ABSTRACT
Introduction: Hearing plays an essential role in the proper physical, social, psychological and educational development of a person. Hearing loss is a common and often undiagnosed condition which is caused by a myriad of conditions. Mainstream school children rely on healthy ears to be able to excel in their academic pursuits. Many conditions that lead to hearing loss are largely preventable. The research sought to determine the prevalence of otologic diseases and compared the pattern of otological disorders among primary school children in rural and urban settings in Edo State, Nigeria. The awareness of teachers in primary schools about the level of screening for disability as part of the requirement of the School Health Policy was also ascertained.
Methodology: A cross-sectional descriptive comparative community-based study was carried out among primary school children in Etsako East and Egor Local Government Areas. The study utilized a multistage sampling technique for the selection of participants. A pretested questionnaire was administered to the parents / care givers. Otologic examination was then carried out on the pupils. Data was analyzed using IBM SPSS® for Windows version 21.0. Odds ratio was computed using binary logistic regression models. The level of significance was set at P value <0.05. Results were presented in frequencies and percentages. Correlation was tested using Pearson Chi –test.
Results: A total of 1356 primary school children participated in the survey, comprising of 768(56.7%) females and 588 (43.3%) males with a male: female ratio of 1:1.3. Their ages ranged from 5 to 16 years. The mean age was 8.6 years ± 2.1SD for the urban dwelling children and 8.4 years ± 2.5SD for the rural dwelling children. The rural children made up 597(44%) while urban children were 759(56%) of the study population. A total of 469(34.6%) of the children did not have any otologic abnormality while 65.4% had otologic abnormalities. The rural children had a prevalence of otologic disorder of 64.3% and the urban children had a prevalence of 66.3%. Wax impaction (Rural 79.7%, Urban59.4%) was the commonest otologic disorder followed by otitis media with effusion (Rural 7.8%; Urban 15.9%). The parents displayed a poor knowledge of risk factors of hearing loss and similarly poor practice of ear screening. A high rate of use of cotton tipped buds was noted in the study population.
Conclusion: Otologic conditions are common in school age children in Edo State. Many of these conditions can easily be detected following screening and are amenable to simple therapy. There is need for the proper implementation of the School Health Policy to ensure that otologic screening of school children to enable early detection of ear diseases to allow for early intervention. There is need for public enlightenment to be stepped up by healthcare workers through various channels to create better awareness about the challenges posed by hearing loss and the need for early identification. Training and retraining of teachers is necessary to ensure the success of school ear screening activities. There is need for improved funding of the school system
Keywords: Otologic, Hearing loss, Screening, rural and urban areas, primary school, children, Edo State, Nigeria.
