Ear screening in primary school children in Lusaka, Zambia

Background: Hearing screening programs for school-aged children are common in the more developed countries, but not in the developing world. Hearing loss is referred to as the silent, overlooked epidemic in developing countries. The 2008 Zambian Ministry of Education statistical bulletin showed that there were a total of 168,866 children with special education needs from grade 1-9. 27,000 children were listed with hearing defects and 70,229 listed as having learning difficulties. Most teachers are not trained to identify hearing defects. A number of the children listed as having a learning difficulty may have hearing impairments. Objective: To evaluate ear diseases leading to hearing impairment among Zambian children entering school in an urban area.Methods: Otoscopy was carried out in Grade one and two primary school children in Lusaka, Zambia. Hearing screening was carried out with OAE and/or screening audiometry. Results were recorded in a simple tally sheet and transferred to an excel worksheet for data analysis.Results: More than a third of the screened children had ear conditions which needed attention. Out of them most children had wax which needed to be removed. Around 10 percent of the children had ear conditions, such as Otitis media with effusion, external Otitis, foreign bodies, CSOM and/or hearing loss.Conclusions: Ear and hearing screening in primary schools is a very necessary tool to establish ear diseases leading to hearing impairment, especially in the developing world. The impression is that a far higher percentage of children are having ear and hearing problems in the developing world compared to statistics from the western countries