A Critical Appraisal of Hearing Impairment among Primary School Children in Port Harcourt, Nigeria

Background: Hearing impairment is the most frequent sensory deficit in human populations affecting over 250 million people in the world. Undetected hearing impairment among primary school children has been linked with poor school performance, low self-esteem and thus poor psycho-social/intellectual development in the child. This paper determines the pattern and prevalence of hearing impairment in primary school children in Port Harcourt.

Methodology: This study was carried out in Port Harcourt. Primary school children of both public and private schools were recruited for this study from January 10th, 2010 to May 21st, 2010. At the schools, Pure Tone Audiometry (PTA) screening was carried out on the pupils whose parents gave informed consent. The data of each child screened was entered into the forms provided (Appendix i and ii) by the research assistants and crosschecked by the researchers.The data was then entered into the database of a software package designed for collection, completion and reporting, the EPI_INFO (version 6) statistical package for epidemiology. Data from the study was analyzed using the computer program EPI-INFO (VERSION 6) and SPSS11.0. The age and sex distribution of the study population; the social class; the prevalence of hearing impairment in relation to age, sex, social class and school type; the risk factors of hearing impairment and its relationship with school performance were determined from the data collected. These data were presented as charts, graphs and tables in simple proportions, and comparisons of sub groups carried out with chi square test. Statistical significance at 95% confidence interval was p value < 0.05.

Results: From 13 selected schools, a total of 802 pupils were screened, 461 (57.5%) were from public schools while 341(42.5%) were from private schools; giving a public to private school population ratio of 1.4:1 The number of pupils was almost equally distributed in all the age groups; 281 pupils (35.0%) were between 5-7 years whereas 253 pupils (31.6%) were > 10 years. There were 405 males (50.5%) and 397 (49.5%) females, giving a male: female ratio of 1.02:1.

Majority of the pupils were from social class III (268 pupils, 33.4%). The prevalence of hearing impairment in primary school children in Port Harcourt was found to be 29.4%. The prevalence of hearing impairment was higher in children in public schools (30.2%) than amongst those in private schools (28.4%). Of the 236 pupils with hearing impairment 76 pupils (52%) had Conductive Hearing Loss (CHL), 35 (24%) had Mixed Hearing loss (MHL) and 35 (24%) had Sensorineural Hearing Loss (SNHL). Of the 236 pupils with hearing loss, 128 (54.1%) had unilateral hearing loss while 108 (45.9%) had bilateral hearing loss.

Conclusion: The prevalence of hearing impairment in primary school children in Port Harcourt was found to be 29.4%. This was significantly higher among the older children and in females. Hearing impairment was more prevalent in children in public than private schools. Conductive hearing loss (CHL) was the commonest type of hearing impairment seen. Moreover, hearing impairment was significantly associated with poor school performance.