A pilot study exploring the feasibility of homeopathic treatment for children with hearing loss in Kenya

• Profound hearing loss significantly impacts children in sub-Saharan Africa • 73% of children receiving homeopathic treatment at a deaf school recorded hearing increase • Homeopathy is a cheap, available, acceptable option for impoverished rural places • A pre-post-test design suggested feasibility of design, treatment and outcomes • Next is testing with real-world outcomes, a comparator, randomisation and blinding Severe hearing impairment has a significant impact on children's safety, ability to learn, socialise, and subsequently earn a living, particularly in sub-Saharan Africa where there is little conventional treatment, and rates are greater than high-income countries and growing. Small improvements in hearing can improve quality of life and safety. Prior treatment of deaf students by Homeopathy for Health in Africa suggested homeopathic treatment may be associated with increased hearing. This pilot study aims to assess the feasibility of conducting a fully powered study of the effectiveness of homeopathic treatment for children with severe hearing impairment. At a school for the deaf in Kenya, parents of children with impaired hearing were offered homeopathic treatment for their children for up to 9 months. Feasibility considerations were the cost, safety, tolerability and deliverability of treatment; recruitment; study design and outcome measurement (suitability, sensitivity, reliability, acceptability). Outcomes measured were: hearing level change via audiometric testing (decibel (dB) measurements at baseline (average of two baseline scores) and 9 months compared at each frequency); qualitative reports by teacher and student, voice and hearing tests. Forty-one children with impaired hearing and parental approval received homeopathic treatment for up to nine months and completed baseline and nine-month tests, but eight were unable to comply with audiology testing due to learning difficulties. Increase in hearing was registered in 73%, with nine students (39%) registering changes at several frequencies, corroborated by student and teacher reports and/or voice/speech tests. Some modification of the trial design is needed: prolonged school absences require treatment and testing flexibility; audiology testing challenges necessitate use of and comparison with other outcomes. To build on these results, robust, larger scale studies incorporating randomisation (possibly at school level), a comparator (no treatment), and blinding (of outcome assessment) are now needed. Measurement of change in important real-life aspects such as injury incidence, academic ability and quality of life are recommended.