Research Article

Burden of hearing loss in Subsaharan Africa: Snapshot from an ENT clinic in Nigeria

Ogunkeyede SA*, Adebola SO, Daniel A and Adeyemo AA

Published: 31 December, 2019 | Volume 3 - Issue 1 | Pages: 001-005

Background: Disabling hearing loss is a prevalent public health issue, with significant impact on patients’ communication. The disability associated with hearing loss depends on the severity of the hearing loss. There are limited rehabilitative measures in resource challenged environment. This study assesses the incidence, the factors for hearing impairment and the management outcome.

Methods: A descriptive three-year chart review of patients managed for hearing loss in a tertiary health center in a developing country. The data collected include demographic data, clinical presentation and risk factors for hearing loss, audiometric reports, rehabilitative measures and management outcome.

Results: The patients with ear symptoms managed within the study period were 1350, of whom 498 (36.8%) had hearing loss of varying degrees. These included 145 (29.1%) males and 353 (70.9%) females with male to female ratio of 1:2.4. The age ranged from 8 to 80 years (median age of 35.7). Disabling hearing loss in the better-hearing ear occurred in 216 (43.4%) of cases. Increasing age and chronic supportive otitis media were associated with disabling hearing loss. The hearing thresholds improved with hearing aids and ear surgical procedures; nonetheless the patients’ rehabilitation was impaired by limited resources.

Conclusion: There is poor rehabilitation of people with hearing loss, though management outcome is commendable in a few of them. Health education will reduce the risk factors for disabling hearing loss and improved rehabilitative measures are needed for these individuals.

Read Full Article HTML DOI: 10.29328/journal.hor.1001016 Cite this Article Read Full Article PDF


Disabling hearing loss; Communication; Developing country Health education; Rehabilitation


  1. Turner JS, Per-Lee JH. Auditory Dysfunction: Hearing Loss. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990.
  2. Olusanya BO, Neumman KJ, Saunders JE. The global burden of disabling hearing impairment: a call to action. Bull World Health Organ. 2014; 92: 367-373. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24839326
  3. International Classification of Functioning, Disability and Health (ICF). Geneva: World Health Organization; 2001.
  4. World Health Organization. Prevention of blindness and deafness. Grades of hearing impairment [Internet]. Geneva: World Health Organization; 2013.
  5. Steel KP. Science, medicine, and the future: new interventions in hearing impairment. BMJ. 2000; 320: 622-625. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/10698884
  6. World Health Organization. Deafness and hearing loss. 2018.
  7. Geneva: World Health Organization. Global costs of unaddressed hearing loss and cost-effectiveness of interventions. 2018.
  8. Mahboubi H, Oliaei S, Kiumehr S, Dwabe S, Djalilian HR. The prevalence and characteristics of tinnitus in the youth population of the United States. Laryngoscope. 2013; 123: 2001-2008. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23606449
  9. Oishi N, Schacht J. Emerging treatments for noise-induced hearing loss. Expert Opin Emerg Drugs. 2011; 16: 235–245. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21247358
  10. Youth population of the United States. Laryngoscope. 2013; 123: 2001-2008.
  11. Basner M, Babisch W, Davis A, Brink M, Clark C, et al. Auditory and non-auditory effects of noise on health. Lancet. 2014; 383: 1325-1332. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24183105
  12. Ganesan P, Schmiedge J, Manchaiah V, Swapna S, Dhandayutham S, Kothandaraman PP. Ototoxicity: A Challenge in Diagnosis and Treatment. J Audiol Otol. 2018; 22: 59-68. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/29471610
  13. Wilson BS, Tucci DL, Merson MH, O'Donoghue GM. Global hearing health care: new findings and perspectives. Lancet. 2017; 390: 2503-2515. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28705460
  14. Zhan W, Cruickshanks KJ, Klein BE, Klein R, Huang GH, et al. Generational differences in the prevalence of hearing impairment in older adults. Am J Epidemiol. 2010; 171: 260-266. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20008889
  15. Olusanya BO, Swanepoel de W, Chapchap MJ, Castillo S, Habib H, et al. Progress towards early Detection services for infants with hearing loss in developing countries. BMC Health Serv Res. 2007; 7: 14. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17266763
  16. Committee on Infant Hearing. Year 2007 Position Statement: Principles and guidelines for early hearing detection and intervention programs. Pediatrics. 2007; 120: 898-921. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17908777
  17. Mc Gavin ZA, Wagner AL, Carlson BF, Power LE. Eboreime E, et al. Childhood full and under-vaccination in Nigeria 2013. 2018: 36: 7294-7299. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30340882
  18. Babalola S. Determinants of the Uptake of the Full Dose of Diphtheria–Pertussis–Tetanus Vaccines (DPT3) in Northern Nigeria: A Multilevel Analysis. Matern Child Health J. 2009; 13: 550-558. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18607704
  19. Prevention of blindness and deafness. 2018.
  20. Rodenburg V, Ruytjens L, Oostenbrink R, Van der Schroeff MP. Repeated Audiometry After Bacterial Meningitis: Consequences for Future Management. Otol Neurotol. 2018; 39: 301-306. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/29659414
  21. Kotby MN, Tawfik S, Aziz A, Taha H. Public health impact of hearing impairment and disability. Folia Phoniatr Logop. 2008; 60: 58-63. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18235192
  22. Stevens G, Flaxman S, Brunskill E, Mascarenhas M, Mathers CD, et al. Global Burden of Disease Hearing Loss Expert Group: Global and regional hearing impairment prevalence: an analysis of 42 studies in 29 countries. Eur J Public Health. 2013; 23: 146-152. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22197756
  23. Lederberg AR, Schick B, Spencer PE. Language and literacy development of deaf and hard-of-hearing children: Successes and challenges. Developmental Psychology. 2013; 49: 15-30. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22845829
  24. World Health Organization. Preferred profile for hearing-aid technology suitable for low- and middle-income countries. 2017.
  25. Laplante LA, Hickson L, Worrall L. Rehabilitation of Older Adults with Hearing Impairment: A Critical Review. J Aging Health. 2010; 22: 143-153. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20056812
  26. Cahart R. Classifying Audiolograms: An approved method of classifying. Laryngoscope. 1945; 55: 1-3.
  27. Nash SD, Cruickshanks KJ, Klein R, Klein BE, Nieto FJ, et al. The prevalence of hearing impairment and associated risk factors: The Beaver Dam offspring study. Arch Otolaryngol Head Neck Surg. 2011; 137: 432-439. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21339392
  28. Islam MS, Islam R, Bhuiyan MA, Rashid S, Datta PG. Pattern and degree of hearing loss in chronic suppurative otitis media. Bangladesh Journal of Otorhinolaryngology. 2010; 16: 96-105.
  29. Tadros SF, Frisina ST, Mapes F, Frisina DR, Frisina RD. High serum aldosterone levels correlate with lower hearing thresholds in aged humans: a possible protective hormone against presbycusis. Hear Res. 2005; 209: 10-18.
  30. Souza DDS, Luckwu B, Andrade WTL, Pessoa LSF, Nascimento JAD, et al. Variation in the Hearing Threshold in Women during the Menstrual Cycle. Int Arch Otorhinolaryngol. 2017; 21: 323-328. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/29018493
  31. Guimaraes P, Frisina ST, Mapes F, Tadros SF, Frisina DR, et al. Progestin negatively affects hearing in aged women. Proc Natl Acad Sci USA. 2006; 103: 14246-1429. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16959884
  32. Price K, Zhu X, Guimaraes PF, Vasilyeva ON, Frisina RD. Hormone replacement therapy diminishes hearing in peri-menopausal mice. Hear Res. 2009; 252: 29-36. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19269311
  33. Ramon GJ, Anders K, Preben H. The risk of hearing loss in a population with a high prevalence of chronic suppurative otitis media. Int J Pediatr Otorhinolaryngol. 2013; 77: 1530-1535. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23906989
  34. Kolo ES, Salisu AD, Yaro AM, Nwaorgu OG. Sensorineural hearing loss in patients with chronic suppurative otitis media. Indian J Otolaryngol Head Neck Surg. 2011; 64: 59-62. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23449378
  35. Park M, Lee JS, Lee JH, Oh SH, Park MK. Prevalence and risk factors of chronic otitis media: the Korean National Health and Nutrition Examination Survey 2010-2012. PLoS One. 2015; 10: e0125905. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25978376
  36. Adeyi A, Tonga N, Olugbenga S. Chronic suppurative otitis media: Socio-economic implications in a tertiary hospital in Northern Nigeria. Pan Afr Med J. 2010; 4: 3. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21119988
  37. Fischer ME, Cruickshanks KJ, Wiley TL, Klein BE, Klein R, et al. Determinants of hearing aid acquisition in older adults. Am J Public Health. 2011; 101: 1449-1455. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21680930
  38. Meyer C and Hickson L. What factors influence help-seeking for hearing impairment and hearing aid adoption in older adults. Int J Audiol. 2012; 51: 66-74. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22256793
  39. Primary care and training resource: advanced level Geneva: World Health Organization; 2006.
  40. Sogebi OA. Assessment of the risk factors for hearing loss in adult Nigerian population. Niger Med J. 2013; 54: 244-249. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/2424995Z

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