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      The prevalence of hearing impairment within the Cape Town Metropolitan area

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      1 , 2 ,
      The South African Journal of Communication Disorders
      AOSIS OpenJournals

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          Abstract

          Background

          There is a lack of data on the prevalence of hearing impairment in South Africa. Current data is unreliable as it is based on national census information which tends to underestimate the prevalence of hearing impairment.

          Aim

          The aim of this study was to estimate the prevalence of hearing impairment in the Cape Town Metropolitan area and to determine factors associated with hearing impairment.

          Method

          A cross-sectional household survey involving 2494 partcipants from 718 households was conducted between the months of February and October 2013. Random cluster sampling was used to select four health sub-districts from eight health sub-districts in the Cape Town Metropolitan area using a method of probability proportional to size (PPS). The survey was conducted according to the World Health Organization (WHO) Ear and Hearing Disorders Survey Protocol and the classifcation of hearing impairment matched the WHO’s criteria for the grading of hearing impairment.

          Results

          The overall prevalence of hearing impairment in the population of this study was 12.35% (95% CI: 11.06% – 13.64%) and prevalence of disabling hearing impairment was 4.57% (95% CI: 3.75% – 5.39%) amongst individuals ≥ 4 years old. The following factors were found to be associated with hearing impairment; male gender, age, hypertension, a history of head and neck trauma and a family history of hearing impairment.

          Conclusion

          Based on the data from communities surveyed during this study, hearing impairment is more prevalent than previously estimated based on national population census information. Interventions for the prevention of hearing impairment in these communities should focus on individuals with associated risk factors.

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          Most cited references54

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          Validation of self-reported hearing loss. The Blue Mountains Hearing Study.

          Large-scale epidemiological studies have often used self-report to estimate prevalence of age-related hearing loss. However, few large population-based studies have validated self-report against measured hearing loss. Our study aimed to assess the performance of a single question and a brief hearing handicap questionnaire in identifying individuals with hearing loss, against the gold standard of pure-tone audiometry. We examined 2015 residents, aged 55-99 years, living in the west of Sydney, Australia, who participated in the Blue Mountains Hearing Study during 1997-1999. Audiologists administered a comprehensive questionnaire, including the question: 'Do you feel you have a hearing loss?' The Shortened Hearing Handicap Inventory for Elderly (HHIE-S) was also administered during the hearing examination, which included pure-tone audiometry. The single question and HHIE-S were compared with measured losses at levels >25, >40 and >60 decibels hearing level (dBHL) to indicate mild, moderate and marked hearing impairment, for pure-tone averages (PTA) of responses to 500, 1000, 2000 and 4000 Hz. The single question yielded reasonable sensitivity and specificity for hearing impairment, and was minimally affected by age and gender. HHIE-S scores >8 had lower sensitivity but higher specificity and positive predictive value. The HHIE-S performed slightly better in younger than older subjects and performed better for moderate hearing impairment. In this older population with a high prevalence of hearing loss (39.4%), both a question about hearing and the HHIE-S appeared sufficiently sensitive and specific to provide reasonable estimates of hearing loss prevalence. Both could be recommended for use in epidemiological studies that aim to assess the magnitude of the burden caused by age-related sensory impairment but cannot measure hearing loss by audiometry.
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            Gender differences in a longitudinal study of age-associated hearing loss.

            Current studies are inconclusive regarding specific patterns of gender differences in age-associated hearing loss. This paper presents results from the largest and longest longitudinal study reported to date of changes in pure-tone hearing thresholds in men and women screened for otological disorders and noise-induced hearing loss. Since 1965, the Baltimore Longitudinal Study of Aging has collected hearing thresholds from 500 to 8000 Hz using a pulsed-tone tracking procedure. Mixed-effects regression models were used to estimate longitudinal patterns of change in hearing thresholds in 681 men and 416 women with no evidence of otological disease, unilateral hearing loss, or noise-induced hearing loss. The results show (1) hearing sensitivity declines more than twice as fast in men as in women at most ages and frequencies, (2) longitudinal declines in hearing sensitivity are detectable at all frequencies among men by age 30, but the age of onset of decline is later in women at most frequencies and varies by frequency in women, (3) women have more sensitive hearing than men at frequencies above 1000 Hz but men have more sensitive hearing than women at lower frequencies, (4) learning effects bias cross-sectional and short-term longitudinal studies, and (5) hearing levels and longitudinal patterns of change are highly variable, even in this highly selected group. These longitudinal findings document gender differences in hearing levels and show that age-associated hearing loss occurs even in a group with relatively low-noise occupations and with no evidence of noise-induced hearing loss.
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              The effect of diabetes on sensorineural hearing loss.

              To identify whether patients with diabetes have a higher incidence of sensorineural hearing loss than the general population and examine whether control of diabetes is related to severity of hearing loss. Retrospective database review; complete data mining of electronic medical record from 1989 to present. Tertiary referral center. Electronic medical records from 53461 nondiabetic age-matched patients and 12575 diabetic patients were reviewed. Presence or absence of diabetes and/or sensorineural hearing loss, serum creatinine, pure tone hearing (dB), speech discrimination (%), serum cholesterol, and triglycerides. Sensorineural hearing loss was more common in the diabetic patients than in age0matched nondiabetic patients from the same institutions. Poor control of diabetes, as measured by increasing serum creatinine, but not apparent in hemoglobin A1C laboratory data, correlated with worsening hearing in patients with diabetes who had sensorineural hearing loss. Sensorineural hearing loss was more common in patients with diabetes than in the control nondiabetic patients, and severity of hearing loss seemed to correlate with progression of disease as reflected in serum creatinine. This may have been due to microangiopathic disease in the inner ear.
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                Author and article information

                Journal
                S Afr J Commun Disord
                S Afr J Commun Disord
                SAJCD
                The South African Journal of Communication Disorders
                AOSIS OpenJournals
                0379-8046
                2225-4765
                08 April 2016
                2016
                : 16
                : 1
                : 105
                Affiliations
                [1 ]Division of Communication Sciences & Disorders, University of Cape Town, South Africa
                [2 ]Clinical Educator, Division of Communication Sciences & Disorders, University of Cape Town, South Africa
                Author notes
                Corresponding author: Lebogang Ramma, lebogang.ramma@ 123456uct.ac.za
                Article
                SAJCD-63-105
                10.4102/sajcd.v63i1.105
                5843235
                27247255
                50310d1b-5b4f-42b0-a812-3d7319ff5938
                © 2016. The Authors

                Licensee: AOSIS OpenJournals. This work is licensed under the Creative Commons Attribution License.

                History
                : 28 September 2014
                : 20 March 2015
                Categories
                Original Research

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