Pediatricians’ Stance on Profound Sensorineural Hearing Loss, its Management and Cochlear Implants in Karachi: A Cross-sectional KAP Study

Objectives: Evaluate pediatricians' knowledge, attitudes, and practices regarding profound sensorineural hearing loss (PSNHL), its Management and cochlear implants in Karachi. Methods: Prospective cross-sectional study by deploying a validated questionnaire (S-CVI=0.95; Cronbach’s ?=0.76–0.82) across the five tertiary care hospitals in Karachi, with a response rate of 58.5 % Results: An important detachment emerged between positive attitudes and clinical practice. The study highlighted a significant knowledge gap among pediatricians, with only 16.2% reporting being very familiar with Profound Sensorineural Hearing Loss (PSNHL). Noticeably, 63.2% were unable to name 2 or more cochlear implant centers in Karachi, and 30.8% could not give any estimate of cost. Confidence in diagnosing PSNHL was moderate (47.0% somewhat confident). Referral practices varied widely: 32.5% referred eligible children for CI evaluation most of the time, whereas 16.2% never referred. Nevertheless, the overall attitude was positive with 79.5% wanting further training in PSNHL, its management and Cochlear Implant Subgroup analyses showed that consultants demonstrated significantly better clinical practices related to CI referrals compared to residents (67% vs. 42%, p<0.001), despite no significant differences in knowledge (p=0.075) or attitudes (p=0.105). No significant differences were observed between pediatricians in private versus public hospitals regarding knowledge (p=0.238), attitudes (p=0.576), or practices (p=0.327). Both groups identified financial constraints and limited access to services as primary barriers. Conclusions: Divergence between Pediatricians knowledge, particularly about referral pathways, resources and positive attitude identify a critical gap in the care continuum which merit immediate heed. Structured CME and guidelines should be incorporated into the curriculum