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Kaspar A, Pifeleti S, Driscoll C, Kuoi MA. Ethical Considerations for Introducing School-Based Hearing and Vision Screening in the Pacific Islands: A Samoan Case Study. Ann Otol Rhinol Laryngol 2024; 133:910-914. [PMID: 39054809 DOI: 10.1177/00034894241266482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Affiliation(s)
- Annette Kaspar
- ENT Department, Tupua Tamasese Meaole Hospital, Ministry of Health, Apia, Samoa
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Sione Pifeleti
- ENT Department, Tupua Tamasese Meaole Hospital, Ministry of Health, Apia, Samoa
| | - Carlie Driscoll
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Maria Ah Kuoi
- ENT Department, Tupua Tamasese Meaole Hospital, Ministry of Health, Apia, Samoa
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Cao C, Song J, Su R, Wu X, Wang Z, Hou M. Structure-constrained deep feature fusion for chronic otitis media and cholesteatoma identification. MULTIMEDIA TOOLS AND APPLICATIONS 2023:1-21. [PMID: 37362730 PMCID: PMC10157598 DOI: 10.1007/s11042-023-15425-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/19/2023] [Accepted: 04/18/2023] [Indexed: 06/28/2023]
Abstract
Chronic suppurative otitis media (CSOM) and middle ear cholesteatoma (MEC) were two most common chronic middle ear disease(MED) clinically. Accurate differential diagnosis between these two diseases is of high clinical importance given the difference in etiologies, lesion manifestations and treatments. The high-resolution computed tomography (CT) scanning of the temporal bone presents a better view of auditory structures, which is currently regarded as the first-line diagnostic imaging modality in the case of MED. In this paper, we first used a region-of-interest (ROI) network to find the area of the middle ear in the entire temporal bone CT image and segment it to a size of 100*100 pixels. Then, we used a structure-constrained deep feature fusion algorithm to convert different characteristic features of the middle ear in three groups as suppurative otitis media (CSOM), middle ear cholesteatoma (MEC) and normal patches. To fuse structure information, we introduced a graph isomorphism network that implements a feature vector from neighbourhoods and the coordinate distance between vertices. Finally, we construct a classifier named the "otitis media, cholesteatoma and normal identification classifier" (OMCNIC). The experimental results achieved by the graph isomorphism network revealed a 96.36% accuracy in all CSOM and MEC classifications. The experimental results indicate that our structure-constrained deep feature fusion algorithm can quickly and effectively classify CSOM and MEC. It will help otologist in the selection of the most appropriate treatment, and the complications can also be reduced.
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Affiliation(s)
- Cong Cao
- School of Mathematics and Statistics, Central South University, Changsha, 410083 China
| | - Jian Song
- Department of Otorhinolaryngology of Xiangya Hospital, Central South University, Changsha, 410008 China
- Key Laboratory of Otolaryngology Major Disease Research of Hunan Province, Changsha, 410008 China
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, 410008 China
| | - Ri Su
- School of Mathematics and Statistics, Central South University, Changsha, 410083 China
| | - Xuewen Wu
- Department of Otorhinolaryngology of Xiangya Hospital, Central South University, Changsha, 410008 China
- Key Laboratory of Otolaryngology Major Disease Research of Hunan Province, Changsha, 410008 China
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, 410008 China
| | - Zheng Wang
- School of Computer Science, Hunan First Normal University, Changsha, 410205 China
| | - Muzhou Hou
- School of Mathematics and Statistics, Central South University, Changsha, 410083 China
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Nylund A, Toivonen L, Korpilahti P, Kaljonen A, Lyberg Åhlander V, Peltola V, Rautakoski P. Influence of Respiratory Tract Infections on Vocabulary Growth in Relation to Child's Sex: The STEPS Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15560. [PMID: 36497633 PMCID: PMC9737346 DOI: 10.3390/ijerph192315560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/16/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
Common health issues have been less examined in studies of early language development, particularly in relation to the child's sex. Respiratory tract infections, often complicated by acute otitis media, are common in children during the first years of life, when early vocabulary development takes place. The present study, conducted in Finland, aimed to investigate whether possible associations between recurrent respiratory tract infections, background factors, and vocabulary growth differ in boys and girls aged 13 to 24 months. The participants (N = 462, 248 boys and 214 girls) were followed for respiratory tract infections and acute otitis media from 0 to 23 months of age. The parents completed daily symptom diaries of respiratory symptoms, physician visits, and diagnoses. The expressive vocabulary was measured with parental reports. We found that recurrent respiratory tract infections were not associated with slower vocabulary development in boys or girls. In fact, boys with recurrent respiratory tract infections had more vocabulary growth during the second year than boys who were less sick. We found that vocabulary growth was associated differently with respiratory tract infections and background factors as a function of the child's sex. The vocabulary growth of boys seems to be more influenced by environmental factors than that of girls.
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Affiliation(s)
- Annette Nylund
- Department of Speech and Language Pathology, Abo Akademi University, 20500 Turku, Finland
| | - Laura Toivonen
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, 20521 Turku, Finland
| | - Pirjo Korpilahti
- Department of Psychology and Speech-Language Pathology, University of Turku, 20500 Turku, Finland
| | - Anne Kaljonen
- Statistics of the STEPS Study (Steps to the Healthy Development and Well-Being of Children), University of Turku, 20500 Turku, Finland
| | - Viveka Lyberg Åhlander
- Department of Speech and Language Pathology, Abo Akademi University, 20500 Turku, Finland
| | - Ville Peltola
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, 20521 Turku, Finland
| | - Pirkko Rautakoski
- Department of Speech and Language Pathology, Abo Akademi University, 20500 Turku, Finland
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Besen E, Paiva KM, Hillesheim D, Cigana LB, Haas P. Congenital syphilis associated with hearing screening failure in southern Brazilian newborns. Braz J Otorhinolaryngol 2022; 88 Suppl 3:S20-S24. [PMID: 34716107 PMCID: PMC9760995 DOI: 10.1016/j.bjorl.2021.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/24/2021] [Accepted: 07/19/2021] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE To estimate the association between congenital syphilis and neonatal hearing screening failure in the state of Santa Catarina between 2017 and 2019. METHODS This is a cross-sectional, retrospective, analytical study with secondary data of neonates from the state of Santa Catarina born between January 2017 and December 2019. We used logistic regression analysis to estimate the association between the main exposure (congenital syphilis) and the study outcome (failure in the Neonatal Hearing Screening). RESULTS The study included 21,434 newborns evaluated in a Brazilian hearing health care service. A total of 351 (1.6%) newborns failed the Neonatal Hearing Screening, and 364 (1.7%) had congenital syphilis. In the adjusted analysis, newborns with congenital syphilis were 3.25 times as likely to fail the Neonatal Hearing Screening as neonates without this disease (95% CI: 2.01; 5.26). As for maternal age, the sample had a higher prevalence (53.5%) of mothers aged 20-29 years. CONCLUSION There was an association between congenital syphilis and failure in Universal Neonatal Hearing Screening in the sample studied. There is a need for investments in public policies to value and strengthen the hearing screening program in the state to provide early diagnosis and intervention. LEVEL OF EVIDENCE: 5
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Affiliation(s)
- Eduarda Besen
- Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - Karina Mary Paiva
- Universidade Federal de Santa Catarina (UFSC), Departamento de Fonoaudiologia, Florianópolis, SC, Brazil
| | - Danúbia Hillesheim
- Universidade Federal de Santa Catarina (UFSC), Programa de Pós-Graduação em Saúde Coletiva, Florianópolis, SC, Brazil
| | - Luciana B Cigana
- Instituto Otovida - Clínica de Audição, Voz, Fala e Linguagem, Florianópolis, SC, Brazil
| | - Patrícia Haas
- Universidade Federal de Santa Catarina (UFSC), Curso de Fonoaudiologia, Florianópolis, SC, Brazil.
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Duan B, Pan LL, Chen WX, Qiao ZW, Xu ZM. An in-depth discussion of cholesteatoma, middle ear Inflammation, and langerhans cell histiocytosis of the temporal bone, based on diagnostic results. Front Pediatr 2022; 10:809523. [PMID: 36016875 PMCID: PMC9395987 DOI: 10.3389/fped.2022.809523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 07/14/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study aimed to conduct an in-depth investigation of the learning framework used for deriving diagnostic results of temporal bone diseases, including cholesteatoma and Langerhans cell histiocytosis (LCH). In addition, middle ear inflammation (MEI) was diagnosed by CT scanning of the temporal bone in pediatric patients. DESIGN A total of 119 patients were included in this retrospective study; among them, 40 patients had MEI, 38 patients had histology-proven cholesteatoma, and 41 patients had histology-proven LCH of the temporal bone. Each of the 119 patients was matched with one-third of the disease labels. The study included otologists and radiologists, and the reference criteria were histopathology results (70% of cases for training and 30% of cases for validation). A multilayer perceptron artificial neural network (VGG16_BN) was employed and classified, based on radiometrics. This framework structure was compared and analyzed by clinical experts according to CT images and performance. RESULTS The deep learning framework results vs. a physician's diagnosis, respectively, in multiclassification tasks, were as follows. Receiver operating characteristic (ROC) (cholesteatoma): (0.98 vs. 0.91), LCH (0.99 vs. 0.98), and MEI (0.99 vs. 0.85). Accuracy (cholesteatoma): (0.99 vs. 0.89), LCH (0.99 vs. 0.97), and MEI (0.99 vs. 0.89). Sensitivity (cholesteatoma): (0.96 vs. 0.97), LCH (0.99 vs. 0.98), and MEI (1 vs. 0.69). Specificity (cholesteatoma): (1 vs. 0.89), LCH (0.99 vs. 0.97), and MEI (0.99 vs. 0.89). CONCLUSION This article presents a research and learning framework for the diagnosis of cholesteatoma, MEI, and temporal bone LCH in children, based on CT scans. The research framework performed better than the clinical experts.
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Affiliation(s)
- Bo Duan
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China
| | - Li-Li Pan
- Department of Radiology, Children's Hospital of Fudan University, Shanghai, China
| | - Wen-Xia Chen
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China
| | - Zhong-Wei Qiao
- Department of Radiology, Children's Hospital of Fudan University, Shanghai, China
| | - Zheng-Min Xu
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China
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Kaspar A, Pifeleti S, Driscoll C, Potoi B, Amosa-Lei Sam F. Knowledge and Attitudes of Pacific Islander Doctors and Medical Students to Childhood Hearing Loss and Hearing Services: Results of a Structured Questionnaire Survey in SAMOA. Glob Pediatr Health 2022; 9:2333794X221126079. [PMID: 36156889 PMCID: PMC9500248 DOI: 10.1177/2333794x221126079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/26/2022] [Indexed: 11/15/2022] Open
Abstract
The Pacific Islands have among the highest global rates of childhood hearing loss in the world. Given the scarcity of ENT Specialists and audiologists in the region, the role of the wider health professional community in addressing preventable childhood hearing loss is crucial. A 10-item 5-point Likert scale questionnaire was administered to medical officers and medical students in Samoa. The statements aimed to investigate knowledge and attitudes to childhood hearing loss and hearing services. Overall, 95.8% of participants selected “Disagree/Strongly Disagree” in response to the statement “Hearing loss is not that important because it does not kill.” There was good knowledge regarding early detection and intervention services for infant hearing assessments (73.6%) and amplification suitability for babies (69.4%-72.2%). Highest knowledge of causes of childhood sensorineural hearing loss was measured for neonatal meningitis/seizures (55.6%), followed by intra-uterine infections (52.8%), and aminoglycosides (52.8%). Knowledge was lowest for jaundice (33.3%) and birth asphyxia (38.9%).
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Affiliation(s)
- Annette Kaspar
- Tupua Tamasese Meaole Hospital, Ministry of Health, Apia, Samoa
- University of Queensland, Brisbane, QLD, Australia
| | - Sione Pifeleti
- Tupua Tamasese Meaole Hospital, Ministry of Health, Apia, Samoa
- National University of Samoa, Apia, Samoa
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Kaspar A, Pifeleti S, Lifeng A, Driscoll C. A preliminary report of the pattern of ear disease among students attending a school for people with disabilities in Samoa. SAGE Open Med 2021; 9:20503121211060182. [PMID: 34881042 PMCID: PMC8646189 DOI: 10.1177/20503121211060182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives The Ear, Nose, and Throat Department of Samoa is developing a school outreach service, and the aim of this study is to determine the pattern of ear disease among students attending a school for people with disabilities in Samoa. Methods The study design is a prospective study of a 2-day outreach visit to a school for people with disabilities by the Samoan Ear, Nose, and Throat team who recorded their clinical findings (N = 28). Two Ear, Nose, and Throat Specialists performed ear examinations for each student and recorded their diagnosis and recommendations as per routine Ear, Nose, and Throat Clinic protocols on a purposefully designed form based on the World Health Organization Ear and Hearing Survey. This information was entered into an Excel spreadsheet for descriptive statistical analysis. Results Results showed that 39% (n = 11) of students passed their initial ear examination, while 61% (n = 17) of students presented with at least one ear condition requiring Ear, Nose, and Throat intervention. The most common pathology was impacted wax (n = 15 ears). Following the Ear, Nose, and Throat Clinic outreach visit, 21 students (75%) no longer required Ear, Nose, and Throat or medical services, five students (18%) required a medical prescription for the treatment of ear disease, and two students (7%) were referred to the Ear, Nose, and Throat Department for further review. Conclusion Students attending schools for people with disabilities are a priority population for the Ear, Nose, and Throat Clinical service outreach programme.
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Affiliation(s)
- Annette Kaspar
- ENT Department, Tupua Tamasese Meaole Hospital, Ministry of Health, Apia, Samoa.,Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Sione Pifeleti
- ENT Department, Tupua Tamasese Meaole Hospital, Ministry of Health, Apia, Samoa
| | - An Lifeng
- ENT Department, Tupua Tamasese Meaole Hospital, Ministry of Health, Apia, Samoa.,ENT Department, China-Japan Union Hospital, Jilin University, Changchun, China
| | - Carlie Driscoll
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
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Kaspar A, Driscoll C, Pifeleti S. Development of a Risk-Factor Questionnaire for the Infant Ear and Hearing Program in Samoa. Matern Child Health J 2021; 25:1501-1507. [PMID: 34390427 DOI: 10.1007/s10995-021-03208-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Congenital hearing loss is the most common sensory disorder present at birth. While universal newborn hearing screening is the standard for most high-income countries, alternative models are under consideration for most low and middle-income countries. The Pacific Islands have among the highest rates of paediatric ear disease and deafness in the world, and an interim Infant Ear and Hearing Program is currently being developed for the Polynesian nation of Samoa. The inclusion of a routine risk-factor questionnaire for childhood deafness in the Infant Ear and Hearing Program package is a feasible alternative for well-baby clinics in Samoa. DESCRIPTION The World Health Organisation advocates that all member states should implement newborn and infant hearing screening. This includes a risk-factor questionnaire developed from the joint committee on infant hearing risk-factors, as well as additional risk-factors unique to low and middle income countries. The present paper examines all known risk-factors for childhood deafness to develop an appropriate and evidence-based questionnaire for inclusion in the Samoan Child Health Book and Infant Ear and Hearing Program package. ASSESSMENT From a starting point of 19 risk-factors, 11 risk-factors were included with no changes; 5 risk-factors were modified to align with current health service availability in Samoa; 2 risk-factors were excluded due to cultural inappropriateness and irrelevance for Samoa; and 1 risk-factor was added for our Samoan and Pacific Island context. CONCLUSION There are 17 items on the final risk-factor questionnaire for childhood deafness developed for Samoa. The Infant Ear and Hearing Program package will also include ear examinations and monitoring of hearing developmental milestones. The risk-factor questionnaire will be reviewed again in 5 years' time for the next edition of the Samoan Child Health Book.
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Affiliation(s)
- Annette Kaspar
- ENT Department, Tupua Tamasese Meaole Hospital, Ministry of Health, Apia, Samoa.
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.
- Public Health, Development and Research Audiologist for the Pacific Islands, ENT Department, Tupua Tamasese Meaole Hospital, Ministry of Health, Apia, Samoa.
| | - Carlie Driscoll
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Sione Pifeleti
- ENT Department, Tupua Tamasese Meaole Hospital, Ministry of Health, Apia, Samoa
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Deep Learning in Automated Region Proposal and Diagnosis of Chronic Otitis Media Based on Computed Tomography. Ear Hear 2021; 41:669-677. [PMID: 31567561 DOI: 10.1097/aud.0000000000000794] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The purpose of this study was to develop a deep-learning framework for the diagnosis of chronic otitis media (COM) based on temporal bone computed tomography (CT) scans. DESIGN A total of 562 COM patients with 672 temporal bone CT scans of both ears were included. The final dataset consisted of 1147 ears, and each of them was assigned with a ground truth label from one of the 3 conditions: normal, chronic suppurative otitis media, and cholesteatoma. A random selection of 85% dataset (n = 975) was used for training and validation. The framework contained two deep-learning networks with distinct functions: a region proposal network for extracting regions of interest from 2-dimensional CT slices; and a classification network for diagnosis of COM based on the extracted regions. The performance of this framework was evaluated on the remaining 15% dataset (n = 172) and compared with that of 6 clinical experts who read the same CT images only. The panel included 2 otologists, 3 otolaryngologists, and 1 radiologist. RESULTS The area under the receiver operating characteristic curve of the artificial intelligence model in classifying COM versus normal was 0.92, with sensitivity (83.3%) and specificity (91.4%) exceeding the averages of clinical experts (81.1% and 88.8%, respectively). In a 3-class classification task, this network had higher overall accuracy (76.7% versus 73.8%), higher recall rates in identifying chronic suppurative otitis media (75% versus 70%) and cholesteatoma (76% versus 53%) cases, and superior consistency in duplicated cases (100% versus 81%) compared with clinical experts. CONCLUSIONS This article presented a deep-learning framework that automatically extracted the region of interest from two-dimensional temporal bone CT slices and made diagnosis of COM. The performance of this model was comparable and, in some cases, superior to that of clinical experts. These results implied a promising prospect for clinical application of artificial intelligence in the diagnosis of COM based on CT images.
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Kaspar A, Driscoll C, Pifeleti S, Faumuina PA. Ethical considerations for universal newborn hearing screening in the Pacific Islands: a Samoan case study. JOURNAL OF MEDICAL ETHICS 2020; 47:medethics-2020-106718. [PMID: 33234548 DOI: 10.1136/medethics-2020-106718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 10/20/2020] [Accepted: 10/25/2020] [Indexed: 06/11/2023]
Abstract
Permanent congenital and early-onset hearing impairment (PCEOHI) is the most common sensory disorder among newborns. The WHO recommends newborn and infant hearing screening for all member states to facilitate early identification and intervention for children with PCEOHI. Ethical implications of newborn/infant hearing screening in low-income and middle-income countries should be considered. Although the Pacific Island region is estimated to have among the highest global burden of hearing loss, hearing health services are limited and virtually non-existent in Pacific Island countries. The aim of this brief report is to consider the ethical implications of implementing hospital-based universal newborn hearing screening (UNHS) in Samoa. Based on well-acknowledged screening principles, this report found that the Samoan context does not satisfy the screening principles for such a programme, and that the implementation of UNHS would, therefore, be unethical. This conclusion was reached even after considering the hypothetical provision of necessary screening and diagnostic audiology equipment from external donors. We recommend that current efforts should be directed towards the wider professional community involved in the daily care of children with a permanent hearing loss. Given the high prevalence of paediatric ear disease in the Pacific Islander population, an interim ear and hearing programme could be considered at the community level. These strategies should provide the infrastructure and referral pathways required in the advent of UNHS in Samoa.
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Affiliation(s)
- Annette Kaspar
- ENT Department, Tupua Tamasese Meaole Hospital, Apia, Tuamasaga, Samoa
- Audiology Division, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Carlie Driscoll
- Audiology Division, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Sione Pifeleti
- ENT Department, Tupua Tamasese Meaole Hospital, Apia, Tuamasaga, Samoa
| | - Penaia A Faumuina
- ENT Department, Tupua Tamasese Meaole Hospital, Apia, Tuamasaga, Samoa
- ORL Consultant, Wanganui Hospital, Wanganui, New Zealand
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Leach AJ, Homøe P, Chidziva C, Gunasekera H, Kong K, Bhutta MF, Jensen R, Tamir SO, Das SK, Morris P. Panel 6: Otitis media and associated hearing loss among disadvantaged populations and low to middle-income countries. Int J Pediatr Otorhinolaryngol 2020; 130 Suppl 1:109857. [PMID: 32057518 PMCID: PMC7259423 DOI: 10.1016/j.ijporl.2019.109857] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE: Summarise the published evidence on otitis media and associated hearing loss in low to middle-income countries (LMIC) and disadvantaged populations. DATA SOURCES: PubMed and other databases. REVIEW METHODS: Firstly, sensitive search strategy using ‘otitis media’, combined with specific key words for each topic of the review, from January 2015 to June 2019. Then, restriction to LMIC and disadvantaged populations. Topics covered included prevention, epidemiology, risk factors, microbiology, prognosis, diagnosis, and treatment. CONCLUSIONS: There was a high degree of methodological heterogeneity and high risk of bias. The majority of studies were school-based. In Africa, Asia and Oceania (e.g., Australian Aboriginal populations) the prevalence of OM was respectively 8% (range 3–16%), 14% (range 7–22%) and 50% (4–95%). Prevalence of any hearing loss in these regions was 12% (range 8–17%), 12% (range 3–24%), and 26% (range 25–28%) respectively. Risk factors in LMIC and disadvantaged populations included age, gender, exposure to smoke and pollution. Microbiology was reported for otitis media with effusion at time of surgery or ear discharge (acute otitis media with perforation or chronic suppurative otitis media). Specimen handling and processing in hospital laboratories was associated with low detection of S. pneumoniae and H. influenzae. Case series described complicated cases of OM due to M. tuberculosis, multidrug resistance and HIV. QOL studies identified discrimination of persons with OM and hearing loss. Diagnostic methods varied greatly, from naked eye to tympanometry. Treatment interventions were reported from four RCTs. Non-RCTs included evaluations of guidelines, surgery outcomes, access to ENTs. IMPLICATIONS FOR CLINICAL PRACTICE: Chronic suppurative otitis media, otitis media with effusion and conductive hearing loss are common in LMIC and disadvantaged populations. Paucity of research, poor regional representation, non-standardised methods and low-quality reporting preclude accurate assessment of disease burden in LMIC and disadvantaged populations. Awareness and adherence to reporting Guidelines should be promoted.
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Affiliation(s)
- Amanda Jane Leach
- Menzies School of Health Research, John Mathews Building 58, Royal Darwin Hospital Campus, Rocklands Dr, Tiwi, NT, 0810, Australia.
| | - Preben Homøe
- Køge University Hospital, Copenhagen, Lykkebækvej 1, 4600, Køge, Denmark.
| | - Clemence Chidziva
- University of Zimbabwe, Department of Surgery, 630 Churchill Avenue, Harare, Zimbabwe.
| | - Hasantha Gunasekera
- University of Sydney, Australia; The Children's Hospital at Westmead, Cnr Hawkesbury Rd &, Hainsworth St, Westmead, NSW, 2145, Australia.
| | - Kelvin Kong
- John Hunter Children's Hospital, Newcastle, Australia; Hunter ENT, Kookaburra Cct, New Lambton Heights, NSW, 2305, Australia.
| | - Mahmood F Bhutta
- Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, UK.
| | - Ramon Jensen
- Dept of Oto-rhino-laryngology and Audiology, F 2071 Rigshospitalet, Blegdamsvej 9, DK, 2100, Denmark; Department of Clinical Medicine, Blegdamsvej 3, 2200, København, Denmark.
| | - Sharon Ovnat Tamir
- Dept of OTO-HNS, Samson Assuta Ashdod University Hospital, Ashdod, Israel; Department of Otolaryngology-Head and Neck Surgery, Assuta University Hospital, Israel; Faculty of Health Sciences, Ben Gurion University of the Negev, Ashdod, Israel.
| | - Sumon Kumar Das
- Menzies School of Health Research, John Mathews Building 58, Royal Darwin Hospital Campus, Rocklands Dr, Tiwi, NT, 0810, Australia.
| | - Peter Morris
- Menzies School of Health Research, John Mathews Building 58, Royal Darwin Hospital Campus, Rocklands Dr, Tiwi, NT, 0810, Australia; Royal Darwin Hospital, Rocklands Dr, Tiwi, NT, 0810, Australia.
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The association between allergic rhinitis and otitis media: A national representative sample of in South Korean children. Sci Rep 2019; 9:1610. [PMID: 30733549 PMCID: PMC6367416 DOI: 10.1038/s41598-018-38369-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 11/23/2018] [Indexed: 11/08/2022] Open
Abstract
Although many studies have reported that allergic rhinitis is an independent risk factor highly related to otitis media in children, there is still lack of epidemiological studies on demographics. The objective of this study was to identify if allergic rhinitis was an independent risk factor for otitis media in children aged between 7 and 12 years by using the nationwide survey data representing the local population of South Korea. This is a secondary study based on the ENT examination data (eg. acute otitis media, otitis media with effusion, chronic otitis media). The subjects of this study were 472 children (248 male and 224 female) who completed the Korea National Health and Nutrition Examination Survey 2015. The presence of otitis media was examined by otolaryngologists using tympanometric measurements, audiometric measurements, and otoscopic examination. Allergic rhinitis was diagnosed by Korean-version of International Study of Asthma and Allergies in Childhood, a total serum immunoglobulin E test, an allergen-specific immunoglobulin E test, a blood eosinophil test, an eosinophil cationic protein test, a nasal cytology for eosinophils test, a skin reaction test, and an antigen simultaneous test. Confounding factors included age, gender, the levels of income for households, and household composition. The relationship between allergic rhinitis and otitis media was analyzed by a complex sample logistic regression analysis and the odds ratio and 95% confidence interval were presented. The results of a complex sample design logistic regression revealed that allergic rhinitis in children was significantly associated with otitis media (p < 0.05). Even after adjusting all confounding factors, children with allergic rhinitis had twice significantly higher risk of otitis (OR = 2.04; 95% CI: 1.30-3.18) than children without allergic rhinitis. This epidemiologic study confirmed the independent relationship between pediatric allergic rhinitis and otitis media. In the future, longitudinal study will be needed to verify causality of allergic rhinitis and otitis media.
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