High prevalence of hearing loss in urban Aboriginal infants: the Djaalinj Waakinj cohort study

Abstract

titis media and associated hearing loss are highly prevalent in Indigenous Australian children. 1 Most relevant prevalence studies have been undertaken in rural and remote regions, although most Indigenous children live in urban areas. 2 One prospective cohort study found that hearing loss was frequent in young Aboriginal children in a semi-arid zone of Western Australia, 3 but its prevalence in Aboriginal infants in urban areas has not been investigated. 4 We therefore estimated the prevalence of hearing loss in Aboriginal infants in Perth, Western Australia, enrolled in the Djaalinj Waakinj cohort study (2017-2021), 5 and examined the association between otitis media and hearing responses.

Early onset of otitis media is a strong predictor of subsequent disease in urban Aboriginal infants: Djaalinj Waakinj cohort study

“…Furthermore, those with evidence of OM at 2 and/or 6 months of age were 3.5 times more likely to have OM at 12 months of age than those with no prior OM. We recently reported that one in three of these infants had moderate hearing loss at 12 months of age 15 . The association between early onset OM and persistent disease at 12 months is consistent with previous studies in remote communities 17 .…”

“…While larger longitudinal studies are needed, our results highlight the feasibility of and need for early ear health assessments in infants living in urban areas, given the generally asymptomatic nature of OM in infancy. Prompt management is then needed to reduce the likelihood of long‐term hearing loss and potential developmental, social, behavioural, educational outcomes and economic consequences 4–6,15 . Twenty of the 125 study participants are known to have had grommets inserted before 3 years of age, a further indication of the disease burden and need for services.…”

“…At 2 and 6 months of age, the research nurse and/or ARA performed a general health check and ear health screening in participants' homes. A further health check and ear health screening were conducted at 12 months of age either in the home or when attending our audiology clinic for a full audiology assessment 15 . The ear health screening included otoscopic inspection of the ear canal and eardrum followed by tympanometry unless contraindicated due to the presence of ear discharge through a perforated membrane.…”

“…Tympanometry using 1000 Hz probe tone was classified in accordance with the presence of a positive peak, indicative of normal middle ear function, and a negative or no peak, indicative of middle ear dysfunction (indicative of OM). Tympanometry results using 226 Hz probe tone were classified according to the ear canal volume, static compliance and tympanometric peak pressure values as described in Table S1 (Supporting information) 15 …”

“…Tympanometry results using 226 Hz probe tone were classified according to the ear canal volume, static compliance and tympanometric peak pressure values as described in Table S1 (Supporting information). 15 The final tympanometry result was based on the child's worst ear. Overall type A (normal) tympanogram included bilateral or unilateral type A when the contralateral ear tympanogram result was unknown (generally when a valid tympanogram could not be obtained).…”