Field-testing of a rapid survey method to assess the prevalence and causes of hearing loss in Gao'an, Jiangxi province, China

Tess Bright; Xin Shan; Jinling Xu; Jianguo Liang; Baixiang Xiao; Robbert Ensink; Islay Mactaggart; Sarah Polack; Jennifer L Y Yip

doi:10.1186/s13690-020-0398-1

Field-testing of a rapid survey method to assess the prevalence and causes of hearing loss in Gao'an, Jiangxi province, China

Arch Public Health. 2020 Mar 6:78:16. doi: 10.1186/s13690-020-0398-1. eCollection 2020.

Authors

Tess Bright¹, Xin Shan², Jinling Xu², Jianguo Liang², Baixiang Xiao³, Robbert Ensink⁴, Islay Mactaggart¹, Sarah Polack¹, Jennifer L Y Yip¹

Affiliations

¹ 1International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1 E7HT United Kingdom.
² Gao'an City People's Hospital, Gao'an, Jiangxi China.
³ 3Zhongshan Opthalmic Centre, Sun Yatsen University, Guangzhou, Guangdong China.
⁴ 4Department of Oto-rhino-laryngology, Gelre Hospitals, Zutphen, The Netherlands.

Abstract

Background: The Rapid Assessment of Hearing Loss (RAHL) survey protocol aims to measure the prevalence and causes of hearing loss in a low cost and rapid manner, to inform planning of ear and hearing services. This paper reports on the first field-test of the RAHL in Gao'an County, Jiangxi Province, China. This study aimed to 1) To report on the feasibility of RAHL; 2) report on the estimated prevalence and causes of hearing loss in Gao'an.

Methods: A cross-sectional population-based survey was conducted in September-October 2018. Forty-seven clusters in Gao'an County were selected using probability-proportionate-to-size sampling. Within clusters, compact segment sampling was conducted to select 30 people aged 50+. A questionnaire was completed covering sociodemographics, hearing health, and risk factors. Automated pure-tone audiometry was completed for all participants, using smartphone-based audiometry (hearTest), at 0.5, 1, 2, 4 kHz (kHz). All participants had their ears examined by an Ear Nose and Throat (ENT) doctor, using otoscopy, and probable causes of hearing loss assigned. Prevalence estimates were age and sex standardised to the Jiangxi population. Feasibility of a cluster size of 30 was examined by assessing the response rate, and the proportion of clusters completed in 1 day.

Results: 1344 of 1421 eligible participants completed the survey (94.6%). 100% of clusters were completed in 1 day. The survey was completed in 4.5 weeks. The prevalence of moderate or greater hearing loss (pure-tone average of 0.5, 1, 2, 4 kHz of > = 41dBHL in the better ear) was 16.3% (95% CI = 14.3, 18.5) and for any level of hearing loss (pure-tone average of > = 26dBHL in the better ear) the prevalence was 53.2% (95% CI = 49.2, 57.1). The majority of hearing loss was due to acquired sensorineural causes (91.7% left; 92.1% right). Overall 54.0% of the population aged 50+ (108,000 people) are in need of diagnostic audiology services, 3.4% were in need of wax removal (7000 people), and 4.8% were in need of surgical services (9500 people). Hearing aid coverage was 0.4%.

Conclusion: The RAHL survey protocol is feasible, demonstrated through the number of people examined per day, and the high response rate. The survey was completed in a much shorter period than previous all-age surveys in China. Some remaining challenges included assignment of causes of probable sensorineural loss. The data obtained from this survey can be used to scale-up hearing services in Gao'an.

Keywords: China; Hearing loss; Population-based survey; Rapid assessment.