PREVALENCE AND RISK FACTORS OF HEARING LOSS AMONG PEDIATRIC PATIENTS AT A TERTIARY TEACHING HOSPITAL IN ACCRA

ABSTRACT

Background: Hearing loss is the most frequent hearing deficit in both adult and pediatric populations, affecting more than 250 million people in the world. The consequences of hearing impairment are diverse and include severe impairment, often resulting in a reduced ability to communicate, delay in language acquisition, economic and educational disadvantage, social isolation and stigmatization. However, these consequences can be reduced by early detection together with appropriate audiological and speech therapy interventions to enhance speech, language and cognitive development in hearing impaired children.

Aim: This research study was aimed at identifying maternal and infant risk factors predisposing children to hearing loss as well as establishing the prevalence of hearing impairment in children aged 6 months to 10 years in a teaching hospital in Ghana.

Methods: Different audiological test batteries (otoscopy, tympanometry, otoacoustic emissions, behavioral audiometry) and instrumentation (GSI TYMPSTAR tympanometer, Interacoustics Paediatric PA5 and Interacoustics AD229e audiometers) were utilized to identify risk factors and determine prevalence of hearing loss in pediatric patients presenting for hearing profile evaluations at a tertiary hospital. Behavioral assessments were performed via visual reinforcement audiometry, and play audiometry

Results: Anaemia was the most prevalent (8.3%) maternal condition reported by the mothers during pregnancy. The prevalent infant risk factors to hearing loss were anoxia after delivery (24.0%), admission of infants at NICU for more than two days (22.9%), ear infection (21.9%), and low birth weight (8.9%). Only 6.3% had family histories of hearing loss. Overall, there were less passes (40.1%) than refers (59.9%) in the OAE tests. No significant associations between hearing loss and demographics (age and gender) in both ears as measured by the various test

batteries across the test frequencies were found. Significant associations between hearing loss and tympanograms were established in both ears across all frequencies via VRA. On the contrary, no significant association was found between hearing loss and tympanograms by play audiometry test results. The prevalence of hearing loss was relatively higher in the younger (0.5 – 2.5 years) children. Profound hearing loss was generally most prevalent across all frequencies in the various assessments, while mild and severe hearing loss were less prevalent.

Conclusion: Maternal and infant risk factors predisposing children to hearing loss were identified. Degrees of hearing loss were assessed and the associated prevalence was estimated. Non-significant associations between hearing loss and demographics were established using the assessment tools. The need to have a mandatory hearing screening for newborns before discharge from hospitals to ensure early detection and intervention of hearing loss is recommended.

Keywords: Risk factors, hearing loss, otoacoustic emission, tympanometry, prevalence