TY - JOUR
T1 - Community health workers obtain similar results using cell-phone based hearing screening tools compared to otolaryngologists in low resourced settings
AU - Shinn, Justin R.
AU - Zuniga, M. Geraldine
AU - Macharia, Ian
AU - Reppart, Jim
AU - Netterville, James L.
AU - Jayawardena, Asitha D.L.
N1 - Funding Information:
The authors would also like to thank the local CHWs, nursing staff, the Tawfiq hospital and all volunteers on the 2017 Kenya More than Medicine team for their help and assistance on this project. This project was funded, in part, by internal funding from the Vanderbilt Department of Otolaryngology .
Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/12
Y1 - 2019/12
N2 - Objective: To establish community health workers as reliable hearing screening operators in a technology-based pre-surgical hearing screening program in a low and middle-income country (LMIC). Methods: This is a cross sectional study that evaluated community health worker driven hearing screening that took place in semi-rural Malindi, Kenya during an annual two-week otolaryngology surgical training mission in October 2017. At five separate locations (four schools) near Malindi, Kenya, children between the ages of 2–16 underwent hearing screening using screening audiometry (Android-based HearX Group). Children were screened by a community health worker who underwent a short training course, a senior otolaryngology resident, or both. Hearing screening results were compared to determine the reliability and concordance between independent, blinded community health worker and otolaryngology resident testing. Results: One hundred and four participants (53% males) underwent hearing screening. Hearing screening pass rate was 93%. Community health workers obtained a similar result to otolaryngology residents 96% of the time (McNemar test: p = 0.16, OR 0.96, 95% CI 0.9–1.0). Conclusion: Community health workers can obtain reliable results using a technology-based, pre-surgical hearing screening platform when compared to otolaryngology residents. This finding has profound implications in low-resourced settings where hearing healthcare specialists (audiologists and otolaryngologists) are limited and can ultimately improve the surgical yield of patients presenting to local otolaryngologists in these settings.
AB - Objective: To establish community health workers as reliable hearing screening operators in a technology-based pre-surgical hearing screening program in a low and middle-income country (LMIC). Methods: This is a cross sectional study that evaluated community health worker driven hearing screening that took place in semi-rural Malindi, Kenya during an annual two-week otolaryngology surgical training mission in October 2017. At five separate locations (four schools) near Malindi, Kenya, children between the ages of 2–16 underwent hearing screening using screening audiometry (Android-based HearX Group). Children were screened by a community health worker who underwent a short training course, a senior otolaryngology resident, or both. Hearing screening results were compared to determine the reliability and concordance between independent, blinded community health worker and otolaryngology resident testing. Results: One hundred and four participants (53% males) underwent hearing screening. Hearing screening pass rate was 93%. Community health workers obtained a similar result to otolaryngology residents 96% of the time (McNemar test: p = 0.16, OR 0.96, 95% CI 0.9–1.0). Conclusion: Community health workers can obtain reliable results using a technology-based, pre-surgical hearing screening platform when compared to otolaryngology residents. This finding has profound implications in low-resourced settings where hearing healthcare specialists (audiologists and otolaryngologists) are limited and can ultimately improve the surgical yield of patients presenting to local otolaryngologists in these settings.
KW - Audiometry
KW - Community health workers
KW - Global health
KW - Hearing loss
KW - Hearing tests
KW - Low- and middle-income countries
KW - Low-resourced settings
KW - Mobile health
KW - Physician-extenders
KW - Public health
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U2 - 10.1016/j.ijporl.2019.109670
DO - 10.1016/j.ijporl.2019.109670
M3 - Article
C2 - 31518844
AN - SCOPUS:85071873299
SN - 0165-5876
VL - 127
JO - International Journal of Pediatric Otorhinolaryngology
JF - International Journal of Pediatric Otorhinolaryngology
M1 - 109670
ER -