Gender Disparity in Hearing Loss in the Adult Population in Ethiopia: Evidence from the National Hearing Survey

Abstract

Abstract Background: Hearing loss is a major global public health challenge affecting over 1.5 billion people, with significant gender disparities in prevalence, severity, and risk factors influenced by occupational, behavioral, and sociocultural exposures. In Ethiopia, where hearing loss burdens aging populations and underserved communities, nationwide evidence on gender disparities remains limited, necessitating targeted evaluation for equitable policy. Objective: To assess gender disparities in hearing loss among the adult population in Ethiopia using data from the National Hearing Survey, Ethiopia. Methods: This retrospective secondary data analysis included all eligible adults from the National Hearing Survey of Ethiopia (NHSE) dataset (2023) who resided in Ethiopia and had complete objective audiometric data. Hearing loss was defined as pure-tone average (PTA) >20 dB in the better ear (0.5, 1, 2, 4 kHz), graded per WHO as mild (21–40 dB), moderate (41–60 dB), severe (61–80 dB), or profound (>80 dB). Data cleaning involved checks for completeness and outliers using IBM SPSS Statistics version 27. Descriptive statistics assessed disparities; bivariable/multivariable logistic regression were used to generate odds ratios (95% CI) to capture associated factors. A p<0.05 was deemed statistically significant. Results: A total of 4,876 adults were analyzed, of whom males constituted 36.2% (n=1,765). Participants' age ranged from 18 to >100 years with a median (interquartile range) of 34 (26 45) years. Hearing loss prevalence was significantly higher in males (27.5%, n=485) than females (21.9%, n=682; p<0.001), with males showing greater severity across all grades and higher presbycusis rates (42.1% vs. 33.6%). Independent factors associated with hearing loss included age >60 years (AOR=4.67, 95% CI 2.50–8.70), lower education levels (no formal: AOR=2.58, 95% CI 1.20–5.51; primary: AOR=2.21, 95% CI 1.05–4.64; secondary: AOR=2.72, 95% CI 1.20–6.21), and chronic suppurative otitis media (AOR=4.67, 95% CI 2.30–9.47). Conclusions: This first NHSE gender analysis reveals male predominance in hearing loss (27.5% vs. 21.9%). Age >60 years, lower educational attainment, and chronic suppurative otitis media independently drive hearing impairment, informing targeted screening and CSOM management to advance SDG 3 and 10. To our knowledge, this provides Ethiopia's first nationally representative evidence of gender disparities from population-based audiometric data. Keywords: Gender disparity, Hearing loss, NHSE, Ethiopia