Hearing impairment and ear pathology in Nepal

Area of Science:

• Public Health
• Epidemiology
• Otolaryngology

Background:

• Hearing impairment is the most common disability globally.
• Ear diseases and hearing loss are significant public health concerns, particularly in low-resource settings.
• Understanding the prevalence and causes of hearing impairment is crucial for effective intervention strategies.

Purpose of the Study:

• To determine the prevalence and primary causes of hearing impairment in Nepal.
• To assess the prevalence of ear diseases within the study population.
• To evaluate the effectiveness of current healthcare-seeking behaviors and treatments.

Main Methods:

• A stratified random cluster sample of 15,845 subjects was recruited from two regions of Nepal.
• Screening involved direct questioning, followed by otoscopy and audiometry for positive cases.
• A questionnaire gathered data on medical history and treatment, with a subset assessed for screening accuracy.

Main Results:

• An estimated 16.6% of the population experiences hearing impairment, and 7.4% have eardrum pathology.
• Otitis media and its sequelae are the leading causes of hearing impairment in school-aged children (55.2%).
• A significant portion of sensorineural deafness (at least 14%) is preventable, linked to infections, trauma, and other factors.

Conclusions:

• Hearing impairment and ear diseases represent a substantial public health burden in Nepal.
• Preventable causes of hearing loss highlight the need for improved public health interventions and education.
• Current healthcare practices for ear conditions appear insufficient, with a high prevalence of untreated or persistent pathology.