Analysing use of the Chinese HHIE-S for hearing screening of elderly in a northeastern industrial area of China.

OBJECTIVE: The aim of the present study was to investigate the use of Chinese version of HHIE-S as a hearing screening tool for the elderly in an industrial area in northeast China. DESIGN: Prevalence, sensitivity and specificity of Chinese version of HHIE-S were calculated. Factors that had impact on HHIE-S were analysed. STUDY SAMPLE: Five hundred and seventy Mandarin speaking participants, aged from 50 to 85 years were included. They were tested with pure tone audiometry and Chinese version of HHIE-S. RESULTS: The prevalence of hearing handicap was 55.3%. The sensitivity and specificity of HHIE-S were 84.5% and 58.3% respectively when the pass/fail criteria were set at PTA0.5-4kHz >40 dBHL. In general, HHIE-S total and subscale scores were significantly associated with severity of hearing impairment. After stratified by severity of hearing impairment, both the prevalence of reported handicap and the scores of HHIE-S were not significantly associated with age. Male participants had significantly higher HHIE-S scores than female participants did. CONCLUSIONS: The Chinese version of HHIE-S contributes useful information to identifying hearing handicap and addressing the rehabilitative needs in the elderly in an industrial city in Mainland China.

Hearing screening and middle ear measures in American Indian infants and toddlers.

UNLABELLED: American Indian children have three times the rate of otitis media compared to the general population, yet prospective cohort studies of OME and hearing loss have not been previously reported in American Indian infants. Between 1997 and 2003, a cohort of 421 infants was enrolled at birth from Minnesota American Indian reservations and an urban clinic and followed to age 2 years. This study reports OAE hearing screening results related to OME diagnoses, as well as risk for recurrent hearing screening failure and OME in American Indian infants and children. METHODS: Infants were prospectively assessed at regular intervals with pneumatic otoscopy, distortion product otoacoustic emissions, and tympanometry by nurses who were trained in all procedures and validated on pneumatic otoscopy. RESULTS: In the newborn period, 23.5% of infants failed hearing screening in at least one ear. Hearing screening failures increased to 29.9% from 2 to 5 months of age. Technical fail results due to excessive noise occurred frequently in infants 6-24 months of age, making interpretation of true pass and fail rates questionable in older infants. OAE test result was associated with OM diagnosis, and this relationship strengthened with age, with the strongest association above 6 months of age. CONCLUSIONS: A high rate of hearing screening failures occurred among American Indian infants in the first 5 months of age, and was significantly associated with a correspondingly high rate of otitis media. Only one infant out of 366 was identified with sensorineural hearing loss, thus essentially all of the hearing screening failures reflected either a middle ear origin or other temporary problems. OAE screening provided a valuable hearing screening measure in this population at high risk for recurrent otitis media, but due to excessive noise in infants 6 months and older, practical use of OAE screening is limited. Use of behavioral assessment is needed after 6 months of age, when high rates of OME persist in this population. Increased efforts to develop public and medical education, as well as screening, diagnosis and treatment programs are needed to detect and decrease recurrent OME in American Indian infants and children.

Otitis media: health and social consequences for aboriginal youth in Canada's north.

OBJECTIVES: Otitis media is endemic among Inuit, First Nations and Métis children in northern Canada, with prevalence rates in some communities as high as 40 times that found in the urban south. Hearing impairment, much of it attributable to chronic otitis media, is the most common health problem in parts of the arctic, and conductive hearing loss among children may affect as many as two-thirds. STUDY DESIGN AND METHODS: There is a need for systematic data based on consistent disease definitions and measures, and taking account of cross-cultural methodological issues and sampling. RESULTS: Otitis media is most likely to develop in infancy. Susceptibility has been linked to immune defects and to a variety of environmental factors. Among the most significant are diet, the decline in initiation and maintenance of breastfeeding, and exposure to cigarette smoke. Hearing loss has been related to difficulties in language acquisition, and to subsequent issues with literacy and school achievement, including learning disabilities and attention deficits. The economic and social costs of otitis media are substantial. CONCLUSION: Approaches to treatment and prevention have enjoyed limited success. Public health and medical practice need to be informed by the traditional knowledge and practices of indigenous peoples.

Middle ear problems in Aboriginal school children cause developmental and educational concerns.

An epidemiological study was carried out in the year 2000 and sought to measure the occurrences of middle ear disease and hearing loss within school aged (4 years to 12 years) Aboriginal children. A number of the local schools and preschools in Coraki and Lismore with a high percentage of Aboriginal students were selected in an effort to identify service gaps regarding essential hearing screenings and assessments. A total of 185 (370 ears) Aboriginal children aged 4 years to 12 years were examined from four schools and three preschools. This examination included otoscopy, tympanometry and audiometry. Data were collected as each child was tested and this was then entered into a computer database on returning to the work place. Results indicated that 61.08% of these children had middle ear problems of some type. Unilateral hearing loss of 30 dB or greater was found in 10.80% of children, bilateral hearing loss of 30 dB and greater was found in 22.16%, and perforation of tympanic membranes in 3.24%. Suggestions are made in relation to the need for ongoing training of Aboriginal Community Audiometrists to provide community, school and preschool screening programs together with health related promotional activities to minimise the occurrences of ear infections.

The Hearing Handicap Inventory for the Elderly screening version adapted for use with elderly Chinese American individuals.

The purpose of this study was to determine whether the Hearing Handicap Inventory for the Elderly (HHIE) screening version translated into Chinese can be used as a valid screening instrument for the identification of hearing impairment in Chinese-speaking elderly persons. One hundred elderly Chinese Americans were screened, and the majority of the subjects did not report hearing handicap. A comparison among different screening protocols (ASHA, 40 dB HL at 1000 and 2000 Hz; HHIE-S > 10 and HHIE-S > 10 and 40 dB HL at 1 and 2 kHz) suggested that the combined HHIE-S and 40 dB HL cutoff at 1000 and 2000 Hz achieved the best referral rates. Some hypotheses explaining the results are discussed relative to cultural and linguistic differences between elderly Chinese Americans and their white English-speaking counterparts.

Hearing problems in Mexican American elderly.

OBJECTIVE: To investigate hearing problems in a sample of elderly Mexican Americans. STUDY DESIGN: A longitudinal field study of a cohort of 3,050 subjects with in-person baseline and a 2-year follow-up. Population-based, cross-sectional, weighted data were analyzed. SETTINGS AND SUBJECTS: Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) consisting of Mexican Americans aged 65 and older provided basic health data using area probability sampling in five southwestern states during 1993 and 1994. MAIN OUTCOME MEASURES: Information was collected regarding demographics, medical conditions, smoking, and alcohol consumption. Hearing problems were identified through a series of self-perceived hearing problem questions, hearing aid use, and inability to hear a normal voice. RESULTS: A hearing problem was identified in 24.5% of this cohort (weighted, 748/3,049). Statistical analysis using a multiple logistic regression model was performed to identify factors jointly associated with hearing problems. Age group (odds ratio [OR] = 2.7, p<0.0001), male sex (OR = 1.9, p< 0.0001), hypertension (OR = 1.4, p<0.001), arthritis (OR = 1.5, p<0.0005), significant depressive symptomatology (OR = 1.4, p<0.002), and ever having consumed alcohol (OR = 1.4, p<0.005) were jointly statistically significantly associated with hearing problems. Number of cigarettes smoked daily (e.g., 0, 1-10, 11-20, etc.) was nearly significantly associated with a hearing problem in the multivariate model (OR = 1.1 for each increased in category, p<0.07). CONCLUSIONS: Hearing problems are common in this population. Control of hypertension, an amelioration of arthritis, and decreasing the consumption of alcohol and cigarettes may lower the likelihood of development of a hearing problem. Initial depressive symptomatology may have occurred subsequent to the hearing loss. A longitudinal study would allow determination of the direction of causation.

Hearing screening in Australian aboriginal university students.

Many indigenous peoples have been found to show an increased prevalence of both middle ear disorder and associated conductive hearing loss. Hearing loss may cause educational disadvantage during school years. For many indigenous populations in developed countries there are now increasing opportunities to participate in established formal education. This has led to greater numbers of indigenous students in post-secondary education. This study examined the results of a three-year hearing health programme for Australian Aboriginal students entering university studies. Prevalence rates were compared with those of urban Aboriginal adult non-students and non-indigenous populations. It was found that 15.5% of indigenous university students had a unilateral or bilateral hearing loss. Recommended screening procedures and methods to enhance classroom listening for indigenous hearing impaired students were suggested.