Prevalence of Hearing Loss in Children: A Systematic Review

Fatima Tahir; Muhammad Sikander Ghayas Khan; Muhammad Ahmed; Amina Iqbal; Arshad Mahmood Naz; Rabia Azmat; Anita Batool

doi:10.61919/gemm8118

Authors

Fatima Tahir Lecturer, Department of Audiology, FAHS, The University of Lahore, Pakistan Author
Muhammad Sikander Ghayas Khan Professor, Department of Rehabilitation Sciences, The University of Lahore, Pakistan Author
Muhammad Ahmed Assistant Professor, Department of Rehabilitation Sciences, The University of Lahore, Pakistan Author
Amina Iqbal Clinical Audiologist, Audiology Centre Gulberg, Lahore, Pakistan Author
Arshad Mahmood Naz Consultant Speech and Language Pathologist, Mayo Hospital Lahore, Pakistan Author
Rabia Azmat Speech and Language Pathologist, Maryam Nawaz School, Johar Town, Lahore, Pakistan Author
Anita Batool Lecturer, Department of Rehabilitation Sciences, The University of Lahore, Pakistan. Author

DOI:

https://doi.org/10.61919/gemm8118

Keywords:

Hearing loss; hearing impairment; school children; conductive hearing loss; otitis media; hearing screening; prevalence.

Abstract

Background: Hearing loss in childhood is a significant public health concern because it may affect speech perception, language development, classroom participation, academic achievement, and psychosocial wellbeing. School-based screening provides an important opportunity for early detection, particularly in settings where routine audiological services are limited. Objective: To synthesize evidence on the prevalence, types, and commonly reported otological contributors of hearing loss among school-going children. Methods: A systematic review with narrative synthesis was conducted using PubMed/MEDLINE, Scopus, and Google Scholar, supplemented by reference-list searching. Observational studies reporting hearing-loss prevalence among school-going children were included. Clinical subgroup studies were interpreted separately from general school-screening populations. Due to heterogeneity in audiometric thresholds, screening procedures, and case definitions, meta-analysis was not performed. Results: Eleven studies were included in the qualitative synthesis. Reported prevalence among general school-screening populations ranged from 2.4% to 21%, with most estimates clustering between approximately 5% and 12%. Conductive hearing loss was the predominant type where classification was reported. In Nepal, conductive hearing loss accounted for 70.47% of identified cases, while sensorineural and mixed hearing loss accounted for 25% and 3.84%, respectively. Commonly reported contributors included cerumen impaction, otitis media, chronic suppurative otitis media, and tympanic membrane abnormalities. Conclusion: Hearing loss among school-going children remains clinically important and is frequently associated with preventable or treatable conductive causes. Standardized school-based screening protocols, clear threshold reporting, diagnostic confirmation, and timely referral pathways are needed to reduce avoidable educational and social consequences.

References

1. Graydon K, Waterworth C, Miller H, Gunasekera H. Global burden of hearing impairment and ear disease. J Laryngol Otol. 2019;133(1):18-25. doi:10.1017/S0022215118001275.

2. Olusanya BO, Davis AC, Hoffman HJ. Hearing loss: rising prevalence and impact. Bull World Health Organ. 2019;97(10):646-646A. doi:10.2471/BLT.19.224683.

3. Helvik AS, Jacobsen GW, Hallberg LRM. Life consequences of hearing loss in terms of activity limitation and participation restriction. Scand J Disabil Res. 2006;8(1):53-66. doi:10.1080/15017410500300413.

4. Alshuaib WB, Al-Kandari JM, Hasan SM. Classification of hearing loss. In: Update on Hearing Loss. London: IntechOpen; 2015. p. 29-37.

5. Golub JS, Brickman AM, Ciarleglio AJ, Schupf N, Luchsinger JA. Association of subclinical hearing loss with cognitive performance. JAMA Otolaryngol Head Neck Surg. 2020;146(1):57-67.

6. Banda FM, Nakstad B. Childhood hearing loss in developing countries: from multidisciplinary team work to public health. In: Wang T, editor. Hearing Loss - From Multidisciplinary Teamwork to Public Health. London: IntechOpen; 2021. doi:10.5772/intechopen.97659.

7. Ruben RJ. Redefining the survival of the fittest: communication disorders in the 21st century. Laryngoscope. 2000;110(2):241. doi:10.1097/00005537-200002010-00010.

8. Kumar S, Aramani A, Mathew M, Bhat M, Rao VV. Prevalence of hearing impairment amongst school going children in the rural field practice area of the institution. Indian J Otolaryngol Head Neck Surg. 2019;71(Suppl 2):1567-1571.

9. Maharjan M, Phuyal S, Shrestha M. Prevalence of hearing loss in school aged Nepalese children. Int J Pediatr Otorhinolaryngol. 2021;143:110658.

10. Jensen JS, Schnohr C, Skovsen CF, Homøe P, Jensen RG. Examination of hearing loss among school-aged children in Greenland. Int J Pediatr Otorhinolaryngol. 2021;149:110865.

11. Munir SB, Saeed I, Khan SG, Rehman SS, Ghayas R, Sikander M, et al. Frequency of hearing impairment in children between the age of 2 to 10 years with middle ear infection. J Pak Med Assoc. 2021.

12. Ertzgaard SI, Kristin N, Sofie T, Sindberg HG, Bang HT, Cosmas M, et al. Prevalence of hearing impairment among primary school children in the Kilimanjaro region within Tanzania. Int J Pediatr Otorhinolaryngol. 2020;130:109797.

13. Osei AO, Larnyo PA, Azaglo A, Sedzro TM, Torgbenu EL. Screening for hearing loss among school going children. Int J Pediatr Otorhinolaryngol. 2018;111:7-12.

14. Absalan A, Pirasteh I, Dashti Khavidaki GA, Nasr Esfahani AA, Nilforoush MH. A prevalence study of hearing loss among primary school children in the south east of Iran. Int J Otolaryngol. 2013;2013.

15. Westerberg BD, Skowronski DM, Stewart IF, Stewart L, Bernauer M, Mudarikwa L. Prevalence of hearing loss in primary school children in Zimbabwe. Int J Pediatr Otorhinolaryngol. 2005;69(4):517-525.

16. Rao RP, Subramanyam MA, Nair NS, Rajashekhar B. Hearing impairment and ear diseases among children of school entry age in rural South India. Int J Pediatr Otorhinolaryngol. 2002;64(2):105-110.

17. Kalpana R, Chamyal PC. Study of prevalence and aetiology of the hearing loss amongst school going children. Indian J Otolaryngol Head Neck Surg. 1997;49(2):142-144.

18. Jacob A, Rupa V, Job A, Joseph A. Hearing impairment and otitis media in a rural primary school in South India. Int J Pediatr Otorhinolaryngol. 1997;39(2):133-138.