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 - 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
UR - http://www.scopus.com/inward/record.url?scp=85071873299&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85071873299&partnerID=8YFLogxK
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 -