Summary
Aboriginal and Torres Strait Islander children experience disproportionately higher rates of ear disease and associated hearing loss, with greater frequency and severity, than non-Indigenous children.
Queensland’s Deadly Ears Program aims to reduce the rates and impact of ear disease and hearing loss on Aboriginal and Torres Strait Islander children by providing a range of frontline services. These include building capability of local primary and allied-health services in its partner communities, as well as direct clinical services with children and families through the delivery of ear, nose and throat (ENT), audiology, speech pathology and occupational therapy services.
The Program provides access to tertiary specialist ear and hearing services for Aboriginal and Torres Strait Islander children from communities across rural and remote Queensland. Referrals into the Program target children and young people whose middle ear disease and associated hearing loss has not been responsive to primary health management. To the end of 2019, services were generally provided twice a year in 11 rural and remote communities or regions across Queensland.
This report presents a summary of the ENT and audiological services provided by the Deadly Ears Program between 2007 and 2019 and an overview of change in ear and hearing health for children receiving services between 2015 and 2019. It focuses on children and young people’s experiences with ear conditions and associated hearing loss. It also looks at variations between regions, referrals to and from the Program, and outcomes of children and young people who received multiple services from the Program.
Deadly Ears services provided
At Deadly Ears outreach clinics from 2007–2019, children and young people aged under 18 were offered an integrated service where they would be seen by both an ENT specialist and an audiologist. Where surgery could be delivered by the Program in that location, children and young people who required surgery within the Program's scope were also offered a surgical service during the same visit.
From 2007 to 2019, 6,140 children and young people had a total of 18,212 visits to a Deadly ears service. Multiple types of services can be received in a single visit.
Between 2007 and 2019:
- 5,938 children and young people received 17,557 ENT clinic services.
- 1,250 children and young people received 1,854 ENT surgery services.
- Starting from 2008, 11,826 audiology services were provided to 4,502 children and young people.
Ear conditions in children and young people improved over time
Between 2015 and 2019, 64% of the 2,586 children and young people who attended an ENT clinic service had an ear condition in at least 1 ear at their first service. The most common type of ear condition was otitis media with effusion (21%)—that is, a collection of fluid in the middle part of the ear, behind the ear drum.
Among the 651 children and young people who attended at least 2 ENT clinic services between 2015 and 2019:
- 77% had at least 1 type of ear condition at their first service, decreasing by 18 percentage points to 59% at their latest service.
- The proportion of children and young people with otitis media with effusion approximately halved, from 35% at the first service to 16% at the latest service.
The proportion of children and young people with at least 1 ear condition decreased between 2015 and 2019
Source: Deadly Ears Program data collection
Three in 5 children with hearing loss improved over time
In the 5-year period 2015 to 2019, 41% of 2,355 children and young people had hearing loss at their first audiology service —19% had unilateral hearing loss (1 ear), and 22% had bilateral hearing loss (both ears).
Children and young people with no ear conditions generally experienced better hearing than those with an ear condition. Among those with an ear condition at their first ENT clinic and audiology service, just over half (55%) experienced some form of hearing loss. In comparison, about 14% of children without an ear condition at their first service had hearing loss.
There are different types of hearing loss, including conductive, sensorineural and mixed. At their first audiology service, 39% of children and young people had conductive hearing loss—that is, hearing loss that results from dysfunction of the outer or middle ear. Conductive hearing loss is commonly associated with the presence of a middle ear condition, including otitis media. Additionally, 2.0% of children had sensorineural hearing loss—hearing loss that results from dysfunction in the inner ear (especially the cochlea).
For children and young people who attended multiple services (2 or more) over time and who had a confirmed hearing status at their first service (that is, did not have a finding of ‘unable to be determined’), the proportion with conductive hearing loss decreased from 64% (288 children) to 35% (161 children) between the first and latest service. In the critical 0–4 age group, the proportion with conductive hearing loss decreased from 65% (128 children) at the first service to 38% (75 children) at their latest service.
The proportion of children aged 0–4 with conductive hearing loss decreased between their first and latest Deadly Ears service
Source: Deadly Ears Program data collection
Among those who had 2 or more services over time and had conductive hearing loss at their first service (total: 228 children; left ear: 225 children; right ear: 221 children):
- 60% (left ear: 136; right ear: 134) had improved at their latest service—that is, moved from a higher degree of hearing loss to a lower degree or no hearing loss
- the rates of bilateral conductive hearing loss decreased from 59% (171 children) to 26% (74 children) between the first and latest service.