Frequency and Determinants of Hoarseness of Voice in Madrassa Students: A Cross-Sectional Study in Peshawar, Pakistan

Hoarseness of voice is a frequently encountered problem for voice-engaged students, such as in madrassas (Islamic schools). It typically presents as a hoarse, strained, or weak voice and is often seen in individuals who use their voice professionally, such as teachers, singers, and clergy. Prolonged recitation and/or environmental exposure may lead to vocal strain.

To determine the frequency of hoarseness of voice and its association with prolonged recitation, environmental factors, and voice care practice in madrassa students.

This cross-sectional study was done on madrassa-going children in Peshawar. Information regarding demographics, hoarseness, recitation, environmental exposure to dust and smoke, hydration, and vocal care measures was collected using a structured, self-administered questionnaire after standardized group instructions. Descriptive statistics and chi-square analyses were conducted to look for a relationship between hoarseness and various suspected predictors such as length of recitation and type of environment.

Of a total of 323 students, 63.4% (205) reported hoarseness of voice. Among the total sample size, males (57%) were more than females (43%), with a mean age of 13.7 ± 3 years. Recitation time and exposure to environmental factors (smoke/dust) showed a significant relationship with hoarseness, at P = 0.015 and P = 0.00058, respectively. More than 2 hours of daily recitation time was associated with more hoarseness (44%) as compared to those who recited less than 30 minutes per day (4.9%). Severe degrees of hoarseness were seen in some of the students, but only 12.6% reported vocal care measures use, including hydration or microphones (P = 0.0098).

Hoarseness was highly prevalent among madrassa students and was significantly associated with longer recitation times and environmental exposure to dust and smoke. Increased awareness concerning the "care" of the voice and preventive measures is needed in the madrassas. More studies are needed to investigate the causal link between these factors and the rise of voice disorders.