https://doi.org/10.1177/1010539520937086 Asia Pacific Journal of Public Health 1–7 © 2020 APJPH Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/1010539520937086 journals.sagepub.com/home/aph Original Article What We Already Know • Prevalence of hearing loss and ear disease is higher in low- and middle-income countries. • Large epidemiological studies in high-income coun- tries have exposed a variety correlates of hearing loss, including age, socioeconomic status, behavioral, and medical risk factors. • Few large epidemiological studies of hearing loss are conducted and published in low- and middle-income countries. What This Article Adds • This is the first peer-reviewed article describing the prevalence of ear disease and hearing loss in a medium to large survey of the Philippines. • Prevalence rates of ear disease and hearing loss were generally higher than would have been predicted based on literature from neighboring regions. • This study is the first to describe evidence suggesting that the proportion of more significant hearing loss is higher in low- and middle-income countries. Introduction Hearing loss is a significant contributor to the global burden of disease for both adults and children. 1,2 The World Health Organization (WHO) estimates that there are 466 million people worldwide with a moderate or greater hearing loss, approximately 80% of whom reside in low- and middle- income countries (LMICs). 3 Hearing loss in LMICs has a high prevalence and a significant proportion of this burden is either preventable or treatable. Yet, when compared with other health conditions, little attention is paid to hearing loss prevention and remediation programs in these regions. 4 A number of large, high-quality, epidemiological studies have investigated the prevalence of hearing loss in high-income 937086APH XX X 10.1177/1010539520937086Asia Pacific Journal of Public HealthNewall et al research-article 2020 1 Macquarie University, Sydney, New South Wales, Australia 2 University of Santo Tomas, Manila, Philippines 3 University of Pretoria, Pretoria, South Africa Corresponding Author: John P. Newall, Australian Hearing Hub, Department of Linguistics, Faculty of Human Science, Macquarie University, Sydney, New South Wales 2109, Australia. Email: john.newall@mq.edu.au A National Survey of Hearing Loss in the Philippines John P. Newall, PhD 1 , Norberto Martinez, MD 2 , De Wet Swanepoel, PhD 3 , and Catherine M. McMahon, PhD 1 Abstract This study aimed to estimate the prevalence of hearing loss in the Philippines using a nationally representative sample. A cross-sectional national survey was undertaken utilizing a 3-stage stratified cluster design. Participants in the present study comprised 2275 adults and children with pure tone hearing assessment results. Prevalence of moderate or worse hearing loss, defined as 4FA ≥41 dBHL, was 7.5% in children <18 years, 14.7% in adults between 18 and 65 years, and 49.1% in adults >65 years. Factors associated with greater risk of moderate hearing loss in the better ear were presence of a middle ear condition (adjusted odds ratio = 2.39, 95% confidence interval = 1.49-3.85) and socioeconomic status (household income; adjusted odds ratio = 1.64, 95% confidence interval = 1.23-2.19). Age was also associated with increased risk, with adjusted odds ratios varying with age category. Prevalence of wax occlusion and outer and middle ear disease was 12.2% and 14.2%, respectively. Prevalence of hearing loss, outer, and middle ear disease appear comparatively high in the Philippines when compared with rates reported in high-income countries. Higher proportions of severe to profound hearing loss were also identified, indicating that there is both an increased prevalence and severity of hearing loss in this population. Keywords global health, public health, noncommunicable diseases, epidemiology, social determinants of health, population health