Evaluation of the use of a questionnaire to detect hearing loss in Kenyan pre-school children

In developing countries, there is a lack of trained personnel and testing e quipment to facilitate the early detection of hearing impairment in childre n. A questionnaire offers a low cost option and the value of this for detec ting hearing impairment in pre-school children was determined in several di stricts in Kenya. The questionnaire was completed by either teachers, paren ts/carers or community nurses. The children were subsequently tested using pure tone audiometry and visual examination of the ear by ENT Clinical Offi cers, who were not given prior access to the results of the questionnaire. A total of 757 (88%) questionnaires were completed. Of the 735 children, wh o could be tested using pure tone audiometry, four were found to have a uni lateral hearing impairment and one was detected by the questionnaire. A tot al of 13 children had a bilateral hearing impairment > 40 dB HL. All were d etected using the questionnaire. There were eight males and five females wi th ages ranging from 4.2 to 6.9 years, mean age 5.7 years and median age 5. 8 years. Eight had a sensorineural hearing impairment and two a mixed heari ng impairment. Three of the children with a sensorineural hearing loss had a family history of hearing impairment. No question detected all children w ith a hearing impairment and some questions were more discerning than other s. There was 100% sensitivity for the questionnaire when a hearing loss of > 40 dB was considered, but specificity was lower at 75%. Negative predicti ve value was 100%, but the positive predictive value was low, 6.75%. It was concluded that a questionnaire of this nature could be usefully applied at Primary Health Care level for detecting hearing impairment at the pre-scho ol stage. There would be need for services available for diagnosis, treatme nt and habilitation before a screening programme was introduced. (C) 2001 E lsevier Science Ireland Ltd. All rights reserved.