Adegbenro et al., J Community Med Health Educ 2013, 3:2 DOI: 10.4172/2161-0711.1000200

Research Article Open Access

Volume 3 • Issue 2 • 1000200J Community Med Health EducISSN: 2161-0711 JCMHE, an open access journal

Prevalence of Tinnitus among NigeriansAdegbenro CA1, Amusa YB2, Ijadunola IKT1 and Adeyemo A3*1Department of Community health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria2Otorhinolaryngology Unit, Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria3ENT Surgery Unit, Department of Surgery, Obafemi Awolowo University Teaching Hospital, Complex. Ile -Ife, Nigeria

AbstractBackground: Tinnitus is a common problem worldwide affecting about 17% of the American population. However

there is dearth of information on the prevalence of this problem among the blacks in the developing countries.

Objective: To establish the prevalence of tinnitus among Nigerians, the result of which can be used as a baseline for future intervention study.

Study Design: A Descriptive cross-sectional survey.

Study Location: Ife central Local Government area of Osun State, Ile-Ife, Nigeria. This has a total estimated population of 150,580 made up of 79623 males and 70967 females living in 11 wards.

Subjects and Methods: The subjects for the study were volunteered 1000 aged 15 years and above. A multistage sampling technique was employed to select the subjects.

The instrument for the data collection was a close-ended questionnaire that elicited information on demographic and history of tinnitus from the sample population. The data were collected between January and March, 2006.

Data analysis was done by using the statistical package for social science (SPSS version 11). The results were presented using, descriptive statistics, cross-tabulation and test of associations.

Results: There were 413 (41.3%) females and 587 (58.7%) males. Forty nine percent of the respondents were in the 3rd – 4th decade of life, and are of the Yoruba ethnic stalk. Tinnitus was reported in 61 (6.1%) of respondents. Tinnitus was found to be most prevalent in age group 45 years and above with a prevalence of 14.3%. Male preponderance was found with a prevalence rate of 3.9%. It was also found to be more prevalent among farmers 33.0% while the lowest prevalence was found among the civil servants and students. The severe type of tinnitus was found in 0.01% of the studied population. Bilaterality was found in 33 (54.1%) and tinnitus was associated with ear diseases in 21 (34.4%) of the affected population.

Conclusion: The prevalence of tinnitus among the Nigerians of the Yoruba stalk in this study is low. It was found to be more among men, and the prevalence was found to rise with advancing age. It is of the less severe type, and it was associated with ear diseases in over a third of the affected population.

*Corresponding author: Adekunle Adeyemo, ENT Surgery Unit, Department of Surgery, Obafemi Awolowo University Teaching Hospital, Ile Ife, Nigeria, Tel: +2438036701170; E-mail: kunleirie@yahoo.co.uk

Received December 19, 2012; Accepted March 20, 2013; Published March 24, 2013

Citation: Adegbenro CA, Amusa YB, Ijadunola IKT, Adeyemo A (2013) Prevalence of Tinnitus among Nigerians. J Community Med Health Educ 3: 200. doi:10.4172/2161-0711.1000200

Copyright: © 2013 Adegbenro CA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Keywords: Tinnitus; Ear-diseases; Bilaterality; External-stimulation;Deafness

IntroductionThe term Tinnitus comes from a Latin word “tinnere” which means

ringing, it is also used to describe sounds that are buzzing, roaring, pulsatile or clicking in nature [1]. It can be defined as the perception of sound or noise without any external stimulation [2]. It may be subjective or objective in nature. The patient alone perceives the sound in subjective tinnitus while in objective tinnitus, it can be perceived by the other listener. Tinnitus may be unilateral or bilateral.

Its prevalence increases with advancing age, and it occurs in both sexes, however it is more common in older males. In the United States of America, it has been found to be almost twice as common in Whites as it is in African-Americans [3]. The American Tinnitus Association estimates 50 million Americans may have experienced prolonged tinnitus, while tinnitus interferes with daily activities of up to 12 million American. European population studies found 7-14% of their population to have talked with their physician aboutTinnitus while potentially disabling Tinnitus occurred in 1-2.4% ofthe people [4]. Most people experiences transient Tinnitus (less thanfive minutes long) that may not require them to seek medical help [4].Tinnitus is associated with many medical conditions. It is associatedwith presbyacusis, menieres disease, otosclerosis, head trauma,acoustic neuroma, middle ear effusion, temporomandibular jointproblems, hyperlipidemia, meningitis and syphilis [5]. Drugs such as

salicylates, NSAID, aminoglycoside, quinine and antidepressants have been associated with tinnitus [6]. The Tinnitus is usually reversible with the cessation of these drugs. Mental illnesses such as anxiety and depression are commonly associated with disabling tinnitus [7]. In the elderly the tinnitus is most commonly associated with hearing loss [8].

Tinnitus is generated within the body from sound sources external to the auditory sensory pathways in objective tinnitus while it is a cognitive phenomenon not audible to an external listener in subjective tinnitus. It is “the false perception of sound in the absence of an acoustic stimulus” [6]. Abnormal signaling that is generated within the auditory pathways (auditory cortex, and the emotional limbic systems) and the central nervous system are thought to be responsible [9,10].

In African blacks living in Nigeria there is paucity of work on

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Medicine & Health Education

ISSN: 2161-0711

Community Medicine & Health Education

Citation: Adegbenro CA, Amusa YB, Ijadunola IKT, Adeyemo A (2013) Prevalence of Tinnitus among Nigerians. J Community Med Health Educ 3: 200. doi:10.4172/2161-0711.1000200

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Volume 3 • Issue 2 • 1000200J Community Med Health EducISSN: 2161-0711 JCMHE, an open access journal

tinnitus. Also evaluating and managing a patient with tinnitus posed a challenge to the Otolaryngologist practicing in this environment.

This study is designed to assess the prevalence of tinnitus among Nigerians living in Ife Central Local Government Area and to determine the demographic correlates and the character of the tinnitus.

Materials and MethodThe study was conducted in Ife Central Local Government Area

of in Osun State, Nigeria, between January and March, 2006. The headquarters is located at Ajebandele which is situated along Ife-Ibadan road. It has a total population of 150,580 made up of 79613 males and 70967 females divided into 11 wards and with a total household of 22,055.

Sample size was determined using the formula: N= Z2 pq/d2

Where:

N=the minimum required sample size

Z=the standard normal deviation, usually set at 1.95 which correspond to 95% confidence level.

P=the proportion in the target population estimated to have particular characteristic (estimated as 50% in the absence of a local epidemiological study)

q=1.0-p=1-05=0.5

d=absolute deviation or amount of difference allowed between the target and the study population.

Therefore N=1.95 x 1.95 x 0.5 x 0.5/0.05 x 0.05

N=380

As the study sampling technic is not by simple random sampling, a multiplication by the design effect is required to correct for the difference in design. This design is usually taken as 2.

Therefore corrected sample size is 380 x 2=760

In order to account for contingencies like non response incomplete response etc and to aid easy mathematical interpretation without losing precision, the sample size was increased to 1000.

Therefore one thousand respondents from the age of 15 years and above were selected for the study based on the sample size determination and on their informed consent. The sampling technique was a multistage sampling technique. The first stage consisted of selection of 4 wards using convenience sampling technique of choosing one in every three wards.

From the 11 wards in the LGA, the second stage was the selection of the streets that were surveyed. In each ward a third of the total number of the streets were selected by simple random technique via balloting. The next stage was the selection on each street one in every three houses. The first house being selected through balloting (simple random technique). Then every eligible household was then selected using cluster sampling. In the final stage, the required 1000 subjects were interviewed from each selected household using defacto method, (i.e. those seen on the spot until this number was obtained.

The interviewer administered close-ended questionnaires after obtaining the consent of the respondents. The information that was sought on the questionnaires is the, biodata and the history of Tinnitus based on Pneumonic ABC C –CLAP for Tinnitus evaluation [11].

The questionnaires were coded and data analysis was done using SPSS version 11. The results were presented in the form of frequency tables, cross-tabulations and test of associations.

Results

Socio demographic data

There were 587(58.7%) males and 413(41.3%) females. The mean age was 35.7 years (range 15-95, SD 18.6).

Educational status

Twenty-five respondents had no formal education, 171 had elementary education while 802(80.2%) had at least secondary education (Table 1).

Ethnicity

The largest ethnic group in the study population was the Yoruba; the Ibos represent 110 of the respondents while the Hausas represent 23 of the respondents. Other minor ethnic groups in the country were responsible for 375.

Marital status

Majority of the respondents’ were married 571(57.1%), 379(37.9%) were single while only 7(0.7%) were divorced.

Occupation

The Civil servants were the largest occupational group 531(53.1%) while the least occupational group was farming with 15(1.5%) respondents.

Parameter Sub group Frequency Percentage (%)

Sex FemaleMale413587

41.358.7

Age in years

15–2425–3435–44 >45

162491221126

16.249.122.112.6

Education

NFE aArabic

1o School2o School3o School

252

171347455

2.50.217.134.745.5

ReligionChristianity

IslamTraditional

6733252

67.332.50.2

Tribe

YorubaIbo

HausaOthers (b)

49211023

375

49.211.02.337.5

Marital

Single Married

DivorcedWidow (er)

3795717

43

37.957.10.74.3

Occupation

FarmingTrading

Civil ServantStudents

Artisan (d)

15185531158111

1.518.553.115.111.1

a = No formal educationb = Efik, Ibibio, Tiv, Edo, Ighala etcc = Civil servants: teachers, Clergy, traffic warden, military personnel, Nurse, Youth corpers etcd = Artisans welders, technician, panel beaters, painters, drivers, hairdresser, food vendor

Table 1: Socio demographic data of respondents.

Citation: Adegbenro CA, Amusa YB, Ijadunola IKT, Adeyemo A (2013) Prevalence of Tinnitus among Nigerians. J Community Med Health Educ 3: 200. doi:10.4172/2161-0711.1000200

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Volume 3 • Issue 2 • 1000200J Community Med Health EducISSN: 2161-0711 JCMHE, an open access journal

Relationship of tinnitus with Socio-demographic dataOf the 1000 respondents, Tinnitus was found in 61(6.1%) (Table

2) of the studied population. The prevalence of tinnitus was found to increase with advancing age (X2=17.04, p

Citation: Adegbenro CA, Amusa YB, Ijadunola IKT, Adeyemo A (2013) Prevalence of Tinnitus among Nigerians. J Community Med Health Educ 3: 200. doi:10.4172/2161-0711.1000200

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Volume 3 • Issue 2 • 1000200J Community Med Health EducISSN: 2161-0711 JCMHE, an open access journal

2. Greenberg JS (2001) Subjective Tinnitus in the Bolby R alford department of Otorhinolaryngology and communicative sciences. Grand round Archives.

3. Adams PF, Hendershot GE, Marano MA; Centers for Disease Control and Prevention/National Center for Health Statistics (1999) Current estimates from the National Health Interview Survey, 1996. Vital Health Stat 10: 201-203.

4. Vesterager V (1997) Tinnitus--investigation and management. BMJ 7082: 728-731.

5. Nodar RH (1996) Tinnitus reclassified; new oil in an old lamp. Otolaryngol Head Neck Surg 114: 582-585.

6. Lockwood AH, Salvi RJ, Burkard RF (2002) Tinnitus. N Engl J Med 347: 904-910.

7. Erlansson SI (2000) Psychological profiles of Tinnitus patients. In: Tinnitus handbook, Tyler RS (Ed.), San diego: Singular publishing Group 25-57.

8. Davis A, El Refaie A (2000) Epidemiology of Tinnitus. Tinnitus Handbook, Tyler RS (Ed.), Singular Publishing Group 1-21.

9. Lockwood AH, Salvi RJ, Coad ML, Towsley ML, Wack DS, et al. (1998) The functional neuroanatomy of tinnitus: evidence for limbic system links and neural plasticity. Neurology 50: 114-120.

10. Levine RA, Melcher JR (2000) Editorial: imaging Tinnitus. J Audiol Med.

11. Nodar RH (1996) Tinnitus reclassified; new oil in an old lamp. Otolaryngol Head Neck Surg 114: 582-585.

12. American Tinnitus Association, about Tinnitus (undated).

http://www.ncbi.nlm.nih.gov/pubmed/15782448http://www.ncbi.nlm.nih.gov/pubmed/15782448http://www.ncbi.nlm.nih.gov/pubmed/15782448http://www.ncbi.nlm.nih.gov/pubmed/9116552http://www.ncbi.nlm.nih.gov/pubmed/9116552http://www.ncbi.nlm.nih.gov/pubmed/8643268http://www.ncbi.nlm.nih.gov/pubmed/8643268http://www.ncbi.nlm.nih.gov/pubmed/12239260http://www.ncbi.nlm.nih.gov/pubmed/12239260http://books.google.co.in/books?hl=en&lr=&id=OlK5vPFccvIC&oi=fnd&pg=PA1&dq=Epidemiology+of+Tinnitus.+In:+Tinnitus+Handbook+Tyler+RS,+ed&ots=NGNrMKvBlq&sig=86JNTPUq0lFZ3oP4iV85_L9uho4#v=onepage&q=Epidemiology of Tinnitus. In%3A Tinnitus Handbook%2http://books.google.co.in/books?hl=en&lr=&id=OlK5vPFccvIC&oi=fnd&pg=PA1&dq=Epidemiology+of+Tinnitus.+In:+Tinnitus+Handbook+Tyler+RS,+ed&ots=NGNrMKvBlq&sig=86JNTPUq0lFZ3oP4iV85_L9uho4#v=onepage&q=Epidemiology of Tinnitus. In%3A Tinnitus Handbook%2http://www.ncbi.nlm.nih.gov/pubmed/9443467http://www.ncbi.nlm.nih.gov/pubmed/9443467http://www.ncbi.nlm.nih.gov/pubmed/9443467http://www.ncbi.nlm.nih.gov/pubmed/8643268http://www.ncbi.nlm.nih.gov/pubmed/8643268http://www.ata.org

TitleCorresponding authorAbstractKeywordsIntroductionMaterials and Method ResultsSocio demographic data Educational status EthnicityMarital status Occupation Relationship of tinnitus with Socio-demographic data OccupationCharacteristics of the tinnitus

DiscussionConclusionAcknowledgementTable 1Table 2Table 3Figure 1Figure 2References