Abstract:
Hearing loss presents a major public health concern worldwide which is exacerbated for developing nations. Considering its potential detrimental effect across the life course on development, cognition, communication and quality of life, it is important that there is adequate access to hearing loss diagnosis, rehabilitation and management. Yet for Pacific nations, despite having higher rates of hearing loss, there is little to no access to ear and hearing health services. The purpose of this study is to initiate this process for Tokelauan populations, by first exploring the hearing status of Tokelauan adult populations living in New Zealand. A secondary purpose is to identify appropriate ways to best engage Tokelauan communities in health research. A questionnaire regarding demographic and noise exposure was distributed, and otoscopy, pure tone audiometry and tympanometry were undertaken on Tokelauan communities from Auckland and Porirua. In particular, Grey Lynn Presbyterian church and EFKT Otara from the former, and Pāhina o Tokelau and Atafu Tokelau Community Group from the latter city. Results from 123 participants were analysed by quantitative statistical methods where possible. The Tokelauan adults in this sample had a hearing loss prevalence of 72% (defined as ≥20 dBHL), and a total disabling hearing loss of 4.1% (≥40 dBHL (WHO criteria) or 6.5% (≥35 dBHL) for all tested frequencies (0.25, 0.5, 1, 2, 3, 4, 6 and 8kHz). The average audiogram distribution revealed significant differences between the lower frequencies and higher frequencies (p < 0.05). The average audiogram however, revealed no ear or gender differences, though the configuration appears to shift with age. The severity of a hearing loss also seems to increase with age. Consistent with previous reporting on Pacific hearing status, Tokelauan adults seem to have high rates of hearing loss, predominantly at a slight to mild extent. The average audiogram for younger adult participants also had more extensive loss than their 30 to 64 year old counterparts. However these results are for a small sample and need to be repeated on a larger, more representative sample of Tokelauan adults and children.