Impact of indian public health standards for rural health care facilities on national programme for control of deafness in India: The results of a cohort study

Socio-demographic and Audiological Profile of the Board-Reviewed Applicants for Hearing Handicap Certification in a Tertiary Care Teaching Institute in Eastern India

To analyze the socio-demographic and audiological profile of the applicants for hearing handicap certification in the Medical Board (henceforth, "Board") of a tertiary care teaching institute. This is a retrospective record review (March 2019-February 2020) from the archival computer database of the institutional Board. The procedure for audiological assessment prior to Board review and thereafter, the evaluation at the Board (computation of hearing impairment) for eligibility for certification was discussed. The socio-demographic profile of the applicants (age, gender, faith) and the types of hearing impairment [HI%; organic (sensorineural, mixed), non-organic (malingering)] were analyzed with relevant statistical parameters. A HI% scale was introduced to classify the severity of the hearing deficit. Of the 163 applicants, 148 had organic hearing loss (average age: 35.4 years; 1.9 times male preponderance) and 15 were malingerers (average age: 35.7 years; 14 times male preponderance). The left ear contributed more to the hearing handicap. Most applicants having sensorineural hearing loss (SNHL; n = 124) were within 10-19 years and 40-49 years (19.35% each), with 12% being ≧ 60 years (age-associated hearing loss). Of the 13 applicants of age ≦ 12 years, eight were diagnosed with brainstem evoked response audiometry, and 10 had HI score of ≥ 70%. Muslim population with SNHL tended to avail certification 1.34 times more than the Hindus. Most of the applicants with mixed hearing loss (MHL; n = 24) were in their fifth and sixth decades (29.2% each), with three times male preponderance. Among the malingerers, the average malingering impairment was 66% (median: 61%; range 44-100%). Among the SNHL population, ~ 30% had HI at 90-100% in contrast to the MHL population of whom 8% had HI at > 90% and 29% had HI at 40- < 55%. Ten applicants among the organic hearing loss group (6.76%) (two with SNHL; eight with MHL) had HI scores of < 40% and were considered ineligible for certification. The outcomes of the review provided a comprehensive account of the socio-demographic profile of the applicants for handicap certification and the type of hearing loss prevailing in a given population. These data, and the severity stratification of the hearing disability through the HI% scale would provide the policymakers and stakeholders with proper directions to work upon.

Hearing healthcare gaps in LMICS: snapshot from a semi-urban community in Nigeria

BACKGROUND

Low and middle-income countries (LMICs) have high prevalence of hearing loss which are mainly due to preventable causes. While urban communities in LMICs are likely to have functional hearing healthcare delivery infrastructure, rural and semi-urban communities may have different reality.

OBJECTIVES

This study aimed to provide: (i) a snapshot of the burden of ear diseases and (ii) a description of available hearing healthcare resources in a semi-urban Nigerian community.

METHODS

A cross-sectional study of households selected by multistage random sampling technique. Seventy-four participants: 39 males and 35 females with mean age of 34 years ± 5.24 were recruited and answered a structured questionnaire. In addition, the availability of hearing healthcare services in 15 health centers within the community were determined.

RESULTS

All participants reported recent occurrence of ear complaints or gave similar history in a household member. Common complaints were ear discharge, ear pain and hearing loss. Medical intervention was sought from patent medicine stores, hospitals and traditional healers. None of the assessed hospitals within the study site was manned by an ENT surgeon or ENT trained nurse.

CONCLUSION

Despite the heavy burden of ear complaints there is inadequate hearing healthcare delivery in a typical LMIC community. This highlights the need for urgent improvement of hearing healthcare.

Auditory effect of noise exposures among commercial and non-commercial light motor vehicle drivers: A comparative cross-sectional study in Lucknow city

Context:

Noise-induced hearing loss, one of the most common and preventable occupational hazard, occurs due to repeated and continuous exposure of loud noise, A single exposure of an impulse of noise at the level of 130--140 dB or long and repeated exposures to loud sounds to an average level of 85 dB or higher for an 8-h period can cause permanent loss of hearing.

Aims:

To study and compare hearing loss over different audiometric frequencies among autorickshaw and non-commercial institutional personal car drivers.

Settings and Design:

This was a cross-sectional comparative study conducted at a tertiary medical college, located in Lucknow during October 2017–November 2018.

Methods and Materials:

The sample size was calculated using EpiInfo7. We took a sample size of 300 drivers, out of which 150 three-wheeler autorickshaw drivers (Tempo), that is, group I and 150 non-commercial car drivers, that is, group II were selected.

Statistical Analysis Used:

For statistical analysis, “Chi-square test of independence” and student's t-tests were used.

Results:

The mean age at which drivers in group I and group II started work was 23.91 ± 7.63 years an d 23.60 ± 5.58 years, respectively. The mean hearing loss in Group I was 21.15 ± 8.65 dB and in group II it was 13.34 ± 5.79 dB.

Conclusions:

Autorickshaw drivers who were exposed to louder noise, that is, autorickshaw drivers in group I had more sensory neural hearing loss than the non-commercial car drivers, that is, group II.

Validation of a questionnaire to identify noise-induced hearing loss among drivers

Objective

To assess the validity of a questionnaire (consisting of 10 items/questions) to identify hearing loss (HL) among three-wheeler tempo and noncommercial car drivers.

Materials and Methods

This was a cross-sectional study conducted in an urban area of Lucknow city. Three-wheeler tempo drivers and noncommercial car drivers were assessed for HL by audiometry. A total of 300 subjects, who fulfilled the study criteria, were selected for the interview and health assessment. The pure tone audiometry was conducted after >12 hours of the last noise exposure to avoid temporary threshold shift.

Results

The percentage of respondents aged between 31 and 40 years was 36%. The highest affirmative response item was "Do you have trouble hearing in noisy background?" constituting 68% and the lowest affirmative response item was "Do you have trouble understanding the speech of women and children?" constituting 33.7%. Kappa values showed that there was significantly (<0.05) mild agreement between most of the items and the gold standard for mid and high-frequency HL. The area under the curve for low, mid, and high frequency HL was 0.76% (95% CI = 0.68-0.84), 0.69 (95% CI = 0.73-0.75), and 0.67 (95% CI = 0.62-0.73), respectively. The sensitivity and specificity were reasonable for all the definition of HL at different cutoff scores.

Conclusion

A self-reported questionnaire-based approach may be used for the assessment of HL especially when audiometry is not feasible.