A three-year study of 15,000 primary school children in Delhi by the Maulana Azad Medical College found a high prevalence of hearing disorder with the potential to lead to deafness. Until now, this was considered to be a low-risk problem in India.
The findings of the study, published in The Journal of Laryngology and Otology, found the total prevalence of ear disorders to be around 17 per cent, all of which could potentially lead to deafness.
Dr Ankush Sayal, consultant ENT surgeon at the Maulana Azad Medical College and Lok Nayak Hospital and consulting author of the study, said: “The last extensive study on screening ear disorders was performed in 1964 where prevalence of diseases like ear infection was considerably lower, at around 2 per cent in India. Now, the prevalence is much higher. We may need to re-look our position as a low-prevalence country for ear diseases.”
The 1964 study was published in the Journal of Speech and Hearing Disorders a year later. In that study, 857 children in schools in southern India were screened and ear disorder prevalence of around 2 per cent was detected.
The Delhi study, conducted from 2008 to 2011 in 30 primary schools in the government sector, looked at children between the age of five and 12. Doctors visited schools and screened children using two tests — otoscopy (where an instrument is inserted to physically examine the ear) and audiometry (a hearing test).
Impacted cerumen or gross ear wax leading to deafness was found in 7.93 per cent of school children; 4.79 per cent suffered from chronic otitis media or severe ear infection in the ear canal or ear drum; 3.06 per cent suffered from otitis media with effusion — ear infection with presence of residual fluid.
The study found that 81.84 per cent of those with ear infection had some perforation in the ear drum while another 18 per cent had other damage to the ear drum like retraction where the position of a part of the ear drum is disturbed, or cholesteatoma or formation of a cyst in the middle ear.
Foreign bodies, like inserted decorative beads, pencil shrapnel and gram seeds, were found in 0.34 per cent of the children.
Pointing out that the findings were worrying, especially since hearing disorders were not covered under the school health programme, Dr Sayal said: “Hearing ailments affect the academic performance of the child, simply because he or she cannot hear what is taught in class. If children are screened regularly using simple procedures in schools and disorders are identified at an early stage, we can prevent potential deafness in many children.”
The growing prevalence of ear disorders, according to the authors, can be attributed to several factors including lack of breast feeding, overcrowding, poor hygiene, poor nutrition, passive smoking and inadequate healthcare. The authors have said that treating of infected ear with traditional home remedies like plant juices and heated mustard oil aggravates the condition.
According to the authors, as per a 1998 analysis of approximately 50 reports published by WHO over the last 30 years on hearing disorders, India was classified as a low-prevalence population, with a prevalence of 2 per cent.