Prevalence of Hearing Loss in Primary School Children in Lusaka, Zambia

Background: Disabling hearing loss has serious implications in a child's development as it reduces the intelligibility of speech thereby interfering with the learning process. This will negatively impact on their vocational choices. Study objective: To determine the prevalence of hearing loss in primary school children in the central zone of Lusaka district, Zambia. Methodology: 1277 children, aged 6 to 13 years, from public primary schools in the central zone of Lusaka district were randomly  selected and examined. Clinical otologic assessment, tympanometry and audiometry screening were conducted on all participants. Children who failed the audiometry-screening test underwent a pure tone audiometry to determine the extent and nature of their hearing impairment. Results: The prevalence of hearing impairment was 11.5% consisting of conductive hearing loss (87.8%), sensorineural hearing loss  (6.8%) and mixed hearing loss (5.4%). Hearing impairment was more common in male children (13.8%) compared to female children (9.3%) (P value= < 0.05). Thirty six point eight percent children had ear disease. The commonest ear disease was wax impaction (66%)found in children followed by otitis media with effusion (20%), foreign body ear (4%) and chronic suppurative otitis media (2%). The odds of developing hearing impairment in children with chronic suppurative otitis media was nine times greater than that of children without chronic suppurative otitis media OR = 9.9(95% CI, 2.33- 47.43). Conclusions: The prevalence of hearing impairment in school children in central zone of Lusaka district is high. This study shows that  chronic suppurative otitis media has a statistical significant association with hearing loss and that the male children are at a higher risk of developing hearing impairment. There is urgent need for ear and hearing care awareness, and screening programs at the  community level in the central zone of Lusaka district. Keywords: Disabling hearing loss, hearing impairment, chronic suppurative otitis media, otologic assessmen