| Hearing as one of the important senses that human aware and perceive the world, play a decisive role in the children’s growth development stage.Deafness and hearing loss is not only seriously impact children’s language development and cognitive learning, but also impact their normal social interaction, physical and mental health. According to foreign reports, the incidence of congenital deafness in newborns is about0.1%～0.3%, and most of them were severe hearing loss or deaf. Preschool age is an important period for children verbal learning and cognitive development, in this stage hearing loss have a serious impact in their language development, learning, social inclusion, physical and mental development,so early detection and early intervention is particularly important. Hearing screening is the most effective means for early detection of hearing loss, not only to find young children, mild-moderate hearing loss or single-ear disease that difficult to detect by subjective judgment, making early intervention, early treatment has become possible. Early study of parts of domestic cities provides the reference datas of children hearing loss incidence, but the datas were greatly different. Gansu Province currently has no research data of preschool hearing status.Gansu Province is located in the northwest of China, landform is long and narrow, geographical environment is complex, with many ethnic groups, urban and rural economic and social development is very uneven, ordinary people’s survival, living conditions is very different. Currently there is no systematic, comprehensive research on hearing status of children aged0to6years in Gansu Province, in addition to the data in the2006National Sample Survey on Disability. Some provinces and cities have done some relevant study in this respect, but reported results vary. Therefore, understanding the prevalence, possible risk factors and age, gender, ethnic, urban and rural distribution characteristics of0～6years-old children with hearing disorders in Gansu Province, and analysising the similarities and differences with other regions is very necessary. It provides the basic data for formulating relevant policies on effective anti-deaf with hearing disability tertiary prevention. The study has important practical significance for carrying out the children’s hearing health care, reduce birth defects and improve the quality of the population. In this study,7337children aged0to6years were screened, and etiology-related factors were investigated to preliminary analysis the hearing status of children aged0to6years in Gansu Province.Part1Analysis on hearing screening of4314pre-school children in kindergarten in Gansu ProvinceIn this study,13counties were randomly selected combined with the geographical distribution in Gansu Province. Using the probability sampling method, the sample size is extracted according to the actual number of children by1.75%by proportion in every county.4314pre-school children in kindergarten aged3～6years old received hearing initial screening Using distortion product otoacoustic emission test (DPOAE). The children who failed initial screening were checked again using automated auditory brainstem response (AABR), Follow-up and relevant assessments of the hearing were provided continually for those who failed both tests. Conducted a questionnaire survey, the data were statistically analyzed to know the risk factor of children with hearing loss and ear disorders. Results show that258children failed initial screening,the positive rate is5.98%(258/4314),38children failed re-screening,and they all have varying degrees of hearing loss confirmed by diagnostic evaluation, the prevalence of hearing loss was0.88%(38/4314). Among themlO children with binaural hearing loss, the prevalence was0.23%(10/4314);28children (13left ears and15right ears) with unilateral hearing loss, the prevalence was0.65%(28/4314). Degree of hearing loss was judge according to WHO/PDH97.3.2children with mild hearing loss,7moderate and1severe among10children with bilateral hearing loss, the prevalence respectively was0.05%(2/4314),0.16%(7/4314) and0.02%(1/4314).28children with Unilateral hearing loss, in which,3cases were mild hearing loss (0.07%,3/4314) and25moderate (0.58%,25/4314). The main cause of hearing loss were otitis media (50.0%), concha atresia (7.9%), ototoxic drugs (5.3%), head injury (5.3%), pregnancy conditions (2.6%), tympanic membrane perforation (2.6%) and unknown cause (26.3%). The results show that otitis media and mild or moderate hearing loss have a higher proportion among preschool children in Gansu Province, prevention and treatment of otitis media is the effective measures to reduce hearing loss. Statistical analysis, the prevalence of hearing loss in the Hui nationality was significantly higher than the Han, the rural than in urban, significant differences in the distribution of the ethnic areas has prompted the national genetic factors play a leading role, need to do further research.Part2Analysis on hearing screening of3023infants less than3years old in Gansu ProvinceThis study randomly selected13counties in Gansu Province3023cases of infants and young children as research subjects, including2009-2010, was born and0to2years of the newborn hearing screening of infants and young children (not including2years old) in2109cases and2008born2to3years (not including914cases of children3years old).0to2-year-old group of early childhood screening and diagnosis process by newborn hearing screening process2to3-year-old group of young children hearing screening using community focus or home, the screening process with the first part. Results show that in the study of2109cases of0to2-year-old infant screening does not pass185cases of positive screening rate of8.77%(185/2109), of which68cases for various reasons did not receive hearing rescreening,117cases accepted complexscreening, rescreening rate of63.24%(117/185), rescreening did not pass the21cases, diagnostic assessment, and ultimately diagnosed hearing-impaired child19cases, the prevalence of9‰(19/2109); a sample of914cases-3-year-old children, only found one cases of hearing-impaired children, the prevalence rate was0.11%. Binaural hearing impairment of15cases the final diagnosis of20cases of hearing-impaired children, the prevalence rate of0.50%(15/3023), single-ear hearing impairment5cases (2cases the left ear, right ear,3cases), prevalence of0.17%(5/3023). Degree of hearing loss classification according to WHO criteria judged by the better ear,15cases of bilateral hearing loss in young children with three cases of mild hearing loss,11cases of moderate and very severe one cases, the prevalence rates were0.10%(3/3023), and0.36%(11/3023) and0.03%(1/3023). Monaural hearing loss, mild one cases (0.03%,1/3023), three cases of moderate (0.10%,3/3023), and one case severe (0.03%,1/3023).The main cause of hearing loss were perinatal factors (20%), otitis media (15%), pregnancy conditions (10%), concha atresia (10%), Cleft lip (5%), and unknown cause (40%). The results show that the prevalence of hearing loss of infant under3years old in Gansu Province was correspond to similar research. Hearing loss prevalence there was no significant difference in gender and ethnic distribution, but the urban children was significantly higher than rural children. Moderate hearing loss have the highest proportion, and mild was second. In addition to unknown reasons, perinatal factor was the primary cause of hearing loss, otitis media took second place.Then the pregnancy factors and congenital malformations were also significant cause. Therefore, it is crucial for reducing the incidence of infant hearing loss to regulate and strengthen the perinatal health care, and actively prevent otitis media, increase health care awareness of parents. |
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