Influência da habilidade comunicacional dos pais nas orientações de saúde ao filho surdo / Influence of parents' communication skills on health guidelines for deaf children / Influencia de las habilidades de comunicación de los padres en las pautas de salud para niños sordos

Objetivo: verificar a influência da comunicação dos pais no recebimento de informações e comportamento de saúde de filhos surdos. Método: estudo transversal realizado com 110 pessoas surdas, selecionadas com a técnica snowball sampling, em municípios no Noroeste do estado do Paraná. Os dados foram coletados de fevereiro a agosto de 2019, mediante aplicação de instrumento estruturado. Na análise dos dados utilizou-se a estatística descritiva e inferencial. Resultados: a maioria dos surdos (95,4%) recebeu alguma orientação de saúde no núcleo familiar; ser orientado sobre a importância de consultas de rotina mostrou-se associado à realização da mesma pelos filhos no último ano (OR= 3,40). O pai que sabe se comunicar em Libras constituiu fator de proteção, pois, nestes casos, ocorreram mais orientações sobre o uso de drogas e consumo abusivo de açúcar. Conclusão: a habilidade comunicacional dos pais possibilita que eles realizem mais orientações relacionadas à saúde e isto influencia o comportamento em saúde de filhos surdos.

Objective: to ascertain the influence of parents' communication on deaf children's reception of health information, and health behavior. Method: in this cross-sectional study of 110 deaf people selected by snowball sampling in municipalities in northwest Paraná state, data were collected from February to August 2019 using a structured instrument. Descriptive and inferential statistics were used in the data analysis. Results: most deaf people (95.4%) received some health guidance in the family; being guided about the importance of routine appointments was found to be associated with the children's attending such appointments in the prior year (OR = 3.40). The parent able to communicate in Libras was a protective factor, because in these cases, more guidance on drug use and sugar abuse occurred. Conclusion: the parents' communication skills enabled them to provide more health-related guidance, and this influenced their deaf children's health behavior.

Objetivo: determinar la influencia de la comunicación de los padres en la recepción de la información sanitaria y el comportamiento sanitario de los niños sordos. Método: en este estudio transversal de 110 personas sordas seleccionadas por muestreo de bola de nieve en municipios del noroeste del estado de Paraná, los datos se recolectaron de febrero a agosto de 2019 mediante un instrumento estructurado. Se utilizó estadística descriptiva e inferencial en el análisis de datos. Resultados: la mayoría de las personas sordas (95,4%) recibió alguna orientación sanitaria en la familia; Se descubrió que el hecho de recibir orientación sobre la importancia de las citas de rutina estaba asociado con la asistencia de los niños a dichas citas el año anterior (OR = 3,40). El padre capaz de comunicarse en Libra fue un factor de protección, porque en estos casos, hubo más orientación sobre el uso de drogas y el abuso de azúcar. Conclusión: las habilidades de comunicación de los padres les permitieron brindar más orientación relacionada con la salud, y esto influyó en el comportamiento de salud de sus hijos sordos.

Processo de diagnóstico da surdez em crianças na percepção de familiares e gestores / Process diagnosis of deafness in children in the perception of familiar and managers

OBJETIVO: Analisar a percepção de familiares e gestores (educação e saúde) sobre o processo de diagnóstico da surdez em crianças de um município do Paraná. MÉTODOS: A coleta de dados deu-se a partir da técnica de grupo focal formado por dez pais e por entrevista aberta individual com gestores. A análise do material extraído foi feita por meio do estudo do conteúdo na modalidade temática. A discussão dos dados foi organizada pela análise das falas dos sujeitos. RESULTADOS: Foi possível extrair duas grandes categorias temáticas: frustração no processo de diagnóstico, acolhimento e orientação; dificuldades na relação intersetorial Saúde e Educação. CONCLUSÃO: Os desdobramentos da surdez diagnosticada tardiamente permearam os âmbitos relacionados à saúde e à educação das crianças com surdez. O diagnóstico precoce e o acolhimento adequado não ocorreu na maioria das crianças e verificou-se que a relação intersetorial (saúde e educação) é insatisfatória.

PURPOSE: To analyze the perception of family and managers (education and health) on the process of diagnosis of deafness in children in a city in Paraná. METHODS: The analysis of the material gathered in the focus groups and on the interviews was made based on the analysis of content of the thematic mode. The discussion of the data was organized based on the analysis of the subjects' testimonies. RESULTS: The thematic categories were: the early diagnosis and hearing health as a human right; and the necessity of adequate support and initial guidance; challenges in the inter-sector and inter-network relations. CONCLUSION: We have reached the conclusion that the repercussions of a late deafness diagnosis have influence in health and education aspects of the deaf children's life. Early diagnosis and adequate support did not happen with the majority of the children. An inadequate inter-sector relation between Health and Education municipal authorities was verified.

Investigation of the A1555G mutation in mitochondrial DNA (MT-RNR1) in groups of Brazilian individuals with nonsyndromic deafness and normal-hearing.

BACKGROUND: Mutations of mitochondrial DNA were described into two genes: The mitochondrially encoded 12S RNA (MT-RNR1) and the mitochondrially encoded tRNA serineucn (MT-TS1). The A1555G mutation in MT-RNR1 gene is a frequent cause of deafness in different countries. AIM: The aim of this work was to investigate the frequency of the A1555G mutation in the MT-RNR1 gene in the mitochondrial DNA in Brazilians individuals with nonsyndromic deafness, and listeners. MATERIALS AND METHODS: DNA samples were submitted to polymerase chain reaction and to posterior digestion with the Hae III enzyme. RESULTS: Seventy eight (78) DNA samples of deaf individuals were analyzed; 75 showed normality in the region investigated, two samples (2.5%) showed the T1291C substitution, which is not related to the cause of deafness, and one sample (1.3%) showed the A1555G mutation. Among the 70 non-impaired individuals no A1555G mutation or T1291C substitution was found. CONCLUSION: We can affirm that A1555G mutation is not prevalent, or it must be very rare in normal-hearing subjects in the State of Paraná, the south region of Brazil. The A1555G mutation frequency (1.3%) found in individual with nonsyndromic deafness is similar to those found in other populations, with nonsyndromic deafness. Consequently, it should be examined in deafness diagnosis. The investigation of the A1555G mutation can contribute towards the determination of the nonsyndromic deafness etiology, hence, contributing to the correct genetic counseling process.

The study of gene GJB2/DFNB1 causing deafness in humans by linkage analysis from district Peshawar.

Families with at least 2 or more individuals having hereditary hearing loss were enrolled from different areas of Khyber Pakhtoonkhwa, mainly from district Peshawar. Detailed history was taken from each family to minimize the presence of other abnormalities and environmental causes for deafness. Families were questioned about skin pigmentation, hair pigmentation, and problems relating to balance, vision, night blindness, thyroid, kidneys, heart, and infectious diseases like meningitis, antibiotic usage, injury, and typhoid. The pedigree structures were based upon interviews with multiple family members, and pedigrees of the enrolled families were drawn using Cyrillic program (version 2.1). All families showed recessive mode of inheritance. I studied 8 families of these 10. For linkage analyses, studies for DFNB1 locus, 3 STR markers (D13S175, D13S292, and D13S787) were genotyped using polyacrylamide gel electrophoresis (PAGE) and haplotypes were constructed to determined, linkage with DFNB1 locus. From a total of 8 families, a single family-10 showed linkage to DFNB1 locus.

Inbreeding as a cause for deafness: Dadhkai study.

BACKGROUND: We report on the higher prevalence of deaf-mutes from a village in Jammu and Kashmir State of India. MATERIALS AND METHODS: A cross-sectional study among 79 deaf mutes using pedigree analysis, audiometry, imaging and molecular analysis. RESULTS: A high rate of hereditary deafness with 79 individuals diagnosed to be suffering from non-syndrome deafness in a total population of 2452 individuals residing in the village. INTERPRETATION: Flourishing of intermarriages led to a population with high prevalence of deafness.

Causas de sorderas profundas en niños chilenos asistentes a escuelas especiales para sordos / Causes of severe deafness in Chilean children enrolled in special schools for the deaf

La relación entre la audición y el desarrollo del lenguaje ha sido ampliamente demostrada, se aprende a hablar imitando los sonidos oídos y dándole la interpretación que oralmente los padres enseñan. Por ello, todos los países se están esforzando por realizar un tamizado universal en neonatos. El Estado de Chile, en un primer esfuerzo por detectar tempranamente las sorderas, está aplicando un tamizado auditivo a neonatos de alto riesgo. No hay en Chile estudio sobre las causas de sorderas, por lo cual se decidió investigar sobre esta materia en un grupo de niños sordos que estudia en alguna de las 4 escuelas especiales de Santiago. Conociendo las causas de sorderas congénitas y las de instalación en la infancia temprana, posibilita su prevención en el control del embarazo y de niño sano. Objetivo: Establecer las causas de sorderas profundas, según los conocimientos de sus padres o tutor legal y ficha escolar, en niños y jóvenes estudiantes de escuelas especiales para sordos. Material y método: En este estudio observacional, el universo fueron todos los niños que asisten a 4 escuelas especiales para sordos en Santiago. La muestra estuvo constituida por 315 casos que representan al 92 por ciento del universo. Se revisaron las fichas escolares de estos niños y la información se contrastó y completó con una entrevista a los padres o tutores. Conclusiones: El 63 por ciento de los niños presentaba sordera congénita, entre ellos el 9 por ciento fue por infección materna. Del total de la población, el 41.5 por ciento presentó sordera congénita de causa desconocida; el 13 por ciento fue adquirida por meningitis y en el 5.8 por ciento de los casos por prematurez.

The relationship between hearing and language development has been widely demonstrated, as children learn to speak by imitating sounds and interpreting them as they are orally taught by their parents. Because of this, countries are trying to put more emphasis on universal screening of newborns. In Chile, the first efforts of early detection of deafness have been in screening high risk newborns. En Chile there are no studies on the causes of deafness, and for this reason the present study seeks to investigate this issue in a group of Deaf children in special schools in Santiago. Understanding the causes of congenital and early childhood deafness allows for better prevention during pregnancy and early childhood. Objective: Establish the causes of severe deafness, according to the knowledge of parents or legal guardians and school records, in young students in special schools for the Deaf. Materials and Methods: In this observational study, the universe consisted of all children that attend 4 special schools for the Deaf in Santiago. The sample consisted of 315 cases, which represent 92 percent of the universe. School records were examined and information was contrasted and completed with and interview with parents or guardians. Conclusions: 63 percent of children suffered from congenital deafness, 9 percent of those due to infection during pregnancy. In 41.5 percent of all cases the cause of deafness was unknown. 13 percent was due to meningitis, and 5.8 percent was due to prematurity.

Comparação dos indicadores de risco para surdez em neonatos encontrados nos anos de 1995 e 2005 / Comparison of indicators of risk of deafness in newborns studied in the years 1995 and 2005

Introdução: Os dados apresentados pelo Centro de Vigilância Epidemiológica do Estado de São Paulo apontam que o número de crianças acometidas por doenças infecto-contagiosas aumenta a cada ano. Algumas dessas doenças são consideradas de risco para a audição. Objetivo: Verificar e comparar a ocorrência de indicadores de risco para Deficiência Auditiva durante o intervalo de 10 anos em uma maternidade de São Paulo. Método: Estudo de caráter quantitativo e retrospectivo, realizado a partir do levantamento e análise de dados dos registros fornecidos por uma maternidade da cidade de São Paulo. Foram levantados os registros dos bebês que nasceram de janeiro a dezembro dos anos de 1995 (n=2.077) e 2005 (n=5.129), e inclusos os que apresentaram indicadores de risco para surdez como prematuridade, baixo peso e asfixia, além de possuir diagnóstico confirmado ou suspeita de doenças infecto-contagiosas do grupo TORSCH-A. Resultados: Foram considerados os prontuários de 565 crianças nascidas em 1995, e de 1047 em 2005. Dentre os indicadores de risco para surdez, observou-se diferença significativa para o indicador prematuridade e asfixia, não havendo diferença significativa para o indicador baixo peso. Os indicadores de risco prematuridade, baixo peso e asfixia foram mais frequentes que a Toxoplasmose, a Sífilis e o HIV+. As crianças nascidas em 1995 tenderam a ter um maior número de indicadores de risco e/ou doenças do que as nascidas em 2005 (p<0,001). Conclusão: A maior incidência de indicadores em 1995 aponta melhoria na saúde, diminuindo ao longo de 10 anos o índice de recém-nascidos com risco para surdez.

Introduction: The data submitted by the Center of Epidemiological Surveillance of the State of São Paulo indicates the number of children affected by infecto-contagious diseases increases yearly. Some of these diseases are considered to be of risk for hearing. Objective: Check and compare the occurrence of risk indicators of the Hearing Loss during the interval of 10 years in a maternity of São Paulo. Method: Quantitative and retrospective study carried out from the research and review of data of registers supplied by a maternity of the city of São Paulo. We surveyed the registers of babies who were born from January through December of the years of 1995 (n=2.077) and 2005 (n=5.129), including those who had risk indicators for deafness and prematurity, low weight and asphyxia, besides having a diagnosis confirmed or suspicion of infecto-contagious diseases of group TORSCH-A. Results: We reviewed reports of 565 children born in 1995, and 1047 born in 2005. Among the risk indicators of deafness, we noticed a significant difference for the indicator of prematurity and asphyxia and there was no significant difference for the low weight indicator. The risk indicators of prematurity, low weight and asphyxia were more frequent than Toxoplasmosis, Syphilis and HIV+. The children born in 1995 tended to have a higher number of risk indicators and/or diseases than those born in 2005 (p<0.001). Conclusion: The major incidence of indicators in 1995 appoints an improvement to health that diminishes the index of newborns with risk of deafness along 10 years.

Prevalence and determinants of blindness, low vision, deafness and major bone fractures among elderly Omani population of Nizwa Wilayat (Nizwa elderly population study – 2005).

Aim: We conducted a survey in 2005 to estimate the prevalence and determinants of visual and hearing impairment in a population aged 60 years and above, from the Nizwa Wilayat of Oman. We also correlated them with major bone fracture. Study Design: Cross-sectional survey. Materials and Methods: Vision was tested on Snellen's 'E' chart. Persons with vision less than 20/200 were reexamined by an ophthalmologist to find cause of impairment. Hearing was tested by a screening audiometer. Self-reported information on fracture of major bones was confirmed by review of case records. The prevalence, 95% confidence intervals (CI), and number of visually impaired individuals were calculated. Statistical Analysis: Univariate method and parametric tests were used for analysis. Results: We examined 1,639 (80.3%) Omani persons aged 60 years and above. The prevalence of blindness (vision less than 20/200 in the better eye) was 37.4% (95% CI 35.7–39.1). Blindness was significantly higher in females (Odd's Ratio = 2.1) but was similar in urban and rural Nizwa (OR = 0.73). The prevalence of vision impairment (20/60 to 10/200) was 36.0% (95% CI 34.3–37.7). Cataract was the principal cause in 50% of the blind. The prevalence of glaucoma, corneal opacity, and chronic trachoma was 3.1%, 66.8%, and 53.2%, respectively. Among participants, 36.1% had diabetes. Hearing impairment was noted in 33.5% and profound hearing loss was noted in 3.6% of participants. In the past year, 1.4% of participants had a major bone fracture. Conclusion: Visual and hearing impairment and blinding eye diseases were common among senior Omani citizens.

Tamizaje universal de hipoacusia en el recién nacido / Universal screening of newborn hypoacusis

Neonatal hearing loss affects 1-3 from every 1000 live newborns. For optimal language and social development, proper diagnosis and treatment must be established before the first 6months of age. In Chile, screening for hearing loss is only performed on high-risk newborns weighting less than 1500 grams. However, about half of the newborns with hearing loss have no risk factors. Given the importance of this disability and the fact that it can be effectively diagnosed, a universal detection program for hearing loss becomes necessary. Further more, effective treatments for hearing loss, like hearing aids and cochlear implants are available in several institutions of our country, including the Clinical Hospital of the University of Chile. Worldwide, the most used screening methods are otoacoustic emissions and auditory brainstem evoked responses, the former, a test that detects the acoustic energy generated by the outer hair cells of the cochlea in response to a brief sound, and the latter a test that measures neural responses of the central auditory pathway. Both are objective and non-invasive techniques. Here we review evidences that support the need of creating a universal newborn hearing screening program in Chile.

Prevalence of early neurodevelopmental disabilities in Mexico: a systematic review / Prevalencia de neuro-discapacidades tempranas en México: una revisión sistemática

OBJECTIVE: Early neurodevelopment disabilities (END) such as cerebral palsy (CP), deafness, blindness, epilepsy, and mental retardation (MR) are very important public health concerns. Although no strong data on END can be obtained in Mexico, the few papers concerning END epidemiology deserve systematic and critical review. Thus, this was the objective of the present paper. METHOD: We performed a systematic review of papers published reporting on the prevalence of END in Mexico. We performed a search in several medical data bases such as PubMed, Artemisa, ImBioMed, and LiLaCS. Each paper was downloaded, read and discussed. We only selected papers published between 1999 and 2008. RESULTS: No data on CP and epilepsy prevalence in infants have been found. Data on deafness prevalence report hearing loss in 0.65/1,000 healthy newborns, and in 2.6/100 in high-risk very premature infants. With regard to blindness, prevalence of retinopathy of premature infants in any stage was reported at ca 10.61 and 22.2/100 in high-risk premature infants. Congenital hypothyroidism (CH) prevalence in infants was found in 4.2/10,000 live newborns after a national universal screening survey. CONCLUSION: No universal data regarding the prevalence of END in Mexico have been investigated, with the exception of CH. Mexico needs more research to determine epidemiologic data focused on designing actions to prevent, treat, and rehabilitate END.

OBJETIVO: Las neuro-discapacidades tempranas (NDT) como la parálisis cerebral (PC), hipoacusia, debilidad visual, epilepsia y retardo mental (RM) son problemas muy importantes de salud pública. Aunque no existen suficientes datos sobre la prevalencia de NDT en México, el objetivo de este trabajo es hacer comentarios sistemáticos y críticos sobre los ya estudios existentes. MÉTODO: Realizamos una búsqueda sistemática de artículos publicados sobre NDT en México. La búsqueda comprendió las siguientes bases de publicaciones: PubMed, Artemisa, ImBioMed y LiLaCS. Cada artículo fue descargado, leído cuidadosamente y comentado. Se seleccionaron aquellos trabajos publicados entre 1999-2008. RESULTADOS: No se han publicado datos sobre la prevalencia de PC y epilepsia en niños mexicanos. La prevalencia de hipoacusia se ha reportado entre 0.65/1,000 en recién nacidos sanos y 2.6/100 en recién nacidos de alto riesgo. La prevalencia de retinopatía de la prematurez como indicador de debilidad visual ha sido reportada entre 10.61-22.2/100 recién nacidos de alto riesgo. La prevalencia de hipotiroidismo congénito (HC) como indicador de RM ha sido encontrada en 4.2/10,000 recién nacidos en el estudio nacional de tamizaje. CONCLUSIÓN: No hay datos sobre la prevalencia de NDT con la excepción del HC en México. Se necesita más investigació.

Long QT syndrome in children with congenital deafness.

The Jervell and Lange-Nielson syndrome(JLN) is an infrequent form of long QT syndrome (LQTS) in which prolonged QT interval and congenital deafness exist together. We attempted to identify patients with LQTS among 127 children (age 1.2-10 years) with congenital hearing loss. The corrected QT interval was measured from 12 lead electrocardiogram(ECG) , using Bazette’s and Friedricia formulae.The QT interval was considered prolonged when it exceeded the upper limit of 440ms and 450ms, respectively. Ten children with congenital deafness had a corrected QT interval longer than 440ms. Although these children did not meet the definite criteria according to Schwartz parameters, all the 10 children could be defined as having intermediate probability of LQTS according to revised criteria. We advise that children with congenital deafness be screened for long QT syndrome .

Screening, diagnosing and treating deafness: the knowledge and conduct of doctors serving in neonatology and/or pediatrics in a tertiary teaching hospital / Avaliação, diagnóstico e tratamento da surdez: conhecimento e conduta de médicos com atuação em neonatologia e/ou pediatria de um hospital-escola terciário

CONTEXT AND OBJECTIVE: Infant hearing deficiency is a human disorder with devastating effects and serious implications for the development of speech and language. Early diagnosis of hearing loss should be the objective of a multidisciplinary team, and early-intervention programs should immediately follow this. The aim of this study was to investigate the knowledge and conduct of pediatricians and pediatric residents in a tertiary teaching hospital regarding deafness. DESIGN AND SETTING: Cross-sectional study in a tertiary hospital in the state of São Paulo, Brazil. METHODS: Eighty-eight questionnaires were randomly distributed to pediatricians and pediatric residents. RESULTS: Thirty-six questionnaires were analyzed. Most respondents (61.1 percent) were residents in pediatrics and/or neonatology. Eighty-three percent of them performed special procedures on babies presenting a high risk of deafness, and 55 percent reported that they had no knowledge of techniques for screening hearing. Most of them were unaware of the classifications of level and type of hearing loss. According to 47.2 percent of them, infants could begin to use a hearing aid at six months of age. Most of them reported that infants could undergo hearing rehabilitation during the first six months of life, and all respondents stated 's responsibilities. CONCLUSIONS: Even though most of the participants followed special procedures with babies presenting a high risk of deafness, they did not routinely investigate hearing. All respondents believed that it is a doctor's responsibility to be concerned about child communication.

CONTEXTO E OBJETIVO: A deficiência auditiva na criança é uma das desordens humanas cujo impacto tem efeito devastador produzindo sérias conseqüências no desenvolvimento da fala e linguagem. O diagnóstico precoce da perda auditiva deve ser objetivo de uma equipe interdisciplinar e ser seguido imediatamente por programas de intervenção precoce. O objetivo foi investigar o conhecimento e condutas de pediatras e residentes em pediatria de um hospital-escola terciário em relação à surdez. TIPO DE ESTUDO E LOCAL: Estudo transversal, hospital terciário do Estado de São Paulo. MÉTODOS: Oitenta e oito questionários distribuídos para pediatras e residentes em pediatria. RESULTADOS: Analisados 36 questionários. A maioria dos entrevistados (61,1 por cento) foi de residentes em pediatria e/ou neonatologia. Oitenta e três por cento realizavam alguma conduta especial com bebês de alto risco para surdez, e 55 por cento referiram não ter conhecimento sobre técnicas de triagem auditiva. A maioria desconhecia as classificações de grau e tipo de perda auditiva. Para 47,2 por cento, a criança poderia utilizar o aparelho auditivo a partir de seis meses. A maioria referiu que a criança poderia realizar reabilitação auditiva nos primeiros seis meses de vida e todos os entrevistados responderam que é função do médico ter preocupação com a comunicação da criança. CONCLUSÕES: Mesmo a maioria adotando condutas especiais com bebês de alto risco para surdez, não se investigava rotineiramente a audição. Todos os entrevistados julgaram ser função do médico se preocupar com a comunicação da criança.

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.

Hearing impairment and socioeconomic factors: a population-based survey of an urban locality in southern Brazil

OBJECTIVE: To provide the first population-based data on deafness and hearing impairment in Brazil. METHODS: In 2003, a cross-sectional household survey was conducted of 2 427 persons 4 years old and over. The study population was composed of 1 040 systematically chosen households in 40 randomly selected census tracts (dwelling clusters) in the city of Canoas, which is in the state of Rio Grande do Sul, in southern Brazil. Hearing function was evaluated in all subjects by both pure-tone audiometry and physical examination, using the World Health Organization Ear and Hearing Disorders Survey Protocol and definitions of hearing levels. The socioeconomic data that were gathered included the amount of schooling of all individuals tested and the income of the head of the household. RESULTS: It was found that 26.1 percent of the population studied showed some level of hearing impairment, and 6.8 percent (95 percent confidence interval (CI) = 5.5 percent-8.1 percent) were classified in the disabling hearing impairment group. The prevalence of moderate hearing loss was 5.4 percent (95 percent CI = 4.4 percent-6.4 percent); for severe hearing loss, 1.2 percent (95 percent CI = 0.7 percent-1.7 percent); and for profound hearing loss, 0.2 percent (95 percent CI = 0.03 percent-0.33 percent). The groups at higher risk for hearing loss were men (odds ratio (OR) = 1.54; 95 percent CI = 1.06-2.23); participants 60 years of age and over (OR = 12.55; 95 percent CI = 8.38-18.79); those with fewer years of formal schooling (OR = 3.92; 95 percent CI = 2.14-7.16); and those with lower income (OR = 1.56; 95 percent CI = 1.06-2.27). CONCLUSIONS: These results support advocacy by health policy planners and care providers for the prevention of deafness and hearing impairment. The findings could help build awareness in the community, in universities, and in government agencies of the health care needs that hearing problems create.

OBJETIVO: Presentar los primeros datos de un estudio de base poblacional sobre sordera y deficiencia auditiva en Brasil. MÉTODOS: Se realizó una encuesta transversal de hogares en 2003 en la que participaron 2 427 personas de 4 años de edad o más. La población de estudio estuvo compuesta por 1 040 hogares escogidos de manera sistemática en 40 sectores censales (conglomerados de viviendas) escogidos al azar en la ciudad de Canoas, estado de Rio Grande do Sul, en el sur de Brasil. Se evaluó la función auditiva de los participantes mediante audiometría tonal liminar y examen físico, según el Protocolo para el Estudio de Trastornos Oticos y Auditivos y las definiciones de niveles auditivos, ambos de la Organización Mundial de la Salud. Entre los datos socioeconómicos colectados estaban los años de escolaridad de las personas estudiadas y los ingresos del jefe del hogar. RESULTADOS: Se encontró que 26,1 por ciento de la población estudiada mostró algún grado de deficiencia auditiva y 6,8 por ciento (intervalo de confianza de 95 por ciento [IC95 por ciento]: 5,5 por ciento a 8,1 por ciento) se clasificó en el grupo con deficiencia auditiva incapacitante. La prevalencia de pérdida auditiva moderada fue de 5,4 por ciento (IC95 por ciento: 4,4 por ciento a 6,4 por ciento); de pérdida auditiva grave, 1,2 por ciento (IC95 por ciento: 0,7 por ciento a 1,7 por ciento); y de pérdida auditiva profunda, 0,2 por ciento (IC95 por ciento: 0,03 por ciento a 0,33 por ciento). Los grupos en mayor riesgo de pérdida auditiva fueron los hombres (razón de posibilidades [odds ratio, OR] = 1,54; IC95 por ciento: 1,06 a 2,23); los participantes de 60 años de edad o más (OR = 12,55; IC95 por ciento: 8,38 a 18,79); los que tenían menos años de escolaridad formal (OR = 3,92; IC95 por ciento: 2,14 a 7,16); y los que tenían menores ingresos (OR = 1,56; IC95 por ciento: 1,06 a 2,27). CONCLUSIONES: Estos resultados respaldan las recomendaciones de los planificadores de...

Genetics of deafness in India.

Linkage analysis in families with hereditary hearing loss have revealed a plethora of chromosomal locations linked to deafness reflecting the extreme heterogeneity of the disorder. 40 of the genes contained within these loci have been mapped lending an insight into the diverse molecules operating in the inner ear and the remarkable complexity of the cellular and molecular processes involved in the transucdation of sound in the auditory system. Among this diversity, Connexin 26 has been found to be the most common cause of deafness the world around. The authors review here the prevalence of this gene in the Indian population as found in their study, together with other deafness genes segregating non-syndromic deafness, accounting for approximately 40% of all cases. This indicates there are several more to be identified yet. Knowledge of the genetic cause of deafness in our families is important for accurate genetic counseling and early diagnosis for timely intervention and treatment options.

Aconselhamento genetico da deficiencia auditiva / Genetic counseling for deafness

Baseando-se em dados por nos coletados e pesquisados na literatura nacional e internacional, fornecemos estimativas de incidencia de surdez infantil nao-sindromica, das frequencias de casos ambientais e geneticos e das frequencias relativas dos tipos de surdez monogenica hereditaria...

Achados audiológicos na toxoplasmose congênita / Audiological findings in congenital toxoplasmosis

O embrião ou feto, durante a gestação, ou o recém-nascido no momento do parto, pode ser afetado pelas infecções congênitas. Dentre estas, temos a toxoplasmose, que ocorre como conseqüência à contaminação da criança pelo protozoário Toxoplasma gondii, por via transplacentária hematogênica (WILSON et al., 1980).O objetivo deste trabalho foi verificar a prevalência de deficiência auditiva periférica e/ou alteração do processamento auditivo central em crianças de 0 a 2 anos de idade, portadoras de toxoplasmose congênita. As crianças, num total de 24, foram submetidas à avaliação audiológica completa. Após análise dos dados obtidos, verificamos que 54,2 por cento das crianças não apresentou alteração auditiva, 12,5 por cento apresentou alteração periférica transitória e 33,3 por cento alteração do Processamento Auditivo Central (PAC). Diante dos achados, pudemos concluir que a Toxoplasmose Congênita é um fator etiológico importante para alteração do PAC.

Hipoacusia neurosensorial. Epidemiología / Neurosensorial hypoacusia. Epidemiology

Objetivo: Estudio de epidemiología y prevalencia de Hipoacusia sensorineural en una muestra de niños de Argentina. Edad de intervención. Manejo en la clínica pediátrica. Población: 1872 niños menores de 17 años que consultan por primera vez al Servicio de O.R.L y Audiología entre 1996/1997 (24 meses). Material y método: evaluación por médico O.R.L, antecedentes por entrevista a los padres y datos de su Historia Clínica. Evaluación audiológica por metodología subjetiva y objetiva. Evaluación de la producción del habla anterior al uso de sistemas de ayuda auditiva. Resultados: Hipoacusia Sensorineural en 609 niños (32,53 por ciento n:1872). En patología bilateral 547 (89,81 por ciento n: 609), de etiología prenatal 171 (28,08 por ciento), perinatal 125 (20,52 por ciento), post natal 113 (18,56 por ciento), desconocida 138 (22,66 por ciento). En patología unilateral 62 (10,19 por ciento n: 609) debido a enfermedades infecciosas 21 (3,45 por ciento), desconocida 20 (3,28 por ciento), otros 21 (3,45 por ciento). La media en edad de intervención profesional especializada en patología bilateral fue 2 años 3 meses (rango4 meses/17 años); en patología unilateral fue 6 años (rango 2/17 años). En todos los niños con hipoacusia de etiología imprecisa se encontró retraso en la adquisición de balbuceo canónico. Rango 13/50 m X 24 m. Conclusión: Teniendo en cuenta los antecedentes de alto riesgo audiológico se podrían haber detectado tempranamente el 48.60 por ciento de los niños. En el 25,94 por ciento de la poblaciónestudiada la etiología fue imprecisa. Como característica de nuestra población se destaca la alta incidencia de rubeola materna como etiología de hipoacusia sensorineural pudiéndose la misma prevenirse con la administración de la vacuna correspondiente. Se jerarquiza la búsqueda de balbuceo canónico como predictor de hipoacusa en ausencia de antecedentes de alto riesgo audiológico. La edad de intervención profesional fue mayor a los 12 meses de vida, enfatizando la necesidadde crear adecuados protocolos de evaluación a nivel nacional.

Audiçäo, comunicaçäo e linguagem: um convite à reflexäo / Reflexions on hearting, communication and language

A comunicação oral distingue o ser humano de todos os outros seres viventes e é obtida por meio de uma corrente de aquisições, cujo elo mais importante é a audição. Já a linguagem exige, para seu pleno desenvolvimento, as funções auditiva e fonatória ou, em outras palavras, os dois pólos de ligação entre os sujeitos da comunicação oral configurando o chamado circuito eletro-acústico da comunicação humana...