{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T11:00:27Z","timestamp":1784890827344,"version":"3.55.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"132","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Aural morbidity remains an under-recognized public health concern in urban slum populations where environmental noise exposure, poor housing, and unsafe hygiene practices co-exist. Evidence on combined socio-environmental determinants of ear health in such settings remains limited.\n                    <jats:bold>Methods<\/jats:bold>\n                    : A community-based, stratified, cross-sectional study was conducted among 384 residents aged 10\u201350 years from six urban slums in Bhubaneswar, stratified into low-, medium-, and high-noise zones. Data were collected using a pre-tested semi-structured questionnaire, otoscopic examination, and tuning fork tests. Associations between socio-demographic, environmental, and behavioral factors with aural morbidity were analyzed using chi-square tests and multivariable logistic regression.\n                    <jats:bold>Results<\/jats:bold>\n                    : Overall aural morbidity prevalence was 21.1% (95% confidence interval (CI): 17.3\u201325.5), comprising infection only (11.2%), hearing loss only (2.6%), and combined morbidity (7.3%). Screening detected hearing loss prevalence increased across exposure gradients\u2014low (2.4%), medium (11%), and high noise zones (15.6%) (\n                    <jats:italic toggle=\"yes\">P\u2009<\/jats:italic>\n                    =\u20090.001). Unsafe ear cleaning (\n                    <jats:italic toggle=\"yes\">P\u2009<\/jats:italic>\n                    =\u20090.017), prior infection (&lt;0.001), ear piercing (\n                    <jats:italic toggle=\"yes\">P\u2009<\/jats:italic>\n                    =\u20090.002), and lack of ear check-ups (\n                    <jats:italic toggle=\"yes\">P\u2009<\/jats:italic>\n                    =\u20090.021) were significantly associated. High noise exposure independently predicted morbidity (AOR), i.e., adjusted odds ratio 8.52; 95% CI: 2.90\u201325.08). Housing factors, including insect presence, flooding, and unsafe water sources, also demonstrated significant associations.\n                    <jats:bold>Conclusion<\/jats:bold>\n                    : Aural morbidity in urban slums reflects intersecting environmental, behavioral, and socio-housing risks. Integrating ear and hearing care within National Health Mission (NHM) platforms and Comprehensive Primary Health Care (CPHC) services can advance progress toward Sustainable Development Goals SDG 3 (Health), SDG 11 (Sustainable Cities), and SDG 6 (Sanitation) through multisectoral urban health interventions.\n                  <\/jats:p>","DOI":"10.4103\/nah.nah_45_26","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T04:00:28Z","timestamp":1783569628000},"page":"756-765","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Socio-Demographic, Environmental, and Self-Mediated Aural Practices Determinants of Aural Health in Urban Slums of Bhubaneswar, India: A multivariable Analysis to Suggest Recommendations"],"prefix":"10.4103","volume":"28","author":[{"given":"Sonali","family":"Kar","sequence":"first","affiliation":[{"name":"Department of Community Medicine, Kalinga Institute of Medical Sciences (KIMS), Kalinga Institute of Industrial Technology University, Patia, Bhubaneswar, Odisha 751024, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angana","family":"Ray","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Kalinga Institute of Medical Sciences (KIMS), Kalinga Institute of Industrial Technology University, Patia, Bhubaneswar, Odisha 751024, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kabikanta","family":"Samantaray","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Kalinga Institute of Medical Sciences (KIMS), Kalinga Institute of Industrial Technology University, Patia, Bhubaneswar, Odisha 751024, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gouri Kumar","family":"Rath","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Kalinga Institute of Medical Sciences (KIMS), Kalinga Institute of Industrial Technology University, Patia, Bhubaneswar, Odisha 751024, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirmalya","family":"Mohapatra","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Kalinga Institute of Medical Sciences (KIMS), Kalinga Institute of Industrial Technology University, Patia, Bhubaneswar, Odisha 751024, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prem Sagar","family":"Panda","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Kalinga Institute of Medical Sciences (KIMS), Kalinga Institute of Industrial Technology University, Patia, Bhubaneswar, Odisha 751024, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"R2-20260724"},{"key":"R6-20260724","first-page":"1","article-title":"Current insights in noise-induced hearing 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