Prevalence of Hearing Loss among Middle and High School Students in General Education Schools of Ulaanbaatar, Mongolia

Abstract

Background: Hearing loss among adolescents remains an important public health concern, as even mild degrees of hearing impairment can adversely affect cognitive development, academic performance, and social interaction. In Mongolia, evidence on the prevalence of hearing loss among school-aged children is limited, providing the rationale for conducting this study. Aim: To determine the prevalence, type, and severity of hearing loss and to assess associated demographic factors among middle and high school students in Ulaanbaatar, Mongolia. Materials and Methods: A school-based cross-sectional study was conducted during 2024–2025 among 1,803 students from 18 general education schools across nine districts of Ulaanbaatar. Hearing screening was performed using pure-tone audiometry according to a standardized protocol, and students who failed the initial screening underwent confirmatory audiometric testing. Hearing loss was classified as mild (21–35 dB), moderate (36–50 dB), or severe (≥50 dB). Demographic information was collected from parents or guardians using a structured questionnaire. Data were analyzed using R software. Associations were assessed using the chi-square (χ²) test, with p<0.05 considered statistically significant. Results: Among the students screened, 7.4% were identified as requiring further evaluation, and hearing loss was confirmed in 2.3%. Parental educational level was significantly associated with hearing loss, while no significant differences were observed by sex. Conclusion: The prevalence of hearing loss among middle and high school students in general education schools in Ulaanbaatar was 2.3%, with no significant difference by sex. Most identified cases were mild and unilateral, highlighting the need for regular school-based hearing screening and strengthened parental health education. The association between parental educational level and hearing loss suggests the importance of addressing social determinants, and further studies are warranted to explore additional risk factors such as the use of personal listening devices.