RESULTS:
Table 1 shows the participant’s background characteristics. The total number of participants was 428 and the majority (90.9%, n = 389) were in primary school, whilst the remainder were in kindergarten (9.1%, n = 39). The mean age of the participants was 9.05 years (standard deviation (SD) = 2.15), of whom 69.40% (n = 297) were males and 30.6% (n = 131) were females. Almost 60% of the participants (n = 260) had 2 to 4 siblings and 34% (n = 147) had more than 5 siblings. Half of the children were a middle child (50.9%, n = 218) and a third of them were firstborns (33.2%, n = 142); the majority of the children lived with both their parents (93.2%, n = 399).
The prevalence of hoarseness among our participants was 7.5%, of which 9.90% were females and 6.40% were males. Table 2 shows that 85% (n = 366) of the participants frequently used a medium to high pitch voice tone. With regards to the voice problem indicators as measured using the Children’s Voice Handicap Index-10 for parents, approximately 4.2% (n=18) of parents reported that their child had severe hoarseness, 19.9% (n=85) reported that their child’s voice was difficult to hear, 13.3% (n=57) claimed that their child’s voice reduced their school outcome, and 11.2% (n=48) of parents claimed that their child’s voice made them feel inferior to other children.
As seen in Table 3, the rate and risk of hoarseness were significantly higher in children with a history of excessive crying in infancy (odds ratio (OR) = 2.733, 95% confidence interval (CI) = 1.315 to 5.683), a previous history of hoarseness (OR = 2.315, 95% CI = 1.109 to 4.832), letter articulation problems, especially ‘R’ and ‘S’ (OR = 2.969, 95% CI = 1.421 to 6.204), stuttering (OR = 3.213, 95% CI = 1.428 to 7.228. In addition, only two children had previous vocal cord surgery, one of whom had hoarseness.
In regard to the RSI, the average score of all participants was 5.08 (SD=6.34, minimum= 0, maximum = 40) and the number of participants with an RSI > 13 was 55 (12.9%). In addition, it was found that the risk of hoarseness increased by four times if the RSI score was >13 (i.e. a child was possibly having LPR; OR = 4.77, 95% CI = 2.17 to 10.51).