Medical Health Advice

FRIDAY, April 3 (HealthDay News) — Children from Hispanic or
low-income families are more likely to have hearing loss, and a serious
but rare eye disease is often missed or mistreated among urban
preschoolers.

The hearing finding was based on a review of five studies conducted
between 1966 and 2007, all of which explored hearing loss among children
of various ethnicities from birth through the age of 19.

In contrast, the vision finding was drawn from a new investigation
conducted between 2003 and 2007 that looked into so-called “refractive
eyesight errors” among black and white children (aged 6 months to about 6
years) living in the Baltimore area.

“Based on the data available in the various studies we looked at, it
appears that in the Hispanic population and in low-income homes, there is
likely a higher burden of pediatric hearing loss,” said Dr. Donald G.
Keamy, lead author of the hearing study and a surgeon at the Massachusetts
Eye and Ear Infirmary and an instructor in the departments of otology and
laryngology at Harvard Medical School.

“But we don’t know the absolute cause of that increased rate,” Keamy
noted. “And it is also very important to point out that the information we
looked at is actually both somewhat old and very fractured, in the sense
that there is no unified national approach to collecting pediatric hearing
loss information. So, we can not even say if the finding is absolutely
true until we have a much more systematic and fresh analysis of the
problem, which would require a more national approach to the assessment of
hearing loss in children.”

Keamy published his team’s observations in the April issue of
Otolaryngology-Head and Neck Surgery. The vision study team, from
Johns Hopkins Medical School in Baltimore, reported its findings in the
April issue of Ophthalmology.

Keamy and his colleagues point out that hearing loss is one of the most
common birth disorders in the United States, noting that two to four of
every 1,000 children are born either deaf or hard-of-hearing.

The current review examined prior research gleaned from medical
databases and U.S. Centers for Disease Control and Prevention reports.

The hearing study authors found that the average rate of hearing
impairment from birth to adolescence was “significantly higher” among all
subgroups of Hispanic-Americans (Mexican-American, Cuban-American, and
Puerto Rican) and to a similar degree among low-income households.

“The bottom line is that pediatric hearing loss is a largely
under-recognized problem that has a great impact on a number of issues,
with regard to learning and language development,” noted Keamy. “And until
we really completely understand the scope of the problem, we can’t fix it
and make things better.”

“So the point here,” he stressed, “is that despite the fact that most
states now screen newborns for hearing loss before hospital discharge, the
process is not entirely standardized, and different techniques are used
which have different sensitivities for detecting hearing loss. So the
indication about the higher risk among Hispanics is, of course, important.
But what we truly hope to accomplish with this work is to encourage the
adoption of a more systematic approach to the overall problem.”

“This study really shows the need for an apples-to-apples approach to
pediatric hearing loss,” agreed Robert D. Frisina, an associate chair of
otolaryngology at the University of Rochester Medical School in New
York.

“This is a relatively novel and interesting analysis,” said Frisina.
“And I haven’t heard of a higher risk among Hispanic households before,
which makes it a little bit surprising and provocative. But before any
health recommendations could be made, it does need to be followed up to
find out with certainty whether or not there is a sampling error here. And
to do that, I think a national repository and national standards for
hearing loss data collection are very much needed.”

As for the vision findings, the Hopkins team — led by Dr. David
Friedman, of the Bloomberg School of Public Health — found that despite
the fact that 5 percent of the nearly 2,300 urban children they examined
had a defect in the eye’s ability to focus on light that was serious
enough to warrant treatment, just 1 percent actually got necessary medical
attention.

On the other side of the coin, they actually uncovered some evidence of
over-treatment, given that one-third of 29 children who had been
prescribed eyeglasses before the study launch actually didn’t need
them.