Prevalence and Risk Factors of Voice Disorders Among Primary School Teachers and Non Teaching Staff in Nairobi

Abstract

Background: Teachers are part of a special group of voice users described as professional voice users. The profession requires the frequent use of the voice at an elevated volume for long hours. This makes teachers more prone to development of voice disorders or dysphonia. Voice disorders will lead to reduction in quality of life, decreased work performance, absent days from work and restrictions in social interactions and activities. Identification and treatment will reduce these negative outcomes. Objective: To determine the prevalence of voice disorders and associated risk factors in primary school teachers and non-teaching staff in Nairobi. Study Design: comparative cross sectional study Study Setting: The study was carried out in 17 randomly selected public primary schools across Nairobi and the study population consisted of primary school teachers in active teaching and the non-teaching staff as a comparison. Methodology: A total of 200 primary school teachers and 200 non-teaching staff were selected from the 17 primary schools. Multi stage random sampling using a ruffle to select the 17 primary schools and 12 teaching staff, 12 non-teaching staff from each school was done. The assessment tools used were a voice risk factor and voice handicap index. A voice disorder was defined as a voice that does not perform, work or sound as it usually does resulting in interference with work or communication. Results: The prevalence of voice disorders was significantly higher in teachers as compared to the non-teaching staff, (24.5% Vs 3.5%), P<0.001, OR=8.9(95%CI:3.9-20). Voice disorders were more prevalent among female teachers. Upper respiratory tract infections (OR=2.58, 95%CI1.32-5.00) were a significant risk factor among teaching staff while allergies (OR=2.63, 95%CI1.44-4.77), stress (OR=2.66, 95%CL1.16-6.09) and chronic use of medications (OR=2.81, 95%CI1.00-4.74) were significant risk factors among non-teaching staff. Teachers had significant higher VHI scores as compared to non-teaching staff. Conclusion/Recommendations: voice disorders among primary school teachers in Nairobi is high compared to non-teaching staff leading to significant levels of handicap. There is a greater need to educate and train these professional voice users on voice hygiene and care of their voice.