The epidemiology of childhood hearing impairment in a multi-ethnic health district.

Objectives: This study investigates whether there are differences in the prevalence, risk factors and age of identification of childhood hearing impairment between the minority and majority ethnic populations in the largely urban multi-ethnic health district of South Glamorgan, in which 5% of the total population belong to minority ethnic communities. The minority ethnic population is highly heterogeneous with communities of Indian subcontinent origin being in the minority. Methods: This was a retrospective study of the under 9-year-old population, in which child surveillance and audiology files of all identified children with moderate to severe hearing impairment born between 1988 and 1996 were reviewed. This incorporated 50 children, of whom 20% were from minority ethnic communities. The data were collected using a structured pro-forma to extract information from the records. Results: Hearing impairment was significantly more common in the minority than majority ethnic population (2.27 compared with 0.83 per 1000). With the exception of consanguinity, there were no significant differences in risk factors between the minority and majority ethnic communities. A genetic cause was found in the majority of children from all groups. There was no significant difference in the age of identification of hearing loss between minority and majority ethnic populations, with hearing loss being identified late in both groups (median age of identification = 19 months and 17 months, respectively). There was a strong association of early identification with both neonatal screening and severity of hearing loss. Conclusion: With current screening methods, hearing impairment is identified late in an unacceptable number of children, regardless of ethnic group. The higher prevalence in minority ethnic communities makes a striking impact on the absolute numbers of affected children, even in an area with a low and very mixed minority ethnic population in which communities other than those of Indian subcontinent origin predominate. This has service implications for early counselling and intervention, speech therapy and educational provision, which must be provided in formats accessible and appropriate to these communities. [ABSTRACT FROM AUTHOR]