Prevalence and Risk Factors of Self-reported Voice Problems Among Yakshagana Artists

Background: Yakshagana /jaksh(phonetic)aga:na/ is a form of folk theater of India. It is a blend of music, acting, dance, costume, dialogue, and stage techniques with an exclusive style and form. Even though Yakshagana artists (singers and actors) are professional voice users, no reports are available in the literature regarding the prevalence of voice problems (VPs) in these performers. Aim: The current study investigated (a) the prevalence of self-reported VPs, (b) the different risk factors associated with the development of VPs, (c) the self-reported vocal health, and (d) the effect of VP on Yakshagana folk artists. Method: This cross-sectional survey was conducted using a self-reported questionnaire. Data for the present study were obtained through convenience sampling by distributing 160 questionnaires to Yakshagana artists in and around Udupi /ud(right tail)upi/ and Mangaluru /ma(eng)galu:ru/ districts of Karnataka state, India. The results of the study are analyzed and discussed based on 129 eligible questionnaires. Results: Career prevalence of self-reported VPs in singers and actors were found to be 91.2% and 74%, respectively, with multiple symptoms of vocal attrition. Frequent throat clearing was found to have a significant association with actors reporting VPs. Around 55% of artists missed their work for 2-3 days or more with an average of 2.12 days (minimum of 1 day to maximum of 5 days). Conclusions: Overall, the results suggest that Yakshagana artists are at greater risk of developing VPs. Hence, there is a need for thorough understanding of factors influencing VPs and for educating the Yakshagana artists about voice care strategies.