Measurement of Hearing Impairment among Greenlandic School-Children: Association Between Self-Reported Data and Clinical Examinations
Abstract Background: Ear infections is the leading cause of hearing impairment among children world-wide and a major public health problem in many indigenous populations. Early onset of hearing impairment compromise communication skills and social and psychological development, and monitoring the prevalence in a population is important to assess the need for interventions both at the school-, societal and clinical settings in a population.Methods: 185 children from 5th to 10th grade from Sisimiut town and the nearby settlements participated in a clinical examination to have ear-examination and pure tone audiometry. Participants filled out a questionnaire at home with their parents before the clinical examination, and hearing impairment was collected as individual self-reports and as audiometric measurements. Ear examinations was assessed by two clinicians and if any discrepancy between self-reports and clinical measures they were re-assessed.Results: A total of 185 children between 9 and 15 years of age (median: 11 years, IQR: 10-13) were included, 60% (n=111) were girls. 247 (70%) of the 355 available otoscopies were clinically assessed as normal. Cohen’s Kappa coefficient was 0.31. Eighteen children (10%) were found to have hearing impairment using a PTA of ≥ 25 dB for either low or high frequencies or both as threshold in one or both ears. 32 children (17%) reported hearing impairment to the extent that they were not able to keep up in school, of which half reported that it had lasted for more than one year. 7 of the 32 children reporting hearing impairment (22%) reported that the extent of their hearing impairment was affecting their classroom experience so they were not able to follow. None of the children had hearing aids. Conclusion: Self-reported and clinically screening for hearing impairment are two different concepts. Even though the two concepts are statistically correlated, the correlation coefficients are low. The contextual processing in which perceived hearing impairment is assessed in a social environment seems to conceptually differ from the measure of hearing by pure tone audiometry. Since both measure hearing impairment, the choice of measure should relate to the purpose and method of the investigation.