WHO Ear and Hearing Disorders Survey in four provinces in China

Abstract

Objective: To investigate the population based prevalence of ear diseases and hearing impairment in Jiangsu, Sichuan, Guizhou and Jilin Provinces in China, develop strategies to provide scientific data for the global database and to draw up prevention and intervention strategies. Methods: Using the WHO Ear and Hearing Disorders Survey Protocol and the probability proportion to size (PPS) sampling technique, 30,733 residents were targeted for investigation in 150 clusters in four provinces. Every subject had an ear examination and pure tone audiometry. Definitions of disabling hearing loss and the classification of hearing impairment used were in accordance with WHO recommendations. Results: Among 30,733 targeted residents, 29,246 individuals (95.2%) participated in the survey. One thousand, three hundred and sixty individuals (4.4%) were absent; 127 individuals (0.4%) refused. The prevalences of hearing impairment and disabling hearing impairment were 14.2% and 5.2% of investigated individuals, respectively: 9.1% of the sample had a mild hearing loss, 3.8% a moderate degree of hearing loss, 1.1% a severe and 0.3% a profound hearing loss. Using data from the fifth population census in China (2000), we calculated the standardized rates of hearing impairment and hearing disability in our study to be 11.7% and 4.4%, respectively. There was a significant difference in the prevalence between males and females, urban and rural dwellers, as well as for different ages. The prevalence of ear diseases was 6.5% of investigated individuals: the standardized rate was 5.9%; 0.2% of investigated individuals had auricle malformation, 2.2% impacted cerumen, 0.2% otitis externa, 0.3% fungi, 0.1% foreign body, 0.1% acute otitis media, 0.9% chronic suppurative otitis media, 1.8% serous otitis media and 1.3% dry perforation of tympanic membrane. Overall, 8.0% of investigated persons were assessed to be likely to benefit from hearing aids, while 4.0% of persons needed medication, 0.1% language/speech rehabilitation, 1.5% non-urgent surgery and 0.9% other treatment. Conclusions: The high prevalence of hearing impairment and disability is a heavy burden on social development and also hinders normal family life. The government and society as a whole should show more concern about these problems. Strategies for prevention and intervention should be focused on less developed regions, rural areas, aging people and non-infectious conditions. Hearing aids services, medication, professional education and training are particularly important in developing countries.

Key words::

• hearing impairment
• disability
• prevalence
• audiometry
• population-based
• survey

Acknowledgements

This study was supported by a WHO grant, donated by CBM, formerly called Christoffel Blindenmission. We gratefully acknowledge the WHO, MOH China and local government officers, community leaders, primary health workers who supported the survey in Jiangsu, Sichuan, Guizhou and Jilin provinces. CBM (formerly called Christoffel Blindenmission) [a German charity working in this field] made the original grant to WHO, who administered the grant to Professor Xingkuan BU, the prinicipal investigator.

We thank the participating institutions, clinicians, and individuals in the four provinces for their active support; and special thanks to Andrew Smith and Peter Alberti for their direction and help in the survey and comments about the report.

Declaration of interest: The authors declare that they have no conflicts of interest.

Contributors

Bu Xingkuan, Liang Chuanyu, Wang Youqin and Du Baodong are principal investigators of Jiangsu, Sichuan, Guizhou and Jilin province respectively; they play the equal role for each province study.

Bu Xingkuan is the responsible person for four provinces study and corresponding author as well.

Zhou Ling and Liu Cheng are responsible for whole statistics of the survey.Xing Guangqian and Zheng Yun are the co-principal investigators of Jiangsu and Sichuan province respectively.

Notes

The protocol has recently been updated to include oto-acoustic emission testing (A.W. Smith, personal communication).