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Deafness: Burden, prevention and control in India



The high burden of deafness globally and in India is largely preventable and avoidable. According to the 2005 estimates of WHO, 278 million people have disabling hearing impairment. The prevalence of deafness in Southeast Asia ranges from 4.6% to 8.8%. In India, 63 million people (6.3%) suffer from significant auditory loss. Nationwide disability surveys have estimated hearing loss to be the second most common cause of disability. A lack of skilled manpower and human resources make this problem a huge challenge. The Government of India has launched the National Programme for Prevention and Control of Deafness. This article highlights the major components of the programme with a focus on manpower development and ear service provision including rehabilitation. Since the programme is also being implemented at the primary healthcare level, it envisages a reduction in the burden of deafness and prevention of future hearing loss in India.
Deafness: Burden, prevention and control in India
Maulana Azad Medical College, Bahadur Shah Zafar Marg,
New Delhi 110002, India
A. K. AGARWAL Department of Community Medicine
Correspondence to SUNEELA GARG;
© The National Medical Journal of India 2009
The high burden of deafness globally and in India is largely
preventable and avoidable. According to the 2005 estimates of
WHO, 278 million people have disabling hearing impairment.
The prevalence of deafness in Southeast Asia ranges from 4.6%
to 8.8%. In India, 63 million people (6.3%) suffer from
significant auditory loss. Nationwide disability surveys have
estimated hearing loss to be the second most common cause of
disability. A lack of skilled manpower and human resources
make this problem a huge challenge. The Government of India
has launched the National Programme for Prevention and
Control of Deafness. This article highlights the major components
of the programme with a focus on manpower development and
ear service provision including rehabilitation. Since the
programme is also being implemented at the primary healthcare
level, it envisages a reduction in the burden of deafness and
prevention of future hearing loss in India.
Natl Med J India 2009;22:79–81
In the process of global epidemiological transition, the economic
burden associated with chronic diseases is on the rise, especially
in low- and middle-income (LAMI) countries.1 Deafness—one
neglected chronic condition—is the most prevalent sensory
disability across nations. According to the 2005 estimates of the
WHO, 278 million people worldwide have disabling hearing
impairment, i.e. moderate-to-profound hearing loss in both ears
(i.e. >41 dB hearing loss).2 Hearing loss is the second most
common cause of years lived with disability (YLD) accounting
for 4.7% of the total YLD. The problem of deafness is dispro-
portionately high in the Southeast Asia region with a prevalence
ranging from 4.6% to 8.8%.3
Population-based surveys in 2003 in India using the WHO
protocol4 estimated the prevalence of hearing impairment to be
6.3% or approximately 63 million people suffering from significant
auditory loss.3 The estimated prevalence of adult onset deafness
in India was found to be 7.6% and childhood onset deafness to be
2%. Earlier during 1977–80, a multicentric collaborative study on
the prevalence and aetiology of hearing impairment was done by
the Indian Council of Medical Research (ICMR) at 4 centres:
Calcutta (Kolkata), Delhi, Madras (Chennai) and Trivandrum
(Thiruvananthapuram) on a total of 11 665 persons in rural areas
and 10 935 in urban areas. The prevalence of hearing impairment
was found to be 10.2%. Severe hearing loss accounted for 24.4%
and mild hearing loss for 15.9%. Overall, rural areas showed a
higher prevalence of hearing loss compared with urban areas.5
The National Sample Survey (NSS) 58th round (2002) surveyed
disability both in urban and rural households and found that
hearing disability was the second most common cause of disability
after locomotor disability.6 Hearing loss accounted for 9% of all
disabilities in the urban and 10% in the rural areas. Depending
upon the extent of a person’s inability to hear properly, the degree
of hearing disability was ascertained. It was estimated that the
number of persons with hearing disability per 100 000 persons
was 291; it was higher in rural (310) compared with urban regions
(236). In the same survey, about 32% of people had profound
(person could not hear at all or could hear only loud sounds) and
39% had severe hearing disability (person could hear only shouted
words). The survey results revealed that about 7% of people were
born with a hearing disability. About 56% and 62% reported the
onset of hearing disability at >60 years of age in the rural and
urban areas, respectively. The incidence of hearing disability in
the past 1 year was reported to be 7 per 100 000 population.6
The magnitude of milder degrees of hearing loss and unilateral
hearing loss would be larger than these estimates for bilateral
hearing loss. The major causes of hearing loss and ear disease in
India have been listed by the WHO survey.3 Ear wax (15.9%) was
the most common cause of reversible hearing loss. Non-infectious
causes such as ageing and presbyacusis are the next most common
causes of auditory impairment in India (10.3%). Middle ear
infections such as chronic suppurative otitis media (5.2%) and
serous otitis media (3%) are other leading causes of hearing loss.
The other causes include dry perforation of tympanic membrane
(0.5%) and bilateral genetic and congenital deafness (0.2%).
The NSS 58th round also enquired about probable causes of
hearing loss in India. In about 25% and 30% cases, for rural and
urban India, respectively, the probable cause was old age. Of the
other reasons, ear discharge and other illnesses were identified as
the cause by a comparatively large proportion of persons with
hearing disability. Also, in the same survey, nearly 1% of hearing
disabled persons reported German measles/rubella as the cause of
hearing disability.
It has been noted by WHO3 that half the causes of deafness are
preventable and about 30%, though not preventable, are treatable
or can be managed with assistive devices. Thus, about 80% of all
deafness can be said to be avoidable. It has also been stated by
WHO3 that there is a shortage of human resources to address
the issue of deafness. The estimated number of ENT specialists
and otologists in India are 7000 and 2000, respectively. The
audiometrist:population ratio was found to be 1:500 000 and
the ratio of speech therapists to the deaf population was 1:200.
There is also a maldistribution of personnel with more people
Medicine and Society
located in urban than rural areas. Human resource analysis revealed
that there is a need to enhance the skills and working capacity of
practising doctors and other personnel.
Considering the enormous impact of deafness on the social,
economic and productive life in India due to its burden and also
gaps in human resources to meet this health challenge, primary
healthcare remains the strategy of choice for the provision and
implementation of prevention of deafness and hearing loss in
India. The Government of India initiated the National Programme
for Prevention and Control of Deafness (NPPCD) in 2006. It was
initially started as a pilot project and was implemented in
25 districts in 10 states and 1 union territory. It will be upscaled
to include 203 districts in all states and union territories by the end
of the eleventh 5-year plan (2007–12).
The NPPCD was launched with the long term objective of
reducing the total disease burden of hearing impairment and deafness
by 25% at the end of the eleventh 5-year plan. The programme aims
to cover three levels of prevention and care: primary, secondary and
tertiary ear care by provision of an appropriate response at these
levels. It aims at preventing avoidable hearing loss on account of
disease or injury, identifying early and treating major ear problems,
and medically rehabilitating persons with deafness of all age
groups. It envisages strengthening existing intersectoral linkages
and developing institutional capacity for ear care services. For the
prevention of auditory impairments, it promotes outreach activities
and public awareness through innovative and effective information,
education and communication (IEC) strategies.
The programme has been integrated along with the umbrella
health mission of the Government of India—the National Rural
Health Mission (NRHM)—at the state and district levels. Under
the NPPCD, funds for execution of the programme are given to the
state health society and programme committee of NRHM to carry
out various activities through district health societies. The role of
the state committee is to function as a supervisory and monitoring
authority for smooth conduct of the strategies to prevent and
control deafness.
The district health society and programme committee are
expected to prepare a micro-plan on an ongoing basis and to
operationalize programme components at the district level
through coordination between different agencies and partners—
government, non-government and community members.
Capacity building and manpower development
Human resource development remains a key component of any
national health programme. The NPPCD through the creation of
trained manpower at multiple levels strengthens the workforce for
efficient and effective delivery of ear care at all levels. Designated
state medical colleges will act as centres of excellence for ear care
interventions in selected districts where the programme is
functional. ENT specialists and audiologists from designated
medical college are assigned the responsibility of providing
technical expertise to the programme in the district. ENT
coordinators at the state medical college impart training to district
ENT surgeons for 5 days under which a reinforcement of hands-
on surgical training in micro-ear procedures pertaining to deafness
is provided. Key procedures that can be performed at the district
level are covered under this training and include myringoplasty,
tympanoplasty, stapedectomy and mastoidectomy. District-level
audiologists/audiometricians are provided a 2-day reorientation
in diagnostic and therapeutic skills. In addition, paediatricians
and obstetricians at the district hospital level and community
health centre level are imparted a day’s training to sensitize them
to various factors responsible for loss of hearing in newborns and
children with special emphasis on antenatal and perinatal care.
Primary healthcare physicians are the key players in the delivery
of public health initiatives in the Indian healthcare delivery system.
The NPPCD involves doctors in primary health centres (PHCs),
school health schemes and those working in various industrial
units in the districts for delivering ear care at the primary care level.
A 2-day training programme is conducted to sensitize these personnel
to their involvement in the NPPCD. Doctors are trained to manage
common ear conditions using standardized guidelines. Similarly,
skills in the use of an otoscope are enhanced and they are exposed
to the surgical and rehabilitation services available in their district
so as to refer patients to the appropriate level of care.
The involvement of grassroots workers, supervisors and
community health volunteers is required to create awareness
among the community about the prevention of hearing loss as well
as to emphasize the need for timely care. The NPPCD sensitizes
men and women multipurpose health workers at the subcentre
level, public health nurses at the PHC, child development project
officers, anganwadi workers (AWW) and their supervisors,
Accredited Social Health Activists (ASHAs) and trained birth
attendants. These workers are expected to play an important role
in facilitating early detection and prevention of hearing loss.
The involvement of community stakeholders is vital for the use
of services planned under the NPPCD. The programme apprises
primary school teachers and parents of hearing/speech impaired
children at the village level about ear care interventions. Teachers
are also trained to provide assistance during the execution of
screening camps organized for schoolchildren.
To fill up the lacunae in audiological services at the district
level, the programme has proposed a post of audiometric assistant
at all districts, to carry out various activities related to deafness
prevention and control. For the acquisition of proper linguistic
and communication skills by a young hearing impaired child, the
programme has proposed a teacher to be trained and inducted for
carrying out hearing and speech rehabilitation of children at the
district level. The feasibility of involving interns who have
finished their graduation in auditory, speech and language
pathology at the All India Institute of Speech and Hearing
impairment (AIISH), Mysore and Ali Yavar Jang National Institute
of Hearing Handicapped (AYJNIHH), Mumbai will be explored
during the implementation of the programme.
Ear health promotion and prevention
To create awareness about hearing and speech problems, grassroots
workers and health personnel will deliver IEC on a continuous basis
to community members. Regular meetings with community-based
organizations such as the gram panchayat, village health committee
and mahila mandals will be conducted to sensitize them about the
importance of early detection of ear problems and hearing loss. The
AWWs and auxiliary nurse midwives (ANMs) will be trained about
the correct posture to feed a baby so as to decrease the incidence of
otitis media due to faulty feeding practices. Emphasis will be placed
on timely referral of children born after a difficult labour or those
who suffered birth asphyxia to screen for loss of hearing. Health
workers will also be trained to assess the speech and hearing of
children visiting immunization clinics and outreach activities.
Local, culture-specific innovative strategies will be adopted for
sensitizing community members including school teachers.
Early detection of ear problems and management
House-to-house surveys to ascertain hearing problems in all age
groups will be done by the AWWs and ASHAs, under the supervision
of multipurpose workers and a record of people with deafness will
be maintained. Based on an assessment schedule, school health
doctors will carry out school-level screening of students of primary
classes to identify and manage any diseases/problems related to the
ear. Medical personnel at the primary and secondary level will be
trained so as to provide adequate standardized ear care at these
health facilities. The priority conditions for local management
include middle ear infections and impacted wax. All persons
requiring special diagnostic facilities, complicated cases and those
needing surgical interventions will be referred to the district hospital.
ENT doctors and audiologists at the district level will provide
comprehensive ear care services. District and community health
centre (CHC) level paediatricians and obstetricians trained under
the programme will screen and refer any child born of a high risk
pregnancy or delivery, as well as those children who are exposed to
a high risk factor in infancy. By an assessment of speech milestones,
paediatricians can detect hearing impairment early, apart from
treating common ear problems in children. A standard set of
equipment and medicines will be provided at all levels for ear care
under the NPPCD. Proper referral linkages between different levels
of care will be strengthened for effective delivery of services.
Community screening camps
These will be organized at the PHC/CHC/district level to screen the
population for deafness and hearing impairment. These camps will
also provide an opportunity to increase awareness about the
prevention and control of deafness. These camps will be conducted
by trained personnel along with private practitioners, wherever
feasible. One screening camp will be organized every month at any
healthcare level—PHC/CHC/district hospital by rotation, thus 24
camps will be organized in each district over a period of 2 years. The
camps will be organized by involving key community stakeholders,
panchayat members, mahila mandals and youth leaders. Non-
governmental organizations (NGOs) identified by the district health
society will also facilitate the organization of these camps.
Rehabilitation and hearing aid provision
Patients with complications that require tertiary care will be referred
to state medical colleges. Patients whose complications are not
amenable to medical or surgical correction and who require hearing
aids will be fitted with the same at the district level. This will
primarily include children suffering from bilateral sensorineural
deafness. About 200 hearing aids will be made available in each
district to be fitted to suitable persons. Older persons with
presbyacusis will be provided hearing aids in collaboration with the
Ministry of Social Justice and Empowerment, which provides
rehabilitative services for the elderly. Wherever feasible, suitable
linkages will be developed with community rehabilitation centres
and district disability rehabilitation centres (DDRC) in consultation
with the Rehabilitation Council of India.
Monitoring and supervision
Monitoring tools have been devised for all levels. Indicators have
been developed to supervise the performance of the districts in
deafness prevention and control. Monthly reports are to be
generated citing progress and submitted to higher levels. On-site
evaluations will also be done to provide periodic supportive
supervision. Feedback will be regularly sought from allied
Supportive activities for other causes of deafness such as noise-
induced hearing loss and congenital deafness require additional
programmatic inputs. The prevention and control of these causes
will be explored and introduced based on the feasibility of
available interventions. A uniform policy for rubella vaccination
under the national immunization programme for congenital
deafness prevention will also be explored. Advocacy regarding
legislation relating to noise and implementation of a hearing
conservation programme will be done. To raise awareness and
accord vital importance to deafness, ‘noise-free days’ and
rashtriya shravan shakti diwas’ will be planned at the national
level. The involvement of preschool teachers through NGOs and
public–private partnership will be attempted. Inclusion of deafness
awareness in textbooks at the primary and secondary school level
through collaboration with the National Council of Educational
Research and Training (NCERT) will be explored. Research for
developing cost-effective, high quality hearing aids within the
country will be promoted. Carrying out community-based studies
will fill epidemiological gaps in data regarding hearing impairment
and deafness. Operational research to improve implementation of
the programme will be conducted at periodic intervals.
Integration of primary ear care with primary and district health
systems is likely to yield the most cost-effective solutions. The
strategies included in the NPPCD, if implemented with political
will and strong leadership, will decrease the magnitude of ear
problems and prevent avoidable deafness in India. Networking
and partnerships with different organizations, professionals and
personnel remain critical to the success of the programme. In the
supportive environment facilitated by the launch of NPPCD, it is
imperative to take firm and enthusiastic actions to reduce the
burden of deafness in India.
1 Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs
of chronic diseases in low-income and middle-income countries. Lancet 2007;
2 World Health Organization. Fact sheet. Deafness and hearing impairment. Available
at (accessed on 10
January 2009).
3 World Health Organization. State of hearing and ear care in the South East Asia
Region. WHO Regional Office for South East Asia. WHO-SEARO. SEA/Deaf/9.
Available at
CARE.pdf (accessed on 10 January 2009).
4 World Health Organization. Ear and hearing disorders survey protocol and software
package. Available at (accessed
on 10 January 2009).
5 Indian Council of Medical Research Report. Collaborative study on prevention and
etiology of hearing impairment. New Delhi:Indian Council of Medical Research; 1983.
6 National Sample Survey Organization. Disabled persons in India, NSS 58th round
(July–December 2002) Report no. 485 (58/ 26/1). New Delhi:National Sample
Survey Organization, Ministry of Statistics and Programme Implementation,
Government of India, 2003.
7 Directorate General of Health Services. National programme for prevention and
control of deafness, Project proposal. New Delhi:Ministry of Health and Family
Welfare; 2006.
... Majority children had congenital deafness (218; 22.66%) followed by cleft lip & palate (212, 22.03%). Our study confirms the findings of several other studies which reported that the prevalence of congenital deafness is more in India and 63 million people suffer from significant auditory loss, due to a lack of skilled manpower and human resources for the management of these defects [11]. The second most common defect was cleft lip & palate. ...
... The prevalence of childhood onset deafness is estimated to be 2%. [1] According to the census of India 2011, among the various identified disability in children, 23% of the children have hearing loss. ...
... In India, 63 million people (6.3%) suffer from significant hearing loss [11]. Comparing the prevalence of disability, found in National Sample Surveys which conducted at different points oftime helps to get the idea about the magnitude of the disability. ...
Full-text available
Abbreviations Deafness caused due to mutations in more than 400independent genes as a series of etiologically heterogeneous disorders. However , in diverse Indian population several studies have been conducted and causes for syndromic and non syndromic forms of deafness occurs because of the defects in just few genes. In India high prevalence of genetic disorders is associated with the consanguine-ous marriages. Each year in Indian population (approximately 1.2 billion) 30,000 infants are affected with this disorder; congenital hearing loss. For genetic counselling, early diagnosis for timely intervention and treatment options, knowledge of genetic causes of hearing loss is important. Now days in hospitals many sources and technologies are available for the testing of hearing loss. Translating genetic and genomic advances into population healthgains, one of the major strategy is population based screening. This review article of the deafness in Indian population deals with the major causes of deafness with special focus on Indian population.
... In the English speaking countries there are many tools available for the assessment of language; for example Early Language Milestone Scale for 0-3 years [6], and REELS [(Receptive Expressive Emergent Language Scale), (original REELS and Newer versions of REELS)] etc. Owing to linguistic variation across languages, these tools are generally not accepted for non-English speaking communities. The observed 3.8% prevalence of speech and language delay in western literature and 4.5% in Indian literature, along with more than 2% children with significant auditory loss since birth, indicates the need for validation of language assessment tools for infants, toddlers and young children [7][8][9]. But at the community level these children are usually not identified due to the lack of indigenous, standard language assessment tools. ...
Full-text available
Introduction: Selection of an effective tool for assessment of language learning outcomes in post cochlear im-plantation is always an important but challenging task. Receptive expressive emergent language test-3rd Eds. (REELT-3) is one of the comprehensive language assessment tools used in India. In case of administration of REELT-3, which is standardized in English speaking typically developing western population, to another language speaking population with post-cochlear implant condition, the test outcome may get compromised owing to linguistics and population variability. The objective of the study is to test and validate REELT-3 in Hindi speaking children with cochlear implantation. Methods: Ninety six typically developing children (22.3 ± 6.9 months, 48 boys and 48 girls) and 96 children with cochlear implantation (25.8 ± 9.2 months, 57 boys and 39 girls) participated in this study. As per the eligibility criteria of REELT-3, infants and toddlers with cochlear implant of age below 36 months participated in this study. Criterion, content and construct validity were tested using correlation based statistical analysis. Results: High content validity was established by obtaining very low correlation coefficient r = 0.16 across two distinct population of typically developing children and children with cochlear implantation. Similarly, correlation coefficient of r = 0.84 revealed high criterion validity across REELT-3 in English and Hindi speaking conditions. Finally, correlation coefficient of r = 0.87was obtained between language raw score and chronological age to establish construct validity. Chronbach alpha coefficient (Chronbach α = 0.85) and interclass correlation coefficient 0.87was observed for REELT-3 which suggests good internal consistency and test-retest reliability, respectively. Receiver Operating Characteristics curve analysis of the REELT-3 suggested that area under curve 0.95 (95% CI = 0.89-0.99, p < 0.001) is excellent. The cutoff Language Ability Score (LAS) was determined as 74.5 with the sensitivity of 87.9% and specificity of 84.1% infer high sensitivity and specificity. Conclusions: These results validate that REELT-3 can be used in assessment of language outcome in Hindi speaking children with post-cochlear implantation. Clinical assessment of receptive and expressive language will be beneficial in effective evaluation as well as in therapeutic planning.
Background The present study was aimed to find out the patterns of Occurrence and management abilities of birth defects (BDs) in Visakhapatnam, one of the north coastal districts of Andhra Pradesh, India during a span of five years. Methods A cross-sectional investigation was held at District early intervention center (DEIC), Visakhapatnam from 2016 to 2020. To identify the pattern and trend of different BDs including seasonal variations, a retrospective analysis of the health center's inpatient database for the past 5 years was done. Male and female children aged 2 months-18 years are included in the study with the prior permission of the concerned medical officer. The screening tool developed by the Ministry of health and family welfare, India, was used for the study. Results Among 26,423 cases, children with birth defects (BDs) are 962, 2229 with deficiencies, 7516 with diseases, and 15716 with developmental delays (DDs) & disabilities were admitted during the study period. From birth defects, congenital deafness occurred in large numbers with 22.66%, and neural tube defect observed in a small number of cases with 0.83% during the period. From the side of deficiencies, severe acute malnutrition has mostly occurred (66.80%) and a small number of children were affected with goiter (1.70%). Conclusion Through this study, it is observed that the incidence of birth defects, as well as genetic disease burden, is high in the Visakhapatnam district. Hence there is a need for strengthening of management services for these diseases in this region.
Birth defects and developmental disabilities are highly disabling, lifelong conditions. Children have special medical and rehabilitation needs. Families require additional social support. The essence of an efficient birth defects service is to ensure that all these activities are integrated through an organized referral system, so that caregivers can access needed services. India forms an example of an emergent birth defects service. Several programme components of the maternal and child health services and social welfare services for persons with disabilities can cater to the needs of children and their families. This article describes these programme components which span through the life course. There are services for preterm and sick newborns, screening and medical care for specific types of birth defects and developmental disabilities, and early intervention services. Several social welfare programmes are available for children with disabilities and their caregivers. The article concludes that India already has in place medical and rehabilitation services for birth defects. These services need to be strengthened and referral linkages between medical and welfare services have to be created to ensure that caregivers are not confronted by a poorly functioning, fragmented set of services.
Background : Hearing impairment is one of the leading causes of disability in Bangladesh. Since half the cases can be prevented through public awareness, early detection and timely management, planning of public health interventions become necessary. To achieve this, a nationwide level of evidence is required. This survey was conducted with the aim of determining the prevalence of hearing impairment in Bangladesh. Materials and methods : The study was a cross-sectional one, conducted between January to May 2013, where a multistage, geographically clustered sampling approach was used. A total of 52 primary sampling units were selected, and from each unit households were selected at random followed by random selection of an individual from each household. In total, 5,220 people were targeted out of which data collection could be completed from 4260 individuals. (82%). Following clinical assessment of study subjects, hearing status was assessed by pure tone audiometry and otoacoustic emission test. Results : The mean age was 32 years among which 58% were females. Among men, there were 29% students, 28% agriculture workers and 14% business men. A major portion of females (63%) were home makers. On clinical examination, 11.5% respondents had impacted ear wax, 6.2% had chronic middle ear infections with eardrum perforation, and 5.3% had otitis media with effusion.On hearing assessment, 34.6% respondents had some form of hearing loss (>25dB in better ear). Conductive hearing loss was found in 12.0%, sensorineural in 4.5% and mixed in 3.8%, where the latter two increased in prevalence with age. Out of the total respondents, 9.6% had disabling hearing loss according to WHO criteria, with a higher prevalence in adults > 60 years(37%). Logistic regression analysis showed age, socioeconomic status, presence of ear wax, chronic suppurative otitis media, otitis media with effusion and otitis externa were significant predictors of disabling hearing loss. Conclusion : The major causes of conductive hearing loss are chronic suppurative otitis media and otitis media with effusion. Chatt Maa Shi Hosp Med Coll J; Vol.20 (1); January 2021; Page 72-76
Introduction: Hearing is essential to learn language and speech and to develop cognitive skills. According to World Health Organisation (WHO), world-wide approximately 350 million people have hearing disorder. The performance of some moderately severe hearing-impaired adults and children using hearing aids is poorer than that of even profoundly hearingimpaired individuals using cochlear implants with advanced speech processing strategies. Aim: To find out the appropriate candidates in need of cochlear implantation in Prayagraj district of Uttar Pradesh, India. Materials and Methods: This cross-sectional study was conducted on hearing-impaired patients attending Ear Nose Throat (ENT) Out Patient Department (OPD) of tertiary health care center in Prayagraj, Uttar Pradesh from August 2011 to July 2012. The study population consisted of 95 patients categorised into four groups (pre-lingual children and adults, post-lingual children and adults) who presented with the chief complaints of impaired hearing and delayed speech. A detailed history, clinical and other relevant systemic examination and investigations were done. Patients were subjected to free field audiometry, pure tone audiometry and Brainstem-Evoked Response Audiometry (BERA) for assessment of hearing threshold level. Patients used hearing aid for six months and after hearing aid use, their hearing threshold and speech discrimination scores were estimated. Patients, whose aided score on open-set sentence test was less than 50%, were selected as candidate for cochlear implants, as they were not significantly benefited by hearing aids. Results: Out of the 95 cases, 48 cases were found to be suitable for cochlear implantation, which formed 50.5% of the study group. Pre-lingual hearing-impaired adults had the highest percentage i.e., 86.7%, fulfilling the criteria for cochlear implantation followed by pre-lingual children, in whom 46.7% fell in this category. A 26.7% of post-lingual children and 20% of post-lingual adults were found suitable for cochlear implantation. Conclusion: The pre-lingual hearing-impaired children and adults are more in need for cochlear implantation than the post-lingual hearing-impaired children and adults. Approximately, 134,501 cases were estimated to be, in need of cochlear implantation in Prayagraj district based on the census estimate of 2011.
Introduction: With the growth in the field of speech and hearing globally, the requirements in training programs have seen a transition in India. One of the changes is an increase in the number of institutions worldwide offering specialization in either audiology or speech-language pathology (SLP) at the master’s level, instead of a dual program. However, in the year 2017, out of 19 speech and hearing institutes offering master’s degrees in the field of speech and hearing, only two provided specialization (as per the website of the Rehabilitation Council of India, 2017). Hence, the present study aimed to investigate the requirement for specialization in the field of speech and hearing. Methods: Using a twenty-item checklist, an e-survey was conducted to obtain the views of the Indian Speech-Language and Hearing Association (ISHA) life members regarding specialization at the master’s level. Results: The majority of the participants indicated that specialization at the master’s level is more beneficial than having a dual degree in speech and hearing. Furthermore, Pearson’s Chi‑square test indicated a significant association between their views on specialization and their educational qualification as well as their specific work area. Conclusion: The results indicated that ISHA life members were of the view that specialization in audiology and in SLP should be conducted in India at the master’s level. This requirement was felt irrespective of whether they had a specialized or a dual degree as well as irrespective of their area of work.
This paper estimates the disease burden and loss of economic output associated with chronic diseases-mainly cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes-in 23 selected countries which account for around 80% of the total burden of chronic disease mortality in developing countries. In these 23 selected low-income and middle-income countries, chronic diseases were responsible for 50% of the total disease burden in 2005. For 15 of the selected countries where death registration data are available, the estimated age-standardised death rates for chronic diseases in 2005 were 54% higher for men and 86% higher for women than those for men and women in high-income countries. If nothing is done to reduce the risk of chronic diseases, an estimated US$84 billion of economic production will be lost from heart disease, stroke, and diabetes alone in these 23 countries between 2006 and 2015. Achievement of a global goal for chronic disease prevention and control-an additional 2% yearly reduction in chronic disease death rates over the next 10 years-would avert 24 million deaths in these countries, and would save an estimated $8 billion, which is almost 10% of the projected loss in national income over the next 10 years.