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Early childhood undernutrition increases risk of hearing loss in young adulthood in rural Nepal.

Publication ,  Journal Article
Emmett, SD; Schmitz, J; Karna, SL; Khatry, SK; Wu, L; LeClerq, SC; Pillion, J; West, KP
Published in: The American journal of clinical nutrition
February 2018

Prevalence of young adult hearing loss is high in low-resource societies; the reasons for this are likely complex but could involve early childhood undernutrition.We evaluated preschool childhood stunting, wasting, and underweight as risk factors for hearing loss in young adulthood in Sarlahi District, southern Nepal.Ear health was assessed in 2006-2008 in a cohort of 2193 subjects aged 16-23 y, who as children <60 mo of age participated in a 16-mo placebo-controlled, randomized vitamin A supplementation trial from 1989 to 1991. At each of five 4-mo assessments, field staff measured children's weight, height, and mid-upper arm circumference (MUAC) and recorded validated parental history of ear discharge in the previous 7 d. Children were classified as stunted [<-2 z score height-for-age (HAZ)], underweight [<-2 z score weight-for-age (WAZ)], or wasted [<-2 z score MUAC-for-age (MUACAZ) or body mass index-for-age (BMIAZ)]. At follow-up, hearing was tested by audiometry and tympanometry, with hearing loss defined as pure-tone average >30dB in the worse ear (0.5, 1, 2, 4 kHz) and middle-ear dysfunction as abnormal tympanometric peak height (<0.3 or >1.4 mmho) or width (<50 or >110 daPa).Hearing loss, present in 5.9% (95% CI: 5.01%, 7.00%) of subjects, was associated with early childhood stunting (OR: 1.64; 95% CI: 1.10, 1.45), underweight (OR: 1.70; 95% CI: 1.18, 2.44) and wasting by BMIAZ (OR: 1.88; 95% CI: 1.19, 2.97) and MUACAZ (OR: 2.14; 95% CI: 1.47, 3.12). Abnormal tympanometry, affecting 16.6% (95% CI: 15.06%, 18.18%), was associated with underweight (OR: 1.46; 95% CI: 1.16, 1.84) and wasting by BMIAZ (OR: 1.80; 95% CI: 1.32, 2.46) and MUACAZ (OR: 1.42; 95% CI: 1.10, 1.84), but not stunting (OR: 1.18; 95% CI: 0.93, 1.49) in early childhood. Highest ORs were observed for subjects with both hearing loss and abnormal tympanometry, ranging from 1.87 to 2.24 (all lower 95% CI >1.00).Early childhood undernutrition is a modifiable risk factor for early adulthood hearing loss.

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Published In

The American journal of clinical nutrition

DOI

EISSN

1938-3207

ISSN

0002-9165

Publication Date

February 2018

Volume

107

Issue

2

Start / End Page

268 / 277

Related Subject Headings

  • Young Adult
  • Vitamin A
  • Thinness
  • Rural Population
  • Risk Factors
  • Randomized Controlled Trials as Topic
  • Prevalence
  • Nutrition & Dietetics
  • Nepal
  • Malnutrition
 

Citation

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ICMJE
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Emmett, S. D., Schmitz, J., Karna, S. L., Khatry, S. K., Wu, L., LeClerq, S. C., … West, K. P. (2018). Early childhood undernutrition increases risk of hearing loss in young adulthood in rural Nepal. The American Journal of Clinical Nutrition, 107(2), 268–277. https://doi.org/10.1093/ajcn/nqx022
Emmett, Susan D., Jane Schmitz, Sureswor L. Karna, Subarna K. Khatry, Lee Wu, Steven C. LeClerq, Joseph Pillion, and Keith P. West. “Early childhood undernutrition increases risk of hearing loss in young adulthood in rural Nepal.The American Journal of Clinical Nutrition 107, no. 2 (February 2018): 268–77. https://doi.org/10.1093/ajcn/nqx022.
Emmett SD, Schmitz J, Karna SL, Khatry SK, Wu L, LeClerq SC, et al. Early childhood undernutrition increases risk of hearing loss in young adulthood in rural Nepal. The American journal of clinical nutrition. 2018 Feb;107(2):268–77.
Emmett, Susan D., et al. “Early childhood undernutrition increases risk of hearing loss in young adulthood in rural Nepal.The American Journal of Clinical Nutrition, vol. 107, no. 2, Feb. 2018, pp. 268–77. Epmc, doi:10.1093/ajcn/nqx022.
Emmett SD, Schmitz J, Karna SL, Khatry SK, Wu L, LeClerq SC, Pillion J, West KP. Early childhood undernutrition increases risk of hearing loss in young adulthood in rural Nepal. The American journal of clinical nutrition. 2018 Feb;107(2):268–277.
Journal cover image

Published In

The American journal of clinical nutrition

DOI

EISSN

1938-3207

ISSN

0002-9165

Publication Date

February 2018

Volume

107

Issue

2

Start / End Page

268 / 277

Related Subject Headings

  • Young Adult
  • Vitamin A
  • Thinness
  • Rural Population
  • Risk Factors
  • Randomized Controlled Trials as Topic
  • Prevalence
  • Nutrition & Dietetics
  • Nepal
  • Malnutrition