Evaluation of the use of a questionnaire to detect hearing loss in Kenyan pre-school children

• Published in: International journal of pediatric otorhinolaryngology Vol. 57; no. 3; pp. 229 - 234
• Main Authors: Newton, Valerie E., Macharia, Isaac, Mugwe, Peter, Ototo, Benson, Kan, S.W.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.03.2001; Elsevier
• Subjects: Audiometry, Pure-Tone; Biological and medical sciences; Child; Child, Preschool; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Female; Health Services - economics; Health Services - supply & distribution; Hearing Disorders - diagnosis; Hearing Disorders - economics; Hearing Disorders - epidemiology; Hearing impairment; Humans; Investigative techniques, diagnostic techniques (general aspects); Kenya - epidemiology; Kenyan pre-school children; Male; Mass Screening; Medical sciences; Non tumoral diseases; Otorhinolaryngology functional investigation (larynx, voice, audiometry, vestibular function, equilibration...); Otorhinolaryngology. Stomatology; Questionnaire validation; Reproducibility of Results; Sensitivity and Specificity; Severity of Illness Index; Surveys and Questionnaires; Tropical medicine; Kenya; Africa; Hearing impairment; Kenyan pre-school children; Questionnaire validation; Human; Preschool age; Performance evaluation; Sanitary program; Questionnaire; Pure tone audiometry; Developing countries; Auditory disorder; Exploration; Medical screening; Symptomatology; Sensitivity; Specificity; Predictive value; ENT disease; Perception hearing loss; Positive predictive value; Diagnosis; Detection; Child; Public health
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/S0165-5876(00)00453-5

In developing countries, there is a lack of trained personnel and testing equipment to facilitate the early detection of hearing impairment in children. A questionnaire offers a low cost option and the value of this for detecting hearing impairment in pre-school children was determined in several districts in Kenya. The questionnaire was completed by either teachers, parents/carers or community nurses. The children were subsequently tested using pure tone audiometry and visual examination of the ear by ENT Clinical Officers, who were not given prior access to the results of the questionnaire. A total of 757 (88%) questionnaires were completed. Of the 735 children, who could be tested using pure tone audiometry, four were found to have a unilateral hearing impairment and one was detected by the questionnaire. A total of 13 children had a bilateral hearing impairment >40 dB HL. All were detected using the questionnaire. There were eight males and five females with ages ranging from 4.2 to 6.9 years, mean age 5.7 years and median age 5.8 years. Eight had a sensorineural hearing impairment and two a mixed hearing impairment. Three of the children with a sensorineural hearing loss had a family history of hearing impairment. No question detected all children with a hearing impairment and some questions were more discerning than others. There was 100% sensitivity for the questionnaire when a hearing loss of >40 dB was considered, but specificity was lower at 75%. Negative predictive value was 100%, but the positive predictive value was low, 6.75%. It was concluded that a questionnaire of this nature could be usefully applied at Primary Health Care level for detecting hearing impairment at the pre-school stage. There would be need for services available for diagnosis, treatment and habilitation before a sreening programme was introduced.