated with hearing loss was a history of otorrhea persisting longer than 1 month (odds ratio, 23.3; 95% confidence limits, 12.11, 45.40).

Conclusions
A high prevalence of hearing loss was identified. Much of this impairment may result from chronic untreated or unrecognized ear infections. Further community-based studies of hearing-impaired children are necessary for planning preventive and curative programs.

(Arch Otolaryngol Head Neck Surg. 1995;121:853-858)

Author Affiliations
From the Department of Otolaryngology—Head and Neck Surgery, School of Medicine (Drs Seely and Norton) and the International Health Program, School of Public Health and Community Medicine (Dr Gloyd), University of Washington, Seattle, and the Department of Ear, Nose, and Throat, School of Medicine and Allied Health Sciences, Freetown, Sierra Leone, West Africa (Dr Omope Wright).

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