Prevalence of hearing loss and factors associated with hearing loss in Ethiopia: findings from the 2023 National Ethiopia Hearing Survey

BMJ Open. 2025 Jan 2;15(1):e086288. doi: 10.1136/bmjopen-2024-086288.

Abstract

Objectives: To assess the prevalence and associated factors of hearing loss in Ethiopia, considering socioeconomic conditions, regional variations and age-related impacts.

Design: Nationwide cross-sectional survey.

Setting: Data were collected from 2 February to 10 June 2023, covering all regions of Ethiopia except Tigray (due to security concerns).

Participants: A sample of 3000 households and 7061 individuals aged 5 years and above was selected using a multistage sampling procedure. Eligible participants had resided in the area for at least 6 months. Exclusions included visitors, critically ill individuals and those with communication difficulties.

Outcome measures: Hearing loss was defined as an average hearing threshold >20 dB in the better ear at frequencies of 0.5 kHz, 1 kHz, 2 kHz and 4 kHz, measured using pure-tone audiometry. Logistic regression analysis was performed to determine factors associated with hearing loss.

Results: The overall prevalence of hearing loss among individuals aged 5+ years was 18.4%. The prevalence was 8.1% among children aged 5-14 years and 73.7% among adults aged 60+ years. Factors significantly associated with hearing loss included being over 60 years old (adjusted OR (AOR)=51.41; 95% CI 36.95, 71.53), having no formal education (AOR=2.12; 95% CI 1.47, 3.08), ear discharge (AOR=3.01; 95% CI 2.07, 4.38), wax presence (AOR=1.92; 95% CI 1.53, 2.40), and tympanic membrane abnormality (AOR=17.17; 95% CI 12.27, 24.02). Participants from the Harari (AOR=3.25; 95% CI 1.85, 5.72) and Somali (AOR=2.37; 95% CI 1.49, 3.77) regions were more likely to experience hearing loss compared with those from other regions.

Conclusions: Hearing loss is highly prevalent in Ethiopia, influenced by both modifiable and non-modifiable factors. Regional disparities in hearing loss suggest a need for targeted interventions. Evidence-based policies and strategies are essential to reduce ear diseases, improve hearing care services, and address disparities in hearing health across regions.

Keywords: EPIDEMIOLOGIC STUDIES; EPIDEMIOLOGY; Health; Health & safety.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Audiometry, Pure-Tone
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Ethiopia / epidemiology
  • Female
  • Hearing Loss* / epidemiology
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Young Adult