Hearing impairment and ear pathology in Nepal

Abstract

A stratified random cluster sample of 15,845 subjects was performed in two regions of Nepal to determine the prevalence and main causes of hearing impairment (the most common disability) and the prevalence of ear disease. Subjects reporting current ear pain, or ear discharge, or hearing impairment on direct questioning by a Nepali health worker (primary screening failed), had otoscopy and audiometry (using the Liverpool Field Audiometer) performed, and a questionnaire administered relating to past history. In every fifth house subjects who passed the primary screening (1,716 subjects) were examined to assess the false negative rate of screening. An estimated 16.6 per cent of the study population have hearing impairment (either ear worse than 30 dB hearing threshold level (HTL) 1.0–4.0 kHz, or 50 dB HTL 0.5 kHz), and 7.4 per cent ear drum pathology, equivalent to respectively 2.71 and 1.48 million people extrapolated to the whole of Nepal. Most hearing impairment in the school age group (55.2 per cent) is associated with otitis media or its sequelae. Probably at least 14 per cent of sensorineural deafness is preventable (7 per cent infectious disease, 3.9 per cent trauma, 0.8 per cent noise exposure, 1 per cent cretinism, and 1 per cent abnormal pregnancy or labour). Most individuals reporting current ear pathology (61 per cent) had never attended a health post, and of those receiving ear drop treatment, 84 per cent still had serious pathology. Of subjects who reported ear drop treatment at any time, 31 per cent still had serious pathology. The use of traditional remedies was prevalent.In conclusion this study shows high prevalences of hearing impairment and ear drum pathology. To reduce hearing impairment in Nepal, particularly in the school age group, a priority should be the effective treatment of otitis media.

Benefits and challenges of newborn hearing screening for developing countries

“…In Bangladesh, prevalence rate of 0.3% for severe hearing loss was reported in a normal school population [41]. In Nepal, the prevalence rate for hearing impairment greater than 30 dB in the general population was 16.6% [42].…”

Chronic suppurative otitis media in Nepal: ethnicity does not determine whether disease is associated with cholesteatoma or not

“…However, other authors have reported significant levels of ear disease in this region. In a robust study, Little et al 4 calculated that 7.4 per cent of the Nepalese population had tympanic membrane pathology, comparing unfavourably with an estimated UK prevalence of chronic otitis media of 4.1 per cent. 6 Interestingly, Little's group found a very similar rate of cholesteatomatous disease (24 per cent) to that seen in our study, and a similar value In addition, we must acknowledge the risk of confounding factors in our study, due to the nature of the ear camps from which our data were drawn.…”

Sociodemographic profile and the associated factors of chronic otitis media in rural areas of eastern Nepal

“…1 In Nepal, approximately 16% of the population suffers of hearing loss and most of the hearing impairment in the school age group (55.2 per cent) is associated with otitis media or its sequelae. 2 A study by B P Koirala institute of health sciences in the Sunsari district found the prevalence of otitis media to be 10.3%. 3 A 13.2% prevalence of otitis media in children in the Morang district of Eastern Nepal has been reported in a study.…”