Supporting the global initiative of preventing childhood hearing loss: Act now, here's how!

Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy 
 Department of Community Medicine, Shri Sathya Sai Medical College & Research Institute, Ammapettai, Chennai, Tamil Nadu, India

Correspondence Address:
Saurabh RamBihariLal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College & Research Institute, 3rd Floor, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India

Full Text

Sir,

Hearing impairment has been acknowledged as a hidden form of human disability, which generally results in potentially serious and long-term adverse aftereffects.[1] In-fact, the recent global estimates suggest that more than 350 million people have disabling hearing loss (viz. hearing loss in excess of 40 dB and 30 dB in the better ear in adults and in children, respectively), of which 32 million are children.[2] Further, a major proportion of children with disabling hearing loss are from the developing nations.[2]

Childhood hearing loss: determinants and consequences

Childhood hearing loss has been attributed to a wide range of factors, with the most common being hereditary, followed by infections, childbirth complications, and consumption of ototoxic drugs either by the expectant mothers or the newborn/children.[2],[3] The consequences of childhood hearing loss have been disastrous and vary from defects in speech development, effect on the ability of an individual to communicate with others, scholastic backwardness, and social and emotional impacts in the form of loneliness or feeling of isolation.[2],[4] In addition, there is an added level of parenting stress both due to social reasons and economic reasons, and people have to face a poor financial status owing to the lesser opportunities for education or employment, and lesser salary, even if employed.[2],[4]

Preventive strategies

However, on a positive note, the estimates from a recent report have suggested that almost 60% of the childhood hearing loss can be easily prevented through implementation of primary prevention measures (such as immunization against infectious agents, avoiding ototoxic drugs, providing quality assured antenatal and perinatal care, regulation of noise levels, compliance with healthy ear care practices, screening children for otitis media, referral to higher centers for specialized care for high-risk infants and children, etc.).[5]

At the same time, early detection and targeted interventions play a defining role in reducing the overall impact of hearing loss on the development and educational achievements of children.[1],[2] The findings of a study done in an African nation have shown that in excess of 40% of the cases of childhood hearing loss presented almost five years after the onset of the condition.[1] The strategy to conduct screening for ear ailments and hearing loss in the pre-school period and in school settings is one of the key approaches to promote early detection and management of hearing loss.[4],[5]

Furthermore, on the basis of extent of hearing loss, the child can be managed with hearing devices, speech therapy, aural rehabilitation, or even by giving an opportunity to allow deaf children/family members to learn sign language or lip-reading skills.[1],[2],[5] However, the biggest challenge for the program managers is to ensure that the hearing aids meet the global needs, as currently only 1 in 10 individuals has an access to the same, with the scenario being even worse in developing nations.[2],[5] In addition, the issues pertaining to the lack of services for fitting and maintaining these devices have also been identified as some of the hurdles in many low-income settings.[2]

Simultaneously, interventions like creating awareness among the general population about the prevalence of childhood hearing loss and the necessity for its early detection and management, increasing political commitment by ensuring that programs for hearing care are integrated into the primary health care, declaring official status to the sign languages, and improving the availability of sign language interpreters to enhance the access to the sign language services, and building linkages with the manufacturers to enhance the production of affordable hearing aids.[5]

 Conclusion

References