ObjectiveTo determine if reliable, objective audiologic data can be obtained by
nonotolaryngology and nonaudiology practitioners using novel mobile
technology in an effort to expand the capacity for early identification and
treatment of disabling hearing loss in the developing world.Study DesignCross-sectional, proof-of-concept pilot study.SettingScreenings took place during an annual 2-week otolaryngology surgical mission
in October 2016 in semirural Malindi, Kenya.Subject and MethodsEighty-seven patients (174 total ears) were included from 2 deaf schools (n =
12 and 9), a nondeaf school (n = 9), a tuberculosis ward (n = 8), and a
walk-in otology clinic at a local hospital (n = 49). An automated,
tablet-based, language-independent, clinically validated, play audiometry
system and wireless otoscopic endoscopy via an iPhone or laptop platform was
administered by Kenyan community health workers (CHWs) and nursing
staff.ResultsVarious degrees of hearing loss and otologic pathology were identified,
including 1 child presumed to be deaf who was found to have unilaterally
normal hearing. Other pathology included 2 active perforations, 2 healed
perforations, 2 middle ear effusions, and 1 cholesteatoma. CHWs and nursing
staff demonstrated proficiency performing audiograms and endoscopy. Patients
screened in a deaf school were more likely to complete an unreliable
audiogram than patients screened in other settings (P <
.01).ConclusionThis study demonstrates the feasibility of a non–otolaryngology-based hearing
screening program. This may become an important tool in reducing the impact
of hearing loss and otologic pathology in areas bereft of otolaryngologists
and audiologists by allowing CHWs to gather important patient data prior to
otolaryngologic evaluation.