Barriers to Timely Diagnosis of Prelingual Hearing Loss: Experience from a Tertiary Hospital in Tanzania
DOI:
https://doi.org/10.55320/mjz.53.3.1147Keywords:
prelingual, hearing loss, delayed diagnosis, barriers, TanzaniaAbstract
Objective: To determine the proportion of delayed diagnosis among children with prelingual hearing loss and examine caregiver sociodemographic characteristics, diagnostic timing, and perceived barriers to timely diagnosis.
Design, participants and main outcome measures: A hospital-based cross-sectional study was conducted among 88 caregivers of children with confirmed prelingual hearing loss at Muhimbili National Hospital. A structured questionnaire collected caregiver characteristics and perceived barriers, while age at confirmed diagnosis was obtained primarily from audiology records. Diagnosis after 3 months of age was classified as delayed according to the Early Hearing Detection and Intervention (EHDI) 1-3-6 benchmark. Data were analysed using SPSS version 23; p ≤ 0.05 was considered statistically significant.
Results: All 88 children had delayed diagnosis (100%; 95% CI, 95.9%-100.0%). Mean age at confirmed diagnosis was 19.51 ± 7.02 months and median age was 18 months (IQR, 15-24 months). Among caregivers, 75% were female, 45.5% had secondary education, 68.2% were married, and 46.6% were self-employed. In exploratory analysis, employment status was moderately associated with diagnosis after 18 months (χ²(2) = 8.610, p = 0.014; Cramer’s V = 0.313). The most frequently reported pre-diagnostic barriers were low awareness/perceived need (10/88, 11.4%; 95% CI, 5.6%-19.9%), financial constraints (9/88, 10.2%; 95% CI, 4.8%-18.5%), and distance to health facilities (9/88, 10.2%; 95% CI, 4.8%-18.5%). Two caregivers (2.3%) also reported post-diagnostic difficulty accessing hearing aids.
Conclusion: Delayed diagnosis was universal in this tertiary-care cohort, with a median diagnostic age far beyond the EHDI benchmark. Strengthening age-appropriate hearing screening, caregiver education, referral pathways, and financial access to diagnostic services may promote earlier diagnosis. Post-diagnostic access to hearing rehabilitation should also be strengthened.
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