Parental suspicion of hearing loss in children with otitis media with effusion

Lo, Phoebe S.Y.; Tong, Michael C. F.; Wong, Eric; Hasselt, C. Andrew van

doi:10.1007/s00431-006-0181-5

Cited by 27 publications

(29 citation statements)

References 25 publications

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“…Only 8% of children with OME visited ENT clinic and 3.5 % of them had ENT operations (adenoidectomy, tonsillectomy and ventilation tubes). Health education of parents helps to increase their awareness of this silent disease and this has been recommended by Lo et al (41) In our study, 23% of children with OME had recurrent AOM compared to 7% in normal children, (p<0.0001). In the multivariate regression model, we found recurrent AOM to be a strong predictor of OME in this age(OR=4.914, 95% CI: 2.677-9.02).…”

Section: Discussionmentioning

confidence: 59%

Prevalence and Risk Factors of Otitis Media with Effusion in School Children in Qassim Region of Saudi Arabia

Alhumaid¹,

Abou-Halawa²

2014

IJHS

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Abstract:Objective: To determine the prevalence of otitis media with effusion (OME) among school children in Qassim region of Kingdom of Saudi Arabia and to determine relevant risk factors in affected children. Methods:Through a cross-sectional study, 1488 children in the age range 6-12 years were randomly selected from 25 primary schools in Qassim region. A questionnaire was used to determine risk factors for OME. Otoscopy and tympanometry were used to diagnose and confirm OME. Pure tone average for children with confirmed OME was measured. Teachers of children were asked to complete a questionnaire evaluating child's level of school performance. Results:Prevalence of OME in the study population was 7.5% (112/1488). In univariate analysis, it was strongly associated with age less than 8 years (p< 0.0001; OR= 4.23, 95% CI: 2.85-6.29 ), family size more than 4 members in the household((p<0.0001; OR= 4.45, 95% CI: 2.23-8.88), mother education less than secondary school education (p<0.0001; OR=2.2, 95% CI: 1.47-3.29), recurrent acute otitis media (AOM) (p<0.0001; OR=5.73, 95% CI: 3.47-9.45), and hearing loss symptom (p< 0.0001; OR= 3.39, 95% CI: 1.92-5.99). It is less strongly associated with history of preschool AOM (p= 0.002; OR= 3.15, 95% CI: 1.67-5.97), nasal discharge (p= 0.003; OR= 1.91, 95% CI: 1.24-2.93) and snoring (p=0.03; OR= 1.76, 95% CI: 1.06-2.94). OME was significantly higher in schools located in rural districts (p<0.001, OR= 2.82, 95% CI: 1.86 -4.28). In multivariate regression model, five of these factors were found to be predictors of OME: age less than 8 years (OR= 5.052, 95% CI:3.289-7.762), family size more than4 members in the household) (OR= 4.192, 95% CI: 2.033-8.643), rural school district (OR=3.037, 95% CI: 1.933-4.772), mother education lower than secondary school education) (OR=2.041, 95% CI:1.602-3.877) and recurrent AOM (OR=4.914, 95% CI: 2.677-9.02). Children with OME tend to have poorer school performance compared to normal children (p=0.067). No significant correlation was found between OME and type of feeding during the first two years of life (p=0.62; OR= 0.87, 95% CI: 0.51-1.49), preschool daycare attendance (p=0.17; OR= 0.71, 95% CI: 0.44-1.16), home exposure to cigarette smoke (p=0.4; OR= 1.34, 95% CI:0.68 -2.65), visits to ENT clinic (p=0.13; OR= 0.58, 95% CI:0.29-1.18), and ENT operations (p=0.12; OR= 0.46, 95% CI: 0.17-1.27). Conclusion:Prevalence of OME in Qassim region reaches 7.5% in school children. Age less than 8 years, family size more than 4 members in the household, mother education less than secondary school education, living in rural area and recurrent AOM are found to be predictors of OME in Qassim region. In this population of children, otoscopy and tympanometry should be used as screening tools for OME.

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Section: Discussionmentioning

confidence: 59%

Prevalence and Risk Factors of Otitis Media with Effusion in School Children in Qassim Region of Saudi Arabia

Alhumaid¹,

Abou-Halawa²

2014

IJHS

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“…Hearing impairment in the group may also be masked by their intellectual impairment, thus overlooked by both parents and teachers, though similarly low parental awareness was also noted recently among a general pediatric population in the same geographic region [51]. Appropriate parent/teacher education is necessary to ensure optimal audiological intervention.…”

Section: Poor Parental Awareness Of Hearing Loss In School Children Wmentioning

confidence: 92%

Hearing loss in Chinese school children with Down syndrome

McPherson

Lai

Leung

et al. 2007

International Journal of Pediatric Otorhinolaryngology

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“…NIHR Journals Library www.journalslibrary.nihr.ac.uk Lo et al 53 compared a parental questionnaire with PTA results in 6-to 7-year-old Chinese children in Hong Kong. They report that parents were able to identify only 20% of the cases of OME (no permanent hearing impairments were identified).…”

Section: False-negative Results From Screening Testsmentioning

confidence: 99%

“…We therefore sought 15 papers 3,7,8,26,[43][44][45][46][47][48][49][50][51][52][53] for full review. All but one 45 (published in 1981) were published between 1996 and 2014.…”

Section: Methodsmentioning

confidence: 99%

A programme of studies including assessment of diagnostic accuracy of school hearing screening tests and a cost-effectiveness model of school entry hearing screening programmes

Fortnum

Ukoumunne

Hyde

et al. 2016

Health Technol Assess

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BackgroundIdentification of permanent hearing impairment at the earliest possible age is crucial to maximise the development of speech and language. Universal newborn hearing screening identifies the majority of the 1 in 1000 children born with a hearing impairment, but later onset can occur at any time and there is no optimum time for further screening. A universal but non-standardised school entry screening (SES) programme is in place in many parts of the UK but its value is questioned.ObjectivesTo evaluate the diagnostic accuracy of hearing screening tests and the cost-effectiveness of the SES programme in the UK.DesignSystematic review, case–control diagnostic accuracy study, comparison of routinely collected data for services with and without a SES programme, parental questionnaires, observation of practical implementation and cost-effectiveness modelling.SettingSecond- and third-tier audiology services; community.ParticipantsChildren aged 4–6 years and their parents.Main outcome measuresDiagnostic accuracy of two hearing screening devices, referral rate and source, yield, age at referral and cost per quality-adjusted life-year.ResultsThe review of diagnostic accuracy studies concluded that research to date demonstrates marked variability in the design, methodological quality and results. The pure-tone screen (PTS) (Amplivox, Eynsham, UK) and HearCheck (HC) screener (Siemens, Frimley, UK) devices had high sensitivity (PTS ≥ 89%, HC ≥ 83%) and specificity (PTS ≥ 78%, HC ≥ 83%) for identifying hearing impairment. The rate of referral for hearing problems was 36% lower with SES (Nottingham) relative to no SES (Cambridge) [rate ratio 0.64, 95% confidence interval (CI) 0.59 to 0.69;p < 0.001]. The yield of confirmed cases did not differ between areas with and without SES (rate ratio 0.82, 95% CI 0.63 to 1.06;p = 0.12). The mean age of referral did not differ between areas with and without SES for all referrals but children with confirmed hearing impairment were older at referral in the site with SES (mean age difference 0.47 years, 95% CI 0.24 to 0.70 years;p < 0.001). Parental responses revealed that the consequences to the family of the referral process are minor. A SES programme is unlikely to be cost-effective and, using base-case assumptions, is dominated by a no screening strategy. A SES programme could be cost-effective if there are fewer referrals associated with SES programmes or if referrals occur more quickly with SES programmes.ConclusionsA SES programme using the PTS or HC screener is unlikely to be effective in increasing the identified number of cases with hearing impairment and lowering the average age at identification and is therefore unlikely to represent good value for money. This finding is, however, critically dependent on the results of the observational study comparing Nottingham and Cambridge, which has limitations. The following are suggested: systematic reviews of the accuracy of devices used to measure hearing at school entry; characterisation and measurement of the cost-effectiveness of different approaches to the ad-hoc referral system; examination of programme specificity as opposed to test specificity; further observational comparative studies of different programmes; and opportunistic trials of withdrawal of SES programmes.Trial registrationCurrent Controlled Trials ISRCTN61668996.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 36. See the NIHR Journals Library website for further project information.

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Parental suspicion of hearing loss in children with otitis media with effusion

Cited by 27 publications

References 25 publications

Prevalence and Risk Factors of Otitis Media with Effusion in School Children in Qassim Region of Saudi Arabia

Prevalence and Risk Factors of Otitis Media with Effusion in School Children in Qassim Region of Saudi Arabia

Hearing loss in Chinese school children with Down syndrome

A programme of studies including assessment of diagnostic accuracy of school hearing screening tests and a cost-effectiveness model of school entry hearing screening programmes

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