Prevalence of hearing loss at primary health care clinics in South Africa

Background: Hearing loss prevalence data in South Africa is scarce, especially within primary health care settings. Objectives: To determine; (i) the prevalence of hearing disorders in patients ≥3 years of age attending two primary health care clinics, and (ii) the nature and characteristics of hearing disorders at these primary health care clinics. Method: A cross-sectional design was used at two primary health care clinics. Non-probability purposive sampling was used to screen participants at clinics for hearing loss with pure tone audiometry. A total of 1236 participants were screened (mean age 37.8 ±17.9 years). Diagnostic testing was available for confirmation of hearing loss on participants who failed the screening. Results: Hearing loss prevalence was 17.5% across both clinics. Most hearing losses were bilateral (70.0%) and were of a sensorineural nature (84.2%). Conclusion: Hearing loss prevalence was comparable at both primary health care clinics. Participants 40 years and older were at significantly higher risk for hearing loss. The current study is the first attempt to establish hearing loss prevalence for primary health care clinics in South Africa.Keywords: Hearing loss, primary health care clinics, South Africa

International survey of audiologists' attitudes toward telehealth

PURPOSE : A better understanding of the attitudes of audiologists toward teleaudiology and their willingness to use teleaudiology is required to progress the application of teleaudiology technologies and services into clinical practice. Audiologists around the world were surveyed on their attitudes toward teleaudiology and their willingness to use it. METHOD : An online survey was sent to audiologists through professional associations' mailing lists. The survey included questions on the use of computer and video-conferencing technologies, awareness and previous use of teleaudiology, and willingness to use teleaudiology. RESULTS : Responses were provided by 269 people from 28 different countries, representing a wide cross-section of experience, qualification, and work settings; 77.8% of respondents were women. Almost all respondents had used PC-based video-conferencing; most had used related technologies and reported positive attitudes toward using these. However, less than 25% had used teleaudiology. CONCLUSIONS : Despite positive attitudes toward telehealth and associated technology, the low number of audiologists who have used teleaudiology for services indicates limited clinical adoption.Portions of this work were presented at the Second International Meeting on Internet & Audiology, Snekkersten, Denmark (September 2015).http://aja.pubs.asha.org/Speech-Language Pathology and Audiolog

Seeking help for tinnitus and satisfaction with healthcare providers including diagnosis, clinical services, and treatment : a scoping review

The objective of this scoping review was to describe the extent and type of evidence related to seeking help for tinnitus and satisfaction with healthcare providers including diagnosis, services and treatments along the clinical pathway. The selection criteria were adults aged 18 and over with tinnitus who sought help and where patient satisfaction with healthcare providers was reported. Online databases MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP) and CINAHL plus (EBSCO) were searched for original studies in English. The search had no date limit. Twenty-one records were eligible for data extraction. Studies reported that the most common healthcare providers seen were general practitioners, ear, nose and throat specialists and audiologists. Depression and tinnitus severity were related to an increase in the number of times help was sought and the type of healthcare provider seen may also impact patient satisfaction. The majority of participants were unlikely to receive a referral to a specialist at the initial GP consultation. Although there is limited research in this area, help-seekers for tinnitus were generally dissatisfied and reported negative interactions with healthcare providers. However, once in a specialised tinnitus clinical setting, studies reported that most help-seekers were satisfied and had positive interactions with healthcare providers.journals.sagepub.com/home/ehpam2024Speech-Language Pathology and AudiologySDG-03:Good heatlh and well-bein

Community-based intervention determines tele-audiology site candidacy

PURPOSE : Sections of the community face barriers to accessing audiology services. The aim of this study was to assess the barriers faced by people in typically underserved community settings and to provide audiology services in their natural environment. Information gathered by questionnaire was used to determine each site's candidacy as a potential tele-audiology site. METHOD : Sixty-three participants were recruited across 3 community sites that were identified as gathering places for individuals who experience barriers to accessing traditional clinical audiology services. Information about demographics and participant experience with barriers to access was gathered by a locally generated, self-administered questionnaire. Pure-tone air-conduction audiometric exams were performed on participants with an automated portable diagnostic audiometer. Afterward, the investigator provided counseling regarding hearing loss rehabilitation or hearing protection. Referrals were made when appropriate. RESULTS : Pure-tone averages were similar within sites but varied across sites. At least 30% of individuals at each site reported they wanted to visit the audiologist more often. Each site reported different principal barriers to access, among them transportation, motivation, and money. Eleven individuals were referred to the next level of care. Questionnaire results revealed special accommodations should be considered at each potential tele-audiology site. CONCLUSION : The present study provided audiology services to individuals in their natural environment, identified many of the obstacles preventing individuals from pursuing traditional audiology services and provided information for the foundation of a tele-audiology practice.Part of this work was presented at the Second International Meeting on Internet and Audiology, Helsingør, Denmark, September 24 25, 2015.The Oticon Foundation for the donation of the KUDUwave Audiometer.http://aja.pubs.asha.orgSpeech-Language Pathology and Audiolog

Self-reported hearing loss and pure tone audiometry for screening in primary health care clinics

OBJECTIVE : To evaluate the performance of self-reported hearing loss alone and in combination with pure tone audiometry screening in primary health care clinics in South Africa. DESIGN : Nonprobability purposive sampling was used at 2 primary health care clinics. A total of 1084 participants (mean age 41.2 years; SD 15.5 years; range 16-97 years, 74.0% female) were screened using self-report and audiometry screening. Those failing audiometric screening and a sample of those who passed audiometric screening were also assessed by diagnostic pure time audiometry, to confirm or negate the finding of a hearing loss. RESULTS : Four hundred and thirty-six participants (40.2%) self-reported a hearing loss with no significant association with gender or race. One hundred and thirty-six participant (12.5%) self-reported hearing loss and failed audiometry screening (35 dB HL at 1, 2, and 4 kHz). Combining self-report with a second stage audiometry screening revealed a high test accuracy (81.0%) for hearing loss, being most accurate (86.1%) to identify high-frequency hearing loss. CONCLUSION : While self-report of hearing loss is an easy and time-efficient screening method to use at primary health care clinics, its accuracy may be limited when used in isolation and it may not be sufficiently sensitive to detect hearing loss. Combining a simple audiometry screening as a second-stage screen can significantly improve overall performance and efficiency of the screening protocol.The financial assistance of the National Research Foundation (NRF) toward this research is hereby acknowledged (Grant No. 87757).https://journals.sagepub.com/home/jpcam2019Speech-Language Pathology and Audiolog

Does clinician continuity influence hearing aid outcomes?

OBJECTIVE : To evaluate whether clinician continuity is associated with successful hearing aid outcomes. DESIGN : A prospective cohort study. Clinician continuity was defined as occurring when apatient was cared for by the same clinician for the hearing assessment, hearing aid selection process, hearing aid fitting and programming, and subsequent hearing aid fine tuning appointments. The hearing aid outcome measures included self-reported hearing aid use,benefit and satisfaction as well as self-reported handling skills and problems experienced with hearing aids. STUDY SAMPLE : Four hundred and sixty-eight adult hearing aid users (mean age 73.9 years ± 10.9) and 26 qualified audiologists (mean age 34 years ± 6.34) recruited from a single hearing clinic in Perth, Western Australia. RESULTS : There were no significant differences in hearing aid outcomes between participants who experienced clinician continuity and those who did not. CONCLUSIONS : Within a controlled practice setting, hearing aid outcomes may not be adversely effected if services are provided by more than one clinician.R. Bennett is funded by an Australian postgraduate award scholarship through the School of Surgery at The University of Western Australia.http://www.tandfonline.com/loi/iija202017-05-31hb2017Speech-Language Pathology and Audiolog

Accuracy of remote hearing assessment in a rural community

BACKGROUND : This study determined the accuracy of pure tone air conduction (AC) thresholds obtained using a synchronous telemedicine approach without a sound booth in a rural South African community. The global need for increased hearing healthcare currently far exceeds the capacity for delivering these services, especially in developing countries. A tele-audiology approach using a portable diagnostic audiometer could provide the solution, enabling hearing assessments to be conducted remotely and without a sound booth. MATERIALS AND METHODS : Hearing thresholds in a sound booth and natural environment were obtained froman initial sample of 20 adults (age range, 19– 63 years; mean age, 50 – 13 years; 55%female), recruited from a rural agricultural community. A subgroup of 10 adults (20 ears) volunteered for the telemedicine threshold testing. AC thresholds (250–8,000 Hz) were determined and subsequently compared in these environments. Typical threshold variability was determined using test–retest correspondence as a reference for the threshold correspondence using a telemedicine mode. RESULTS : Test–retest threshold correspondence in the booth and natural environmentswas within – 5 dB in 96.7%and 97.5%of comparisons, respectively. No significant differences were obtained in AC hearing thresholds determined in the telemedicine configuration comparedwith those recorded in the gold standard booth environment. Threshold correspondence between the telemedicine compared with booth and natural environments were within – 5 dB in 82% and 85% of comparisons, respectively. CONCLUSIONS : The current study demonstrates the validity of using synchronous telemedicine for conducting hearing assessments in a remote rural agricultural community without a sound booth.http://online.liebertpub.com/TMJhb201

Auditory-cognitive training for adult cochlear implant recipients : a study protocol for a randomised controlled trial

BACKGROUND: There is an urgent need to develop new therapies to improve cognitive function in adults following cochlear implant surgery. This study aims to determine if completing at-home computer-based brain training activities improve memory and thinking skills in adults following their first cochlear implant. METHODS: This study will be conducted as a single-blind, head-to-head, randomised controlled trial (RCT). It will determine whether auditory training combined with adaptive computerised cognitive training will elicit greater improvement in cognition, sound and speech perception, mood, and quality of life outcomes in adult cochlear implant recipients, when compared to auditory training combined with non-adaptive (i.e. placebo) computerised cognitive training. Participants 18 years or older who meet the clinical criteria for a cochlear implant will be recruited into the study. RESULTS: The results of this trial will clarify whether the auditory training combined with cognitive training will improve cognition, sound and speech perception, mood, and quality of life outcomes in adult cochlear implant recipients. DISCUSSION: We anticipate that our findings will have implications for clinical practice in the treatment of adult cochlear implant recipients.William Demant Foundation and Ear Science Institute Australia.http://www.trialsjournal.compm2022Speech-Language Pathology and Audiolog

Hearing loss in urban South African school children (grade 1 to 3)

OBJECTIVE : This study aimed to describe the prevalence and characteristics of hearing loss in school-aged children in an urban South African population. METHOD : Children from grade one to three from five schools in the Gauteng Province of South Africa formed a representative sample for this study. All children underwent otoscopic examinations, tympanometry and pure tone screening (25 dB HL at 1, 2 and 4 kHz). Children who failed the screening test and 5% of those who passed the screening test underwent diagnostic audiometry. RESULTS : A total of 1070 children were screened. Otoscopic examinations revealed that a total of 6.6% ears had cerumen and 7.5% of ears presented with a type-B tympanogram. 24 children (12 male, 12 female) were diagnosed with hearing loss. The overall prevalence of hearing loss was 2.2% with Caucasian children being 2.9 times more (95% confidence interval, 1.2–6.9) likely to have a hearing loss than African children. CONCLUSION : Hearing loss prevalence in urban South African school-aged children suggest that many children (2.2%) are in need of some form of follow-up services, most for medical intervention (1.2%) with a smaller population requiring audiological intervention (0.4%).National Research Foundation (NRF)http://www.elsevier.com/locate/ijporl2017-05-31hb2016Speech-Language Pathology and Audiolog

Self-reported cochlear implant management skills : development and validation of the self-administered Cochlear Implant Management Skills (CIMS-self) survey

OBJECTIVE : A self-administered device management survey was developed and validated to investigate the ability of cochlear implant recipients to self-report physical handling and care for their hearing implant device(s) and to identify factors that may influence self-reported management skills. DESIGN : Survey development and validation. A prospective convenience cohort design study. SETTING : Specialist hearing implant clinic. PARTICIPANTS : Forty-nine post-lingually hearing impaired, adult cochlear implant recipients, at least 12 months postoperative. MAIN OUTCOME MEASURES : Survey test–retest reliability, responsiveness, criterion validity and sensitivity and specificity compared to clinician evaluation of device management skills. Correlations between self-reported management skills and participant demographic, audiometric, cognitive function, clinical outcomes and device factors. RESULTS : The self-administered Cochlear Implant Management Skills survey was developed, demonstrating high test–retest reliability (ICC = 0.884, P < 0.001; CI 95%: 0.721–0.952), responsiveness to intervention (management skills training) [t(20) = −3.245, P = 0.004], criterion validity (ICC = 0.765, P < 0.001; CI 95%: 0.584–0.868) and sensitivity (0.89). No associations were found between self-reported management skills and participant factors. CONCLUSIONS : This study demonstrated that a self-report survey is an effective method for the evaluation of skills required for cochlear implant device management.The Cochlear Foundation and the Ear Science Institute Australia.http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1749-44862018-02-27hj2017Speech-Language Pathology and Audiolog