Australian-first study set to unveil major impact of ear disease on Aboriginal children

Researchers from Telethon Kids Institute have been awarded a $1.1 million NHMRC ‘Targeted Call for Hearing Health’ grant to conduct the first ever study following Aboriginal babies from birth through to five years to uncover the true prevalence of middle ear infections and hearing loss.

This unique opportunity will demonstrate the feasibility and effectiveness of implementing an ear and hearing screening program for Aboriginal babies from just two months of age, providing integrated rapid access to specialist ear health care if recurring ear infections, known as otitis media (OM), are detected.

The grant will continue the work of the Djaalinj Waakinj (listening talking) project, which began in 2018 and involved Aboriginal health researchers visiting 125 families in their homes to conduct ear checks for babies at two – four, six – eight and 12 – 18 months of age.

Lead investigator Associate Professor Chris Brennan-Jones, from the Wesfarmers Centre of Vaccines and Infectious Diseases, based at Telethon Kids Institute, Curtin University and Perth Children’s Hospital, said that Aboriginal children have some of the highest rates of OM in the world and, if left untreated, can lead to permanent hearing loss and major long-term issues.

“Through Djaalinj Waakinj, researchers connected with families within their own communities to see how many children were developing ear disease, as well as how early/often they should be checked for early signs and, instead of waiting two years on a public hospital waitlist, close collaborations with local Aboriginal health organisations and Ear, Nose and Throat specialists allowed fast-tracked access to urgent treatment like grommet surgery,” said A/Prof Brennan-Jones.

“We discovered that Aboriginal babies show first signs of ear disease at just eight weeks of age, with 50 per cent of children suffering debilitating OM by six to eight months. 

“By their first birthday, 69 per cent were experiencing significant hearing loss ­– the average hearing level of children in the study was just over 40 dB, meaning it would be difficult for them to hear voices clearly.

“If you can’t hear, you can’t learn ­– leading to potential life-long consequences surrounding speech, education, behaviour, social relationships, employment and other future endeavours.

“These findings pin-pointed the vital urgency for early diagnosis and treatment of OM and have informed national policy and service delivery to ensure preventable hearing loss is addressed in the crucial developmental years ahead of starting school.  

“The Djaalinj Waakinj children, as well as over 200 families from the regional Pina Karnpi (good ears) group based in Kalgoorlie, are the first cohort of Aboriginal babies in Australia who have had their ear and hearing health observed since birth.

“Checking in on their ear health journey every six months from birth to five years of age will give us the very first prevalence estimates for OM and hearing loss throughout this age bracket and answer key questions relating to the fluctuations of ear health issues in early life, as well as identifying potential risk and protective factors associated with ear disease,” said A/Prof Brennan-Jones.

The grant will also allow researchers to investigate the effectiveness of the ‘Blow, Breathe, Cough’ health promotion intervention in Aboriginal children aged three years and up, which aims to resolve ear infections and prevent hearing loss without the need for surgery.

For Mrs Valerie Swift, a Chief Investigator on this project and Aboriginal Co-Director of the Djaalinj Waakinj Centre for Ear and Hearing Health at the Wesfarmers Centre of Vaccines and Infectious Diseases, the importance of this research hits very close to home after growing up with painful ear infections and significant hearing loss.

“Throughout my school life I was often in trouble for not listening to the teacher, being put at the back of the class or outside the door for not ‘paying attention’ – no one realised I simply couldn’t hear what they were saying,” said Mrs Swift.

“Every child deserves an opportunity to grow and develop to their full potential, so supporting families with access to information and treatment through this research so they can improve their child’s quality of life is a wonderful thing to be part of.

“I feel very passionate about this work and the fact that the need for this research was, and continues to be, supported by members of the Aboriginal community. The Djaalinj Waakinj project was guided by the Aboriginal Community Advisory Group, and we owe it to the community to undertake this research and identify strategies to inform policy and service delivery changes to the way ear health is currently managed.

“This has made a huge difference to the lives of these kids, and we would like to recognise everyone involved in this collaboration, including the many families involved in the project, the Aboriginal Community Advisory Group, Cockburn Integrated Health, Moorditj Koort Aboriginal Corporation, Child and Adolescent Health Service, East Metropolitan and South Metropolitan Health Services, Hearing Australia, Curtin University, Telethon Speech and Hearing and St John of God Murdoch Hospital,” concluded Mrs Swift.

Visit the Wesfarmers Centre of Vaccines and Infectious Diseases for more information about this ear health research.

View the research paper High prevalence of hearing loss in urban Aboriginal infants: the Djaalinj Waakinj cohort study online at The Medical Journal of Australia.