CORRELATES OF HEARING DIFFICULTY IN ADULT PAKISTANI POPULATION

Abstract

Hearing impairment is common among theelderly and it compromises communication withresultant poor psychological functioning inaffected individuals of all ages. To describe, agegender, literacy and residency status associatedwith self reported hearing difficulty in adults andits prevalence in Pakistan, we used data from theNational Health Survey of Pakistan (NHSP)1990-94; with written permission from theFederal Ministry of Health, Islamabad. Weselected all the adults aged 26 and above whoresponded to the question “Do you havedifficulty in hearing?” Individuals respondingaffirmatively to this question were identified ashaving difficulty in hearing. A two-stagestratified sample design was adopted for NHSP.Design-based analysis with SUDAAN 9.01 wasdone using logistic regression. Odds Ratios (OR)were computed for the association of selfreported difficulty in hearing with variousdemographic variables.The overall prevalence of difficulty inhearing was 16%, and 95% Confidence Interval(CI) was 15%, 18% (n = 5843). In malesprevalence of difficulty in hearing was 14%,95% CI 12%, 15%, while prevalence in femaleswas 19%, 95% CI 16%, 21%. In the 26- 40 yearold adults, prevalence of difficulty in hearingwas 8%, 95% CI 7%, 10%. Age gradient wasobserved, as 41-55 year old age group hadprevalence of 13%, 95% CI 11%, 15%, while inthe 56 years and above age group, prevalencewas 36%, 95% CI 32%, 40%.Adults with difficulty in hearing weremore likely to be in the age group of 41 to 55years (OR 1.64, 95% CI 1.31, 2.07), and 56years and above group (OR 5.88, 95% CI 4.62,7.48) compared to 26-40 year age group. Maleswere almost half as likely to report difficulty inhearing compared to females (OR 0.60, 95% CI0.47, 0.76). Adults with difficulty in hearingwere more likely to be rural dwellers (OR 1.14)compared to urban dwellers but this associationwas not statistically significant; no statisticallysignificant differences were found betweenliterate adults (defined as being able to read andwrite) and illiterate adults. Similarly nostatistically significant differences were foundbetween marital status and difficulty in hearing.Results of Hosmer-Lemeshow goodness-of-fittests using Wald F and Chi-Square conclude thatthe model was a good fit for the data.The results of this unique nationallyrepresentative survey, demonstrate that ruralwomen above the age of 55 years were mostlikely to report difficulty in hearing; healtheducation efforts at limiting hearing impairment,early diagnosis and treatment would beparticularly beneficial for this demographicgroup in the country.