Impact on performance of hearing screening program through prevalence and diagnostic age evaluation in elementary school students in north-eastern city of Iran, Mashhad

Background
Lack of a national neonatal screening protocol in Iran, displaces routine hearing screening at elementary school entry. Early diagnosis of hearing loss (HL) leads to early intervention and improvement of developmental skills in children. The current research aimed to determine diagnostic age and causes of HL in male students at school entry to evaluate this hearing screening performance and its efficacy as a guideline for deciding early diagnosis.

Methods
This cross sectional study included 2277 male students aged 6–7 years from elementary school boys in Mashhad, Iran from 2010 to 2011. We evaluated subjects’ medical archives, interviewed with their parents and hygiene teacher and took physical examination, demographic information, birth and HL history for data gathering. Audiologic assessment consisted of otoscopy, tympanometry and audiometry.

Results
36 (1.58%) of students had hearing impairment. Prevalence of HL in urban schools was significantly higher than rural ones (P = 0.02). Making diagnosis by physician was significantly more than by parents (P < 0.04) with no diagnosis role of teachers. There was a significant association between using earphone and HL intensity (P = 0.001). The common age of diagnosis was at elementary school entry (P < 001). :

Discussion
Screening protocol at elementary school entry suggested late diagnosis and poor outcome in Iran. National screening is necessary in newborns, elementary school entry and when suspect to HL. The parents, teachers and population should have much greater awareness of HL diagnosis. In present study, chicken pox may lead to HL, there¬fore routine vaccination is recommended.