# Effect of Ear Health, Care Practices, and Hearing Loss on Academic Performance among Male Adolescents in Residential Schools: A cross-sectional study in Eastern India

## TL;DR

This study found that ear health issues and poor ear care practices are linked to lower academic performance in male adolescents in Indian residential schools.

## Contribution

The study establishes a novel link between chronic ear morbidity and hearing loss with academic performance in a residential adolescent population.

## Key findings

- 43% of participants had ear morbidity, with 85% of these cases being bilateral.
- Hearing loss was detected in 5% of participants, and it was strongly correlated with lower academic performance.
- Self-ear cleaning with cotton buds was common, and exposure to loud noises and physical trauma were also linked to worse academic outcomes.

## Abstract

This study aimed to investigate the association between ear health, ear care practices, and academic performance among male adolescents in residential schools.

A cross-sectional study was conducted among 684 male adolescents residing in residential schools in Deoghar, Jharkhand, India, during World Hearing Day 2023. Data were collected on socio-demographic characteristics, ear care practices, and academic performance. Comprehensive ear examinations and pure tone audiometry were performed to assess ear morbidity and hearing thresholds.

Ear morbidity was identified in 43% of participants, with bilateral involvement in 85% of these cases. Ear-related symptoms were reported by 26.3% of participants, including ear pain (46.1%) and hearing difficulty (37.2%). Chronic ear morbidity was present in 36.5% of the cohort. Hearing loss was detected in 5% of participants, with 4.6% experiencing mild and 0.4% moderate hearing loss; among these, 74.1% had bilateral involvement. Self-ear cleaning was commonly practiced (93%), predominantly using cotton buds (85.2%). Multivariate analysis showed that inserting substances into the ear (Spearman's rho [ρ] = -0.095; P = 0.014), exposure to loud firecrackers (ρ = -0.095; P = 0.014), being slapped hard (ρ = -0.102; P = 0.008), presence of chronic ear morbidity (ρ = -0.185; P <0.001), and hearing loss (ρ = -0.292; P <0.001) were significantly and negatively correlated with academic performance.

The study reveals a high prevalence of ear morbidities, which were associated with lower academic performance among the study population. Regular screenings, educational interventions and timely healthcare are crucial to protect this vulnerable group.