Hearing loss prevalence and risk factors among Sierra Leonean children.

OBJECTIVES To determine hearing loss prevalence among a group of Third World children, to describe the physical examination and audiometric findings in the hearing-impaired children, and to assess the association of hearing loss with several known risk factors. It was hypothesized that chronic otorrhea would be the risk factor most strongly associated with hearing loss. DESIGN Community screening program to identify and evaluate hearing-impaired children. Case-control analysis of hearing loss risk factors. A survey taker, blinded to the children's hearing status, ascertained risk factors. SETTING Rural community in eastern province of Sierra Leone, West Africa. PATIENTS Population-based sample of 2015 children aged 5 to 15 years. Risk factor analysis was performed in 184 children and an equal number of matched controls. MAIN OUTCOME MEASURE Hearing loss determined according to World Health Organization, Geneva, Switzerland, definition. RESULTS A total of 184 (9.1%) of 2015 children were found to have mild or greater hearing loss. The prevalence of bilateral profound hearing impairment was 4.0 per 1000. We assessed physical examination and audiometric findings. The risk factor most strongly associated with hearing loss was a history of otorrhea persisting longer than 1 month (odds ratio, 23.3; 95% confidence limits, 12.11, 45.40). CONCLUSIONS A high prevalence of hearing loss was identified. Much of this impairment may result from chronic untreated or unrecognized ear infections. Further community-based studies of hearing-impaired children are necessary for planning preventive and curative programs.