Paediatric ear disease and hearing loss in the Solomon Islands

Abstract

According to the World Health Organisation (WHO), around 90% of the global burden of hearing loss is found in Low-and Middle-Income Countries (LMICs). It is estimated that 75% of childhood hearing loss in LMICs is preventable. Otitis media (OM) and infectious diseases that may be avoided through immunisations are the leading causes of preventable hearing loss in children. Given the wellknown adverse effects of hearing loss in childhood development, the WHO is leading global efforts to address the burden of hearing loss in children through public health measures. Newborn and Infant Hearing Screening (NIHS) and school-based hearing screening programmes are key strategies that should facilitate early identification and intervention for children with hearing disorders. There is very little in the audiology literature on childhood hearing loss in the Pacific Islands. Yet, this region is estimated to have among the highest global burden of OM and disabling hearing loss. The limited literature indicates that OM begins early in life, and may quickly progress to advanced/chronic stages of disease and potentially fatal complications. Ear, Nose and Throat (ENT) and audiology services are virtually non-existent throughout the Pacific Islands, and public health measures such as community ear/hearing screening programmes may be a feasible option until more sophisticated ENT/audiology services become available. The Solomon Islands are a Pacific Island nation that is currently developing the outreach service of the ENT Clinic at the National Referral Hospital in the capital city, Honiara. The present study was developed to assess community engagement and readiness for ear/hearing screening programmes for children, as well as to assess the prevalence of OM and hearing loss among children in Honiara. Should the results of the study indicate that OM and hearing loss are a significant public health issue among children, and that caregivers are supportive of ear/hearing services, the recommendation for routine community-based ear/hearing screening programmes in Honiara will be justified. Parental knowledge and attitudes to childhood hearing loss and hearing services was assessed through semi-structured interviews with 150 parents attending community clinics in Honiara. The highest level of parental knowledge found regarding causes of hearing loss was for OM (94%). Knowledge of routine childhood immunisations (84%) and breast-feeding (76%) as public health measures to reduce/prevent OM were also high. The knowledge of fathers was generally the same or better than that of mothers. Approximately half of participants (56%) agreed that curses may cause childhood hearing loss. There was high parental support for infant hearing screening programmes (96%) and v Publications included in this thesis