Translation and Validation of a Swahili Version of the Tinnitus Handicap Inventory

Abstract

Background: The Tinnitus Handicap Inventory questionnaire addresses the functional, emotional and catastrophic aspects of tinnitus. Its questions are uncomplicated and the responses are most precise when administered in local languages. Thus, it has been translated into multiple languages. Objective: To translate and validate a Swahili version of the Tinnitus Handicap Inventory. Study Design: This was a cross-sectional study. Study Setting and Duration: The study was conducted from March 2021 to January 2022 at the Kenyatta National Hospital Ear, Nose and Throat clinic. Study Subjects: There were 50 patients with tinnitus attending the Kenyatta National Hospital Ear, Nose and Throat clinic. Methodology: The Brislin model was used to translate the English Tinnitus Handicap Inventory into Swahili. Forward and back translation by blinded bilingual Otorhinolaryngologists was done. History, examination, pure tone audiometry and tinnitus loudness and pitch matching tests were done on patients. The Swahili questionnaire was administered to 50 patients with a re-test given two weeks later. Data Analysis: The Cronbach's alpha and Pearson Product moment tests were calculated to determine the internal consistency, validity and reliability of the Swahili version. Correlations of hearing loss, tinnitus loudness and pitch matching tests and handicap were drawn. Results: Fifty patients aged 21 to 61 years were recruited. The Cronbach’s alpha was 0.944 showing excellent internal consistency and validity. The Pearson Product moment was 0.969 confirming reliability. The Fisher’s Exact test confirmed an association between hearing loss and handicap levels and an association between tinnitus loudness and pitch matching test with P values of 0.025 and 0.003 respectively. Conclusion: The Swahili Tinnitus Handicap Inventory demonstrated excellent internal consistency, reliability and validity. Hearing loss and tinnitus loudness and pitch have a negative impact on the handicap level a patient with tinnitus experiences. Recommendations: The Swahili Tinnitus Handicap Inventory be used in assessing the handicap level in tinnitus patients and follow up for response to their management.