Irshad Ali Shaikh, Masood Ali Shaikh


Hearing impairment is common among the
elderly and it compromises communication with
resultant poor psychological functioning in
affected individuals of all ages. To describe, age
gender, literacy and residency status associated
with self reported hearing difficulty in adults and
its prevalence in Pakistan, we used data from the
National Health Survey of Pakistan (NHSP)
1990-94; with written permission from the
Federal Ministry of Health, Islamabad. We
selected all the adults aged 26 and above who
responded to the question “Do you have
difficulty in hearing?” Individuals responding
affirmatively to this question were identified as
having difficulty in hearing. A two-stage
stratified sample design was adopted for NHSP.
Design-based analysis with SUDAAN 9.01 was
done using logistic regression. Odds Ratios (OR)
were computed for the association of self
reported difficulty in hearing with various
demographic variables.
The overall prevalence of difficulty in
hearing was 16%, and 95% Confidence Interval
(CI) was 15%, 18% (n = 5843). In males
prevalence of difficulty in hearing was 14%,
95% CI 12%, 15%, while prevalence in females
was 19%, 95% CI 16%, 21%. In the 26- 40 year
old adults, prevalence of difficulty in hearing
was 8%, 95% CI 7%, 10%. Age gradient was
observed, as 41-55 year old age group had
prevalence of 13%, 95% CI 11%, 15%, while in
the 56 years and above age group, prevalence
was 36%, 95% CI 32%, 40%.
Adults with difficulty in hearing were
more likely to be in the age group of 41 to 55
years (OR 1.64, 95% CI 1.31, 2.07), and 56
years and above group (OR 5.88, 95% CI 4.62,
7.48) compared to 26-40 year age group. Males
were almost half as likely to report difficulty in
hearing compared to females (OR 0.60, 95% CI
0.47, 0.76). Adults with difficulty in hearing
were more likely to be rural dwellers (OR 1.14)
compared to urban dwellers but this association
was not statistically significant; no statistically
significant differences were found between
literate adults (defined as being able to read and
write) and illiterate adults. Similarly no
statistically significant differences were found
between marital status and difficulty in hearing.
Results of Hosmer-Lemeshow goodness-of-fit
tests using Wald F and Chi-Square conclude that
the model was a good fit for the data.
The results of this unique nationally
representative survey, demonstrate that rural
women above the age of 55 years were most
likely to report difficulty in hearing; health
education efforts at limiting hearing impairment,
early diagnosis and treatment would be
particularly beneficial for this demographic
group in the country.


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Pakistan Medical Research Cou 1998.


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