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Prevalence of hearing loss among school-age children in Metropolitan Bangkok
Rada Dara1, Angkana Lertpoompunya1, Maliwan Tammasaeng2
1Department of Communication Sciences and Disorders, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Insights
A school-based hearing screening in Bangkok found 6.1% of pupils had hearing impairment. Teacher-administered forms were ineffective, highlighting the need for improved methods like tympanometry for accurate childhood hearing loss detection.
Area of Science:
- Public Health
- Audiology
- Pediatrics
Background:
- Congenital hearing loss affects approximately 1 in 500 newborns, with higher prevalence in low- and middle-income countries.
- Hearing is crucial for communication, social interaction, and learning in children.
- Childhood hearing impairment impacts development and requires early detection.
Purpose of the Study:
- To determine the prevalence of childhood hearing loss in Bangkok.
- To identify factors associated with hearing impairment in schoolchildren.
- To evaluate the effectiveness of different school-based hearing screening methods.
Main Methods:
- A cross-sectional study involving 407 primary school pupils in Bangkok.
- Hearing screening conducted by teachers using a form, followed by audiologists using otoscopy, tympanometry, and audiometry.
- Analysis of agreement between screening methods and audiometric results using Cohen's kappa coefficient.
Main Results:
- 6.1% of pupils exhibited hearing impairment (2.9% bilateral, 3.2% unilateral).
- A significant portion (8.1%) had abnormal tympanometry despite normal audiometry.
- Teacher-administered screening showed no significant agreement (κ=0.013) with audiometry, while otoscopy (κ=0.158) and tympanometry (κ=0.382) showed significant agreement.
Conclusions:
- Childhood hearing impairment affects children across all socioeconomic statuses.
- The current teacher-administered screening form in Thailand lacks sensitivity for detecting hearing impairment.
- Future screening programs should incorporate otoscopy and tympanometry for more reliable childhood hearing loss detection.
Background:
Hearing is essential for communication, social interaction, and learning. Approximately 1 in 500 newborns have congenital hearing loss, with the prevalence being higher in low- and middle-income countries. This study aimed to report the prevalence of childhood hearing loss in Bangkok, assess associated factors, and evaluate the performance of different school-based screening approaches.
Methods:
This cross-sectional study was conducted from July 2023 to March 2024. Pupils were randomly recruited from nine primary schools in central Bangkok. Hearing screening was conducted by schoolteachers and audiologists. The teachers conducted initial screening using a hearing screening form, followed by professional screening procedures performed by audiologists, including otoscopy, tympanometry, and audiometric screening.
Results:
A total of 407 pupils participated in this study (mean age 7.9 years, SD 0.8). No significant relationships between demographic factors and hearing status were revealed. Audiometric screening identified hearing impairment in 6.1% of pupils, including 2.9% with bilateral and 3.2% with unilateral impairment. Notably, 8.1% of pupils had abnormal tympanometry despite normal audiometric screening results. Using Cohen's kappa coefficient, the teacher-administered screening form (κ = 0.013) showed no significant agreement with the audiometric results. Meanwhile, otoscopy (κ = 0.158) and tympanometry (κ = 0.382) demonstrated significant agreement with the audiometric results.
Conclusions:
Children of any socioeconomic status can suffer hearing impairment. A hearing screening form completed by trained primary school teachers failed to capture childhood hearing impairment in Thailand and should be revised to improve its sensitivity. Moreover, in future hearing screening programs, the use of both auditory and tympanometry should be considered to provide the most reliable outcomes.
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