{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T15:05:50Z","timestamp":1784905550660,"version":"3.55.0"},"reference-count":28,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Audiol. Res.","Audiology Research"],"abstract":"<jats:p>Background: Hearing health in Kazakhstan is documented through parallel administrative systems whose indicators are often conflated. We examined three administrative layers of hearing health during 2020\u20132025: dispensary registration of ear and hearing-loss diagnoses, disability certification as a severe administrative endpoint, and cochlear implantation (CI) as the specialised treatment response, with reference to Global Burden of Disease (GBD) 2021 estimates. Methods: We conducted a national ecological, region-year, multi-source administrative registry study across all 20 regions of Kazakhstan from 2020 to 2025. The dataset included 114 region-year observations and integrated Dispensary Report Form No. 12, the State Register of Persons with Disabilities, and the Electronic Register of Inpatient Patients. Dispensary indicators were interpreted as registered healthcare-utilisation measures, not population prevalence or incidence. Trends were assessed using Mann\u2013Kendall tests with Benjamini\u2013Hochberg false-discovery-rate correction. Regional patterns were examined using Spearman correlation, inequality metrics, and exploratory clustering. Results: Among adults, registered H60\u2013H95 annual morbidity increased from 231,209 to 278,897 cases (CAGR +3.8%; FDR p = 0.016), and first-time registrations rose from 126,513 to 167,674 (CAGR +5.8%; FDR p = 0.016). Active dispensary observation declined modestly from 21,840 to 19,881. H65\u2013H66 chronic otitis first-time registration remained stable, while active observation declined sharply. Paediatric H90\u2013H91 registration was stable. In 2025, 31,560 persons were registered with hearing impairment-related disability, including 26,522 adults. CI procedures increased from 285 to 523. Adult CI activity was intermittent between 2012 and 2018 (peak 140 in 2013), ceased in 2019\u20132020, and was re-established from 2021 (14 \u2192 129 procedures in 2025), reaching 24.7% of all CI. Most procedures were concentrated in Almaty and Astana. Compared with the GBD-2021 estimate of 17,212 per 100,000, administrative indicators captured much narrower service-utilisation and severe-certification layers. Conclusions: Kazakhstan\u2019s administrative data describe distinct hearing-health layers rather than competing prevalence estimates. Adult screening, regional audiology capacity, post-CI rehabilitation, and longitudinal outcome registries are priority areas.<\/jats:p>","DOI":"10.3390\/audiolres16040104","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T13:53:26Z","timestamp":1784901206000},"page":"104","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hearing Impairment in Kazakhstan, 2020\u20132025: Dispensary Registration, Disability Certification, and Cochlear Implantation Response, with Reference to Global Burden of Disease 2021 Modelled Estimates"],"prefix":"10.3390","volume":"16","author":[{"given":"Zhadra","family":"Bukenova","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Astana Medical University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1345-5592","authenticated-orcid":false,"given":"Galiya","family":"Orazova","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Astana Medical University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aigerim","family":"Baimagambetova","sequence":"additional","affiliation":[{"name":"School of Public Health and Management, Astana Medical University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhadyra","family":"Karashutova","sequence":"additional","affiliation":[{"name":"National Scientific Center for Health Development Named After Salidat Kairbekova, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisulu","family":"Talgatova","sequence":"additional","affiliation":[{"name":"National Scientific Center for Health Development Named After Salidat Kairbekova, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1271-7010","authenticated-orcid":false,"given":"Zulfiya","family":"Zholdybayeva","sequence":"additional","affiliation":[{"name":"Department of ENT Diseases, Astana Medical University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sauran","family":"Yerdessov","sequence":"additional","affiliation":[{"name":"Department of Medicine, Nazarbayev University School of Medicine, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulnara","family":"Kulkayeva","sequence":"additional","affiliation":[{"name":"National Scientific Center for Health Development Named After Salidat Kairbekova, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2527367","DOI":"10.1080\/07853890.2025.2527367","article-title":"Global, regional, and national burden of hearing loss from 1990 to 2021: Findings from the 2021 global burden of disease study","volume":"57","author":"Shen","year":"2025","journal-title":"Ann. Med."},{"key":"ref_2","unstructured":"World Health Organization (2021). World Report on Hearing, World Health Organization."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1080\/14992027.2021.1883197","article-title":"Estimating the global costs of hearing loss","volume":"60","author":"McDaid","year":"2021","journal-title":"Int. J. Audiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.otc.2018.01.002","article-title":"World Health Organization and Its Initiative for Ear and Hearing Care","volume":"51","author":"Chadha","year":"2018","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1001\/jamainternmed.2013.1868","article-title":"Hearing loss and cognitive decline in older adults","volume":"173","author":"Lin","year":"2013","journal-title":"JAMA Intern. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1001\/jamaoto.2023.3509","article-title":"Hearing Loss, Hearing Aid Use, and Risk of Dementia in Older Adults","volume":"150","author":"Cantuaria","year":"2024","journal-title":"JAMA Otolaryngol.\u2014Head Neck Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1111\/jgs.12429","article-title":"Hearing loss and depression in older adults","volume":"61","author":"Mener","year":"2013","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1111\/jgs.13456","article-title":"Association Between Hearing Impairment and Risk of Hospitalization in Older Adults","volume":"63","author":"Genther","year":"2015","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1001\/jama.2010.451","article-title":"Spoken language development in children following cochlear implantation","volume":"303","author":"Niparko","year":"2010","journal-title":"JAMA"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Cuda, D., Manrique, M., Ramos, \u00c1., Marx, M., Bovo, R., Khnifes, R., Hilly, O., Belmin, J., Stripeikyte, G., and Graham, P.L. (2024). Improving quality of life in the elderly: Hearing loss treatment with cochlear implants. BMC Geriatr., 24.","DOI":"10.1186\/s12877-023-04642-2"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e161","DOI":"10.1097\/MAO.0000000000000946","article-title":"Cochlear Implant Access in Six Developed Countries","volume":"37","author":"Sorkin","year":"2016","journal-title":"Otol. Neurotol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Bukenova, Z., Orazova, G., Kassenova, D., Panahian, V., Mussina, A., Suleimenova, R., and Zhakhina, G. (2026). Burden of hearing loss and diagnostic utility of a screening tool in Kazakhstan: Insights from national and cross-sectional analyses. Front. Public Health, 14.","DOI":"10.3389\/fpubh.2026.1788652"},{"key":"ref_13","unstructured":"(2026, March 01). Order of the Minister of Health of the Republic of Kazakhstan No. 92 Dated 12 September 2025 on Amending Order No. KP DSM-306\/2020 on Rules for the Provision of Audiology Services. Available online: https:\/\/adilet.zan.kz\/rus\/docs\/V2500036828."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","article-title":"Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"335","author":"Altman","year":"2007","journal-title":"BMJ"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Benchimol, E.I., Smeeth, L., Guttmann, A., Harron, K., Moher, D., Petersen, I., S\u00f8rensen, H.T., von Elm, E., Langan, S.M., and RECORD Working Committee (2015). The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement. PLoS Med., 12.","DOI":"10.1371\/journal.pmed.1001885"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"245","DOI":"10.2307\/1907187","article-title":"Nonparametric Tests Against Trend","volume":"13","author":"Mann","year":"1945","journal-title":"Econometrica"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ciminello, E., Cuda, D., Forli, F., Fetoni, A.R., Berrettini, S., Mattei, E., Falcone, T., Cuccu, A., Ciccarelli, P., and Ceccarelli, S. (2025). Trends and Incidence of Hearing Implant Utilization in Italy: A Population-Based Study. Audiol. Res., 15.","DOI":"10.3390\/audiolres15060175"},{"key":"ref_18","first-page":"5243","article-title":"The German cochlear implant registry: One year experience and first results on demographic data","volume":"281","author":"Plontke","year":"2024","journal-title":"Oto-Rhino-Laryngol. Neck Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/j.anl.2025.09.009","article-title":"Establishing a comprehensive national auditory implant registry in Japan: Trends and demographics from the first two years (2023\u20132024)","volume":"52","author":"Akazawa","year":"2025","journal-title":"Auris Nasus Larynx"},{"key":"ref_20","unstructured":"Ministry of Healthcare of the Republic of Kazakhstan (2026, March 01). Order of the Minister of Health of the Republic of Kazakhstan Dated December 21, 2020 No. \u049aP DSM-306\/2020: On Approval of the Rules for Providing Audiological Care to the Population of the Republic of Kazakhstan. Available online: https:\/\/adilet.zan.kz\/eng\/docs\/V2000021849."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1007\/s00420-015-1083-5","article-title":"Occupational noise exposure and hearing: A systematic review","volume":"89","author":"Lie","year":"2016","journal-title":"Int. Arch. Occup. Environ. Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s13293-021-00369-0","article-title":"Sex differences in noise-induced hearing loss: A cross-sectional study in China","volume":"12","author":"Wang","year":"2021","journal-title":"Biol. Sex. Differ."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1002\/ajim.20223","article-title":"The global burden of occupational noise-induced hearing loss","volume":"48","author":"Nelson","year":"2005","journal-title":"Am. J. Ind. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1001\/jamaoto.2020.0998","article-title":"Unilateral Cochlear Implants for Severe, Profound, or Moderate Sloping to Profound Bilateral Sensorineural Hearing Loss: A Systematic Review and Consensus Statements","volume":"146","author":"Buchman","year":"2020","journal-title":"JAMA Otolaryngol.\u2014Head Neck Surg."},{"key":"ref_25","first-page":"4779","article-title":"Quality control in cochlear implant therapy: Clinical practice guidelines and registries in European countries","volume":"279","author":"Loth","year":"2022","journal-title":"Oto-Rhino-Laryngol. Neck Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e50292","DOI":"10.2196\/50292","article-title":"Hearing Rehabilitation with a Chat-Based Mobile Auditory Training Program in Experienced Hearing Aid Users: Prospective Randomized Controlled Study","volume":"12","author":"Han","year":"2024","journal-title":"JMIR mHealth uHealth"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e10752","DOI":"10.1002\/btm2.10752","article-title":"Artificial intelligence-enabled innovations in cochlear implant technology: Advancing auditory prosthetics for hearing restoration","volume":"10","author":"Zhang","year":"2025","journal-title":"Bioeng. Transl. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"52","DOI":"10.32921\/2225-9929-2024-2-56-52-60","article-title":"Comparative Analysis of Methods of Audiological Screening of the Adult Population: Global and Kazakhstani Experience","volume":"2","author":"Bukenova","year":"2024","journal-title":"J. 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