The Use of Tele Practice in Assessment of Middle Ear Function in Adults Living with HIV During the COVID-19 Pandemic

Abstract

Coronavirus disease (COVID-19) pandemic is the latest threat to global health that causes severe acute respiratory syndrome (SARS). Tele-practice has inadvertently sprung to the forefront to become a common practice amongst healthcare providers during COVID-19. Limited evidence exists on the use of tele-practice in assessing middle ear function in adults living with HIV during the COVID-19 pandemic. The aims of this study were to investigate the use of tele-practice for assessment of middle ear function in adults with HIV during the COVID-19 pandemic. A quantitative observational, cross-sectional design was adopted. A total of 134 adults diagnosed with HIV were purposively selected from the HIV clinic. An audiology researcher, in the role of site-facilitator, captured video otoscopic images of the tympanic membrane using a video otoscopy for all participants through asynchronous tele-practice. All captured images were sent to two independent otorhinolaryngologists for diagnosis. Findings of this study indicated that tele-practice can be used to assess middle ear function in adults living with HIV during COVID-19 pandemic. When asynchronous tele-practice was used, there was a moderate diagnostic agreement (k = 0.58) between the two otorhinolaryngologists on abnormality versus normality, but poor agreement (k = 0.15) on the nature of abnormality (e.g. OME vs CSOM). Current findings highlight the urgent need for a widespread use of tele-practice during the continued clinical follow up and management of adults living with HIV, and the implementation of tele-practice, particularly in low- and middle-income countries (LMICs) where capacity versus demand challenges related to ear and hearing care continue to exists.

Conducting clinical research in the era of the COVID-19 pandemic: Challenges and lessons for Speech-Language Pathology and Audiology research

“…If adapted suitably, ICT has been demonstrated and recommended to possess the potential to transform the entire research process, including increasing awareness of and access to clinical studies (Bailey et al, 2020 ; Shamsuddin et al, 2021 ; Rothwell et al, 2021 ). Through the use of remote interfaces and apps as well as telehealth technologies, be it synchronous, asynchronous or hybrid models (Khoza-Shangase et al, 2021 ; Sebothoma et al, 2021 ), there have been significant research enhancing changes such as participant recruitment, communication with patients regarding eligibility for various studies and for informed consent and for monitoring symptoms and drug side effects for clinical trials (e.g. drug safety trials) and longitudinal studies (Bailey et al, 2020 ; Roshan das et al, 2021 ; Rothwell et al, 2021 ).…”

“…Coronavirus disease 2019 (COVID-19), originally recorded in Wuhan, China in 2019, has become a global pandemic that has significantly impacted how the world lives and functions (Perez, Perez, & Roman, 2020 ), as declared by the World Health Organization (WHO) on the 11th March 2020. Within academia, the pandemic has impacted how teaching and learning and research activities are conducted, with challenges caused by the measures put in place to curb the spread of the virus influencing all decisions made (Khoza-Shangase, Moroe, & Neille, 2021 ; Perez et al, 2020 ; Sebothoma, Khoza-Shangase, Masege, & Mol, 2021 ). As far as research is concerned, significant challenges have been encountered in terms of the planning of clinical research designs, sourcing of funding for research as research priorities change, as well as significant questions around ethical clearance of studies conducted during the COVID-19 pandemic.…”

“…As far as research is concerned, significant challenges have been encountered in terms of the planning of clinical research designs, sourcing of funding for research as research priorities change, as well as significant questions around ethical clearance of studies conducted during the COVID-19 pandemic. Questions around ethical clearance have had ethical committees and institutional research review boards challenged by their mandate to facilitate ethical research whilst adhering to health and safety regulations implemented to protect and safeguard the safety of research participants and researchers (Beach et al, 2020 ; Lumeng et al, 2020 ; Perez et al, 2020 ; Sebothoma et al, 2021 ; Wieten, Burgart, & Cho, 2020 ). Weiner, Balasubramaniam, Shah and Javier ( 2020 ) believed that the impact that the COVID-19 pandemic had on general research and on research specific to the pandemic raises numerous important factors: (1) the significance of research, (2) challenges of research, especially during public health emergencies (PHEs) and (3) resources and opportunities towards improving research to become more efficient and cost effective.…”

In pursuit of increasing the application of tele-audiology in South Africa: COVID-19 puts on the alert for patient site facilitator training

“…The well-documented challenges relating to the availability of audiologists for the size of the population requiring ear and hearing care (capacity versus demand), as well as the advent of COVID-19 and its direct patient interaction challenges, over and above the vestibulocochlear signs and symptoms linked to it (Khoza-Shangase, in press), call for a serious re-imagining of the human resource strategy as well as the service delivery model for ear and hearing care within the South African context (Khoza-Shangase & Masondo, 2021 ; Muñoz, Nagaraj, & Nichols, 2020 ; Saunders & Roughley, 2021 ; Sebothoma, Khoza-Shangase, Masege, & Mol, 2021 ). Key to this re-imagining exercise is a paradigm shift that embraces the application of innovative service delivery models with the inclusion of paraprofessionals (Khoza-Shangase, 2021 ).…”

“…Although telepractice has been around for over two decades (Kim et al, 2020 ), its application has gained much popularity during the COVID-19 pandemic (Sebothoma et al, 2021 ). Due to the virus’s highly infectious nature, non-pharmaceutical measures to prevent its spread had to be implemented, and these significantly affected person-to-person contact for clinical care provision (Khoza-Shangase, Moroe, & Neille, 2021 ).…”