Reducing the Burden of Communication Disorders in the Developing World

Olusanya, Bolajoko O.; Ruben, Robert J.; Parving, Agnete

doi:10.1001/jama.296.4.441

Cited by 122 publications

(109 citation statements)

References 16 publications

(15 reference statements)

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“…The necessity of early hearing detection and intervention (EHDI) to contest the detrimental consequences, both individual and societal, of permanent congenital or early-onset hearing loss (PCEHL) is widely documented [2][3][4]. With at least 90% of infants with PCEHL residing in the developing world [5], focus has shifted from validation of EHDI to the development of contextually feasible models of service delivery [6][7].…”

Section: Introductionmentioning

confidence: 99%

Newborn hearing screening at a community-based obstetric unit: Screening and diagnostic outcomes

Kock

Swanepoel

Hall

2016

International Journal of Pediatric Otorhinolaryngology

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Objective: Postnatal visits at community-based midwife obstetric units (MOUs) have been proposed as an alternative primary healthcare screening platform in South Africa. This study evaluated the outcomes of distortion product otoacoustic emissions (DPOAEs) and automated auditory brainstem response (AABR) screening conducted by a dedicated nonprofessional screener at a community-based MOU in the Western Cape, South Africa.Methods: Universal newborn hearing screening (UNHS) at a community-based MOU was evaluated over a 16-month period. A dedicated non-professional screener was trained to follow a two-stage screening protocol targeting bilateral hearing loss. A two group comparative design was used alternating AABR (Maico MB11 BERAphone TM) and DPOAE (Bio-logic AuDX I) technology on a daily basis. Infants referring the initial screen received a follow-up appointment in two days' time and were rescreened with the same technology used at their first screen.Those referring the second stage were booked for diagnostic assessments.Results: 7452 infants were screened including 47.9% (n=3573) with DPOAE and 52.1% (n=3879) with AABR technology. Mean age at first stage screen was 6.1 days. The initial bilateral referral rate was significantly lower for AABR (4.6%) compared to DPOAE (7.0%) and dropped to 0.3% and 0.7% respectively following the second stage screenings. First rescreen and initial diagnostic follow-up rates of 90% and 92.3% were obtained for the DPOAE group and 86.6% and 90% for the AABR group. Follow-up rates showed no significant difference between technology groups. Diagnostic assessment revealed a higher prevalence rate for bilateral sensorineural hearing loss among the AABR group (1/1000) compared to the DPOAE group (0.3/1000). Screening technology had no significant influence on daily screening capacity (23 AABR/day; 24 DPOAE/day). 3Conclusions: Postnatal visits at community-based MOUs create a useful platform for hearing screening and follow-up. AABR technology with negligible disposable costs provides opportunity for AABR screening to be utilised in community-based programmes. AABR screening offers lower initial referral rates and a higher true positive rate compared to DPOAE.

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Section: Introductionmentioning

confidence: 99%

Newborn hearing screening at a community-based obstetric unit: Screening and diagnostic outcomes

Kock

Swanepoel

Hall

2016

International Journal of Pediatric Otorhinolaryngology

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“…Spoken communication is central to human interaction and constitutes the basis for virtually all social, educational, and corporate relationships globally (Olusanya, Ruben & Parving, 2006).…”

Section: Introductionmentioning

confidence: 99%

“…In older individuals and adults hearing loss has a decisively negative impact on aspects such as social participation, emotional and behavioral well-being, and employment status. Hearing loss often leads to isolation and feelings of uncertainty, anger, anxiety and increased stress with rippling effects on families, significant others and the pursuit of quality interpersonal communication (Olusanya, Ruben & Parving, 2006). All of these psychosocial dimensions are closely related to the basic well-being needed to achieve a sense of quality of life.…”

Section: Introductionmentioning

confidence: 99%

“…This is made worse by the association between communication disorders, such as hearing loss, and poverty due to significantly higher unemployment rates that render affected individuals largely economically dependent (Olusanya, Ruben & Parving, 2006). Hearing loss may be perpetuated in these poorer communities because of the exposure to more risks of hearing loss, such as unhygienic living conditions, disease outbreaks, lack of access to health care and poorer knowledge about prevention (Olusanya, Ruben & Parving, 2006). Thus a cycle of hearing loss contributing to poverty and poverty contributing to hearing loss may be perpetuated.…”

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confidence: 99%

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Telehealth in audiology: The need and potential to reach underserved communities

Swanepoel

Clark

Koekemoer³

et al. 2010

International Journal of Audiology

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196

169

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Permanent hearing loss is a leading global health care burden, with 1 in 10 people affected to a mild or greater degree. A shortage of trained healthcare professionals and associated infrastructure and resource limitations mean that hearing health services are unavailable to the majority of the world population. Utilizing information and communication technology in hearing health care, or tele-audiology, combined with automation offer unique opportunities for improved clinical care, widespread access to services, and more cost-effective and sustainable hearing health care. Tele-audiology demonstrates significant potential in areas such as education and training of hearing health care professionals, paraprofessionals, parents, and adults with hearing disorders; screening for auditory disorders; diagnosis of hearing loss; and intervention services. Global connectivity is rapidly growing with increasingly widespread distribution into underserved communities where audiological services may be facilitated through telehealth models. Although many questions related to aspects such as quality control, licensure, jurisdictional responsibility, certification and reimbursement still need to be addressed; no alternative strategy can currently offer the same potential reach for impacting the global burden of hearing loss in the near and foreseeable future.

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“…Poor people without disabilities can develop them, due to inadequate nutrition, unclean environments, disease, inefficient health services and poor infrastructure (7,8,9,10). Untreated and chronic diseases affect increasing numbers of people in developing countries (11,12), resulting in physical and functional disability (9,10,13,14).…”

Section: Introductionmentioning

confidence: 99%