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Jiang CY, Han K, Yang F, Yin SY, Zhang L, Liang BY, Wang TB, Jiang T, Chen YR, Shi TY, Liu YC, Chen SW, Tong BS, Liu YH, Pan HF, Han YX. Global, regional, and national prevalence of hearing loss from 1990 to 2019: A trend and health inequality analyses based on the Global Burden of Disease Study 2019. Ageing Res Rev 2023; 92:102124. [PMID: 37972859 DOI: 10.1016/j.arr.2023.102124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023]
Abstract
As a severe public health issue, hearing loss has caused an increasingly disease burden, especially in the elderly population. Hearing loss may inevitably induce asymmetric hearing, which makes it difficult for elderly individuals to locate sound sources, therefore resulting in increased postural instability and falling risk. To emphasize the public health emergence of hearing loss, we investigated the temporal trend of prevalence of hearing loss over the last 30 years and further predicted its changes in the next 20 years, decomposed the trend according to demographic factors and epidemiological changes, and quantified the cross-country healthy inequalities, using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. In 2019, there were more than 140 million cases of hearing loss worldwide, a 93.89% increase from 70 million cases in 1990. The age-standardized rate (ASR) also increased with an estimated annual percentage change of 0.08% per year. Population growth and aging are the major drivers contributing to the changes, accounting for 60.83% and 35.35%. Of note, the contribution of aging varies showing a gradual increasing trend with sociodemographic index (SDI) elevating. Also notable, there were significant health inequalities across 204 countries and territories, with slope index of inequality rising over time. Projection of the global burden of hearing loss from 2020 to 2040 indicated progressive increases in both case number and ASR. These reflect the heavy disease burden of hearing loss that needed more targeted and efficient strategies in its prevention and management.
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Affiliation(s)
- Chuan-Ya Jiang
- Department of Otolaryngology, Head and Neck Surgery, Wuhu Hospital, East China Normal University, Wuhu, 241001, China; Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Ke Han
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Fan Yang
- Department of Ophthalmology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China
| | - Si-Yue Yin
- Department of Oncology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China
| | - Lei Zhang
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Bing-Yu Liang
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Tai-Bao Wang
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Tao Jiang
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yue-Rong Chen
- Department of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Tai-Yu Shi
- Department of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Yu-Chen Liu
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Shan-Wen Chen
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Bu-Sheng Tong
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Ye-Hai Liu
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
| | - Yan-Xun Han
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
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Saunders JE, Bessen S, Magro I, Cowan D, Gonzalez Quiroz M, Mojica-Alvarez K, Penalba D, Reike C, Neimczak C, Fellows A, Buckey J. School Hearing Screening With a Portable, Tablet-Based, Noise-Attenuating Audiometric Headset in Rural Nicaragua. Otol Neurotol 2022; 43:1196-1204. [PMID: 36351228 DOI: 10.1097/mao.0000000000003692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To investigate the utility and effectiveness of a noise-attenuating, tablet-based mobile health system combined with asynchronous telehealth evaluations for screening rural Nicaraguan schoolchildren for hearing loss. STUDY DESIGN Prospective population-based survey. SETTING Rural Nicaraguan communities. PATIENTS There were 3,398 school children 7 to 9 years of age. INTERVENTIONS Diagnostic automated and manual audiometry, detailed asynchronous telehealth evaluations. MAIN OUTCOME MEASURES Referral rates, ambient noise levels, and audiometric results as well as hearing loss prevalence, types, and risk factors. RESULTS Despite high ambient noise levels during screening (46.7 dBA), no effect of noise on referral rates on automated audiometry or confirmatory manual audiometry in those who failed automated testing was seen. The overall audiometric referral rate was 2.6%. Idiopathic sensorineural hearing loss (SNHL) and cerumen impaction were the most common types of hearing loss in this population with an estimated prevalence of hearing loss (all types) of 18.3 per 1,000 children. SNHL was associated with both drug exposure during pregnancy (p = 0.04) and pesticide exposure in the home (p = 0.03). CONCLUSION Hearing screening using a tablet-based, noise-attenuating wireless headset audiometer is feasible and effective in rural low-resource environments with moderately elevated ambient noise levels. The referral rate with noise-attenuating headsets was much lower than that previous reports on this population. In addition, manual audiometry resulted in much lower referral rates than automated audiometry. The confirmed hearing loss rate in this study is comparable to reports from other low-income countries that use some form of noise attenuation during screening. Pesticide exposure and drug exposure during pregnancy are potential causes of SNHL in this population.
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Affiliation(s)
- James E Saunders
- Department of Surgery, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine at Dartmouth
| | - Sarah Bessen
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Isabelle Magro
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Devin Cowan
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | | | | | - Donoso Penalba
- Research Centre on Health, Work and Environment (CISTA) at National Autonomous University of Nicaragua, Leon (UNAN-Leon), Leon, Nicaragua
| | - Catherine Reike
- Space Medicine Innovations Laboratory, Geisel School of Medicine at Dartmouth
| | - Chris Neimczak
- Department of Medicine Dartmouth-Hitchcock Medical Center, Space Medicine Innovations Laboratory, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Abigail Fellows
- Space Medicine Innovations Laboratory, Geisel School of Medicine at Dartmouth
| | - Jay Buckey
- Department of Medicine Dartmouth-Hitchcock Medical Center, Space Medicine Innovations Laboratory, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
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Saunders JE, Bessen S, Magro I, Cowan D, Quiroz MG, Mojica-Alvarez K, Penalba D, Reike C, Niemczak CE, Fellows A, Buckey JC. Community health workers and mHealth systems for hearing screening in rural Nicaraguan schoolchildren. J Glob Health 2022; 12:04060. [PMID: 35938885 PMCID: PMC9359107 DOI: 10.7189/jogh.12.04060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background We aimed to investigate the effectiveness of using minimally trained community health workers (CHW) to screen schoolchildren in rural Nicaragua for hearing loss using a tablet-based audiometric system integrated with asynchronous telehealth evaluations and mobile health (mHealth) appointment reminders. Methods A population-based survey was conducted using community health workers (CHWs) to perform tablet-based audiometry, asynchronous telehealth evaluations, and mHealth reminders to screen 3398 school children (7-9 years of age) in 92 rural Nicaraguan communities. The accuracy of screening, test duration, testing efficiency, telehealth data validity, and compliance with recommended clinic visits were analyzed. Results Minimally trained CHWs successfully screened children within remote rural schools with automated audiometry (test duration = 5.8 minutes) followed by manual audiometry if needed (test duration = 4.3 minutes) with an estimated manual audiometry validity of 98.5% based on a review of convergence patterns. For children who were referred based on audiometry, the otoscopy and tympanometry obtained during telehealth evaluations were high quality (as reviewed by 3 experts) in 44.6% and 80.1% of ears, respectively. A combination of automated short message service (SMS) text messages and voice reminders resulted in a follow-up compliance of 75.2%. No families responded to SMS messages alone. Conclusions Tablet-based hearing screening administered by minimally trained CHWs is feasible and effective in low- and middle-income countries. Manual audiometry was as efficient as automated audiometry in this setting. The physical exam tasks of otoscopy and tympanometry require additional training. Mobile phone messages improve compliance for confirmatory audiometry, but the utility of SMS messaging alone is unclear in this population.
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Affiliation(s)
- James E Saunders
- Department of Surgery Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Sarah Bessen
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Isabelle Magro
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Devin Cowan
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Marvin Gonzalez Quiroz
- Research Centre on Health, Work and Environment (CISTA) at National Autonomous University of Nicaragua, Leon (UNAN-Leon), Leon, Nicaragua
- Centre for Nephrology, University College London, London, UK
| | | | - Donoso Penalba
- Department of Public Health at National Autonomous University of Nicaragua, Leon (UNAN-Leon), Leon, Nicaragua
| | - Catherine Reike
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
- Space Medicine Innovations Laboratory, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Christopher E Niemczak
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
- Space Medicine Innovations Laboratory, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
- Department of Medicine Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Abigail Fellows
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
- Space Medicine Innovations Laboratory, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Jay C Buckey
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
- Space Medicine Innovations Laboratory, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
- Department of Medicine Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
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Bhamjee A, le Roux T, Schlemmer K, Graham MA, Mahomed-Asmail F. Audiologists’ Perceptions of Hearing Healthcare Resources and Services in South Africa’s Public Healthcare System. Health Serv Insights 2022; 15:11786329221135424. [PMID: 36386271 PMCID: PMC9661562 DOI: 10.1177/11786329221135424] [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: 05/25/2022] [Accepted: 10/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Hearing loss poses a significant burden globally. Its prevalence is exceptionally high in countries across the African region, where healthcare resources and services remain inaccessible. This study aimed to describe audiologists’ perceptions regarding hearing healthcare resources and services within South Africa’s public healthcare system. Methods: A national self-developed telephonic survey was conducted with audiologists in public healthcare system hospitals across South Africa, with the final sample comprising 100 audiologists. Results: Most (82%) audiologists indicated that their hospitals did not have adequate hearing healthcare resources to render efficient audiology services to patients. Binaural amplification devices (invasive and non-invasive) for adults with bilateral hearing loss who adhered to the criteria for these devices were perceived to be unavailable in most hospitals. Audiologists also perceived that universal newborn hearing screening services, adult aural rehabilitation services, and follow-up care for all hearing devices post-warranty expiration were limited. Conclusion: Efforts should be made to upsurge hearing healthcare resources, including increasing the financial budgets allocated to audiology resources so that increased diagnostic and screening audiology equipment and hearing devices can be procured where required, and additional audiologists can be employed within the South African public sector hospitals where needed.
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Affiliation(s)
- Aaqilah Bhamjee
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Talita le Roux
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Kurt Schlemmer
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Department of ENT Head and Neck Surgery, University of Kwazulu Natal, Durban, South Africa
| | - Marien Alet Graham
- Department of Science, Mathematics and Technology Education, University of Pretoria, Pretoria, South Africa
| | - Faheema Mahomed-Asmail
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
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5
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Digital Technology for Remote Hearing Assessment—Current Status and Future Directions for Consumers. SUSTAINABILITY 2021. [DOI: 10.3390/su131810124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Globally, more than 1.5 billion people have hearing loss. Unfortunately, most people with hearing loss reside in low- and middle-income countries (LMICs) where traditional face-to-face services rendered by trained health professionals are few and unequally dispersed. The COVID-19 pandemic has further hampered the effectiveness of traditional service delivery models to provide hearing care. Digital health technologies are strong enablers of hearing care and can support health delivery models that are more sustainable. The convergence of advancing technology and mobile connectivity is enabling new ways of providing decentralized hearing services. Recently, an abundance of digital applications that offer hearing tests directly to the public has become available. A growing body of evidence has shown the ability of several approaches to provide accurate, accessible, and remote hearing assessment to consumers. Further effort is needed to promote greater accuracy across a variety of test platforms, improve sensitivity to ear disease, and scale up hearing rehabilitation, especially in LMICs.
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6
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Dillard LK, Martinez RX, Perez LL, Fullerton AM, Chadha S, McMahon CM. Prevalence of aminoglycoside-induced hearing loss in drug-resistant tuberculosis patients: A systematic review. J Infect 2021; 83:27-36. [PMID: 34015383 DOI: 10.1016/j.jinf.2021.05.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/05/2021] [Accepted: 05/10/2021] [Indexed: 11/26/2022]
Abstract
Objectives estimate the prevalence of ototoxic hearing loss in drug-resistant tuberculosis (DR-TB) patients treated with aminoglycoside antibiotics via a systematic review and meta-analysis. Estimate the annual preventable cases of hearing loss in DR-TB patients and leverage findings to discuss primary, secondary and tertiary prevention. Methods studies published between 2005 and 2018 that reported prevalence of post-treatment hearing loss in DR-TB patients were included. We performed a random effects meta-analysis to determine pooled prevalence of ototoxic hearing loss overall and by medication type. Preventable hearing loss cases were estimated using World Health Organization (WHO) data on DR-TB treatment and prevalence determined by the meta-analysis. Results eighteen studies from 10 countries were included. Pooled prevalence of ototoxic hearing loss and the corresponding 95% confidence interval (CI) was 40.62% CI [32.77- 66.61%] for all drugs (kanamycin: 49.65% CI [32.77- 66.61%], amikacin: 38.93% CI [26.44-53.07%], capreomycin: 10.21% CI [4.33-22.21%]). Non-use of aminoglycosides may result in prevention of approximately 50,000 hearing loss cases annually. Conclusions aminoglycoside use results in high prevalence of ototoxic hearing loss. Widespread prevention of hearing loss can be achieved by following updated WHO guidelines for DR-TB treatment. When hearing loss cannot be avoided, secondary and tertiary prevention should be prioritized.
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Affiliation(s)
- Lauren K Dillard
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI 53726, United States.
| | - Ricardo X Martinez
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Lucero Lopez Perez
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Amanda M Fullerton
- Department of Linguistics, Macquarie University, Sydney, New South Wales, Australia
| | - Shelly Chadha
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Catherine M McMahon
- Department of Linguistics, Macquarie University, Sydney, New South Wales, Australia
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Lechien JR, Allen JE, Barillari MR, Karkos PD, Jia H, Ceccon FP, Imamura R, Metwaly O, Chiesa-Estomba CM, Bock JM, Carroll TL, Saussez S, Akst LM. Management of Laryngopharyngeal Reflux Around the World: An International Study. Laryngoscope 2020; 131:E1589-E1597. [PMID: 33200831 DOI: 10.1002/lary.29270] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/02/2020] [Accepted: 11/05/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To investigate worldwide practices of otolaryngologists in the management of laryngopharyngeal reflux (LPR). METHODS An online survey was sent on the management of LPR to members of many otolaryngological societies. The following aspects were evaluated: LPR definition, prevalence, clinical presentation, diagnosis, and treatment. RESULTS A total of 824 otolaryngologists participated, spread over 65 countries. The symptoms most usually attributed to LPR are cough after lying down/meal, throat clearing and globus sensation while LPR-related findings are arytenoid erythema and posterior commissure hypertrophy. Irrespective to geography, otolaryngologists indicate lack of familiarity with impedance pH monitoring, which they attribute to lack of knowledge in result interpretation. The most common therapeutic regimens significantly vary between world regions, with a higher use of H2 blocker in North America and a lower use of alginate in South America. The duration of treatment also significantly varies between different regions, with West Asia/Africa and East Asia/Oceania otolaryngologists prescribing medication for a shorter period than the others. Only 21.1% of respondents are aware about the existence of nonacid LPR. Overall, only 43.2% of otolaryngologists believe themselves sufficiently knowledgeable about LPR. CONCLUSIONS LPR knowledge and management significantly vary across the world. International guidelines on LPR definition, diagnosis, and treatment are needed to improve knowledge and management around the world. LEVEL OF EVIDENCE N.A. Laryngoscope, 131:E1589-E1597, 2021.
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Affiliation(s)
- Jerome R Lechien
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Anatomy and Experimental Oncology, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Faculty of Medicine, University Libre de Bruxelles, Brussels, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France
| | | | - Maria R Barillari
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of Naples SUN, Naples, Italy
| | - Petros D Karkos
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology and Head and Neck Surgery, Thessaloniki Medical School, Thessaloniki, Greece
| | - Huan Jia
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Fabio P Ceccon
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Otolaryngology-Head and Neck Surgery, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Rui Imamura
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology, Clinical Hospital, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Osama Metwaly
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Otolaryngology-Head & Neck Surgery, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
| | - Carlos M Chiesa-Estomba
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology-Head & Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain
| | - Jonathan M Bock
- Division of Laryngology and the Professional Voice Department of Otolaryngology, Communication Science Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Thomas L Carroll
- Division of Otolaryngology, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Sven Saussez
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Anatomy and Experimental Oncology, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Faculty of Medicine, University Libre de Bruxelles, Brussels, Belgium
| | - Lee M Akst
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A
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Availability of ENT Surgical Procedures and Medication in Low-Income Nation Hospitals: Cause for Concern in Zambia. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1980123. [PMID: 32280679 PMCID: PMC7128045 DOI: 10.1155/2020/1980123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 02/26/2020] [Indexed: 11/17/2022]
Abstract
Background Ear, nose, and throat (ENT) diseases are an oft overlooked global health concern. Despite their high prevalence and associated morbidity and mortality, ENT diseases have remained neglected in health care delivery. In Zambia and many other low-income countries, ENT services are characterized by poor funding, unavailable surgical procedures, and erratic supply of essential drugs. Objective To investigate ENT service provision in Zambia with regard to availability of surgical procedures and supply of essential drugs. Methods A descriptive cross-sectional survey was conducted using a piloted structured questionnaire between 17 January 2017 and 2 January 2018. Included in the study were the 109 hospitals registered with the Ministry of Health (MoH) across the 10 provinces of Zambia. Results Of the participating hospitals, only 5.9% (n = 1) and 40% (n = 1) and 40% (n = 1) and 40% (n = 1) and 40% (n = 1) and 40% (n = 1) and 40% (n = 1) and 40% (n = 1) and 40% (n = 1) and 40% (n = 1) and 40% (n = 1) and 40% (n = 1) and 40% ( Conclusion ENT service delivery in Zambia is limited with regard to performed surgical procedures and availability of essential drugs, necessitating urgent intervention. The findings from this study may be used to direct national policy on the improvement of provision of ENT services in Zambia.
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Seedat RY. Juvenile-Onset Recurrent Respiratory Papillomatosis Diagnosis and Management - A Developing Country Review. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2020; 11:39-46. [PMID: 32099513 PMCID: PMC7007786 DOI: 10.2147/phmt.s200186] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 01/14/2020] [Indexed: 01/04/2023]
Abstract
Recurrent respiratory papillomatosis (RRP) is a condition caused by human papillomavirus (HPV), usually HPV types 6 and 11, which is characterized by recurrent papillomas of the respiratory tract, mainly the larynx. Patients usually present between the ages of 2 and 6 years. The initial presenting symptom is progressive dysphonia, followed by stridor and respiratory distress. Treatment consists of repeated microlaryngoscopic procedures to remove the papillomas as there is no cure. The poor availability and accessibility of appropriate healthcare services in developing countries are barriers to the early diagnosis and appropriate management of patients with juvenile-onset recurrent respiratory papillomatosis (JoRRP), requiring many patients to have a tracheostomy. The introduction of prophylactic vaccines that include HPV6 and HPV11 is necessary in order to reduce the incidence of JoRRP.
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Affiliation(s)
- R Y Seedat
- Department of Otorhinolaryngology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
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10
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Interplay Between Socioeconomic Status and Otitis Media Disease Burden in Resource-rich and Resource-poor Nations. Otol Neurotol 2019; 39:e817-e824. [PMID: 30080766 DOI: 10.1097/mao.0000000000001943] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES/HYPOTHESIS To characterize global differences in otitis media (OM)-related disease burden between socioeconomically advantaged and disadvantaged nations. METHODS Using the Global Health Data Exchange, worldwide OM burden was evaluated using age-standardized disability-adjusted life years (DALYs) per 100,000 individuals in 183 countries from 1990 to 2015. Countries were organized by socioeconomic status using Human Development Index (HDI) values collected from the United Nations Development Program. Gini coefficients and concentration indices were employed to analyze disparities in OM disease burden. RESULTS From 1990 to 2015, the mean DALY rate across all nations decreased by 21.9%. When considering disease burden in relation to socioeconomic status, age-standardized DALYs decreased as HDI values increased (p < 0.001). For both children and adults, DALY rates were significantly different between HDI groups (p < 0.01). Gini coefficients decreased from 0.821 in 1990 to 0.810 in 2015, indicating a modest reduction in international health inequality. Global disparities in OM disease burden, as measured by the concentration index, worsened from 1990 to 2010 before showing a small trend reversal in 2015. CONCLUSIONS To our knowledge, this is the first analysis investigating socioeconomic-related global disparities in OM disease burden using HDI values, Gini coefficients, and concentration indices. While the overall mean decrease in DALY rate from 1990 to 2015 is encouraging, the net decrease in concentration index during this period suggests less-developed nations continue to shoulder a disproportionate burden. Greater resource allocation to resource-poor nations may be warranted, as disease burden negatively impacts these countries to a greater degree.
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Bhutta MF, Bu X, de Muñoz PC, Garg S, Kong K. Training for hearing care providers. Bull World Health Organ 2019; 97:691-698. [PMID: 31656334 PMCID: PMC6796672 DOI: 10.2471/blt.18.224659] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/12/2019] [Accepted: 05/14/2019] [Indexed: 12/31/2022] Open
Abstract
The lack of an appropriately trained global hearing-care workforce is recognized as a barrier to developing and implementing services to treat ear and hearing disorders. In this article we examine some of the published literature on the current global workforce for ear and hearing care. We outline the status of both the primary-care workforce, including community health workers, and specialist services, including audiologists, ear, nose and throat specialists, speech and language therapists, and teachers of the deaf. We discuss models of training health workers in ear and hearing care, including the role of task-sharing and the challenges of training in low and middle-income countries. We structure the article by the components of ear and hearing care that may be delivered in isolation or in integrated models of care: primary care assessment and intervention; screening; hearing tests; hearing rehabilitation; middle-ear surgery; deaf services; and cochlear implant programmes. We highlight important knowledge gaps and areas for future research and reporting.
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Affiliation(s)
- Mahmood F Bhutta
- Department of Ear, Nose and Throat, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, England
| | - Xingkuan Bu
- Jiangsu Ear and Hearing Centre, Jiangsu Province Hospital, Nanjing, China
| | | | - Suneela Garg
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
| | - Kelvin Kong
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
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Bright T, Mújica OJ, Ramke J, Moreno CM, Der C, Melendez A, Lara Ovares E, Sandoval Domingues EI, Santana Hernandez DJ, Chadha S, Silva JC, Peñaranda A. Inequality in the distribution of ear, nose and throat specialists in 15 Latin American countries: an ecological study. BMJ Open 2019; 9:e030220. [PMID: 31326937 PMCID: PMC6661698 DOI: 10.1136/bmjopen-2019-030220] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 06/18/2019] [Accepted: 06/19/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To explore sociogeographical inequalities in the availability and distribution of ear, nose and throat specialists (ENTs) in 15 Latin American (LA) countries. DESIGN Ecological. SETTING Spanish and Portuguese-speaking countries of LA.The number of registered ENTs in 2017 was obtained from the National ENT Society in each country. OUTCOME MEASURES The ENT rate/million population was calculated at the national and subnational (eg, state) level. Three measures were calculated to assess subnational distributive inequality of ENTs: (1) absolute and (2) relative index of dissimilarity; and (3) concentration index (using the Human Development Index as the equity stratifier). Finally, the ratio of ENTs/million population in the capital area compared with the rest of the country was calculated. RESULTS There was more than a 30-fold difference in the number of ENTs/million population across the included countries-from 61.0 in Argentina (95% CI 58.7 to 63.4) to 2.8 in Guatemala (95% CI 2.1 to 3.8). In all countries, ENTs were more prevalent in advantaged areas and in capital areas. To attain distributive equality, Paraguay would need to redistribute the greatest proportion of its ENT workforce (67.3%; 95% CI 57.8% to 75.6%) and Brazil the least (18.5%; 95% CI 17.6% to 19.5%). CONCLUSIONS There is high inequality in the number and distribution of ENTs between and within the 15 studied countries in LA. This evidence can be used to inform policies that improve access to ear and hearing services in the region, such as scale-up of training of ENTs and incentives to distribute specialists equally. These actions to reduce inequities, alongside addressing the social determinants of ear and hearing health, are essential to realise Universal Health Coverage.
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Affiliation(s)
- Tess Bright
- International Centre for Evidence in Disability, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Oscar J Mújica
- Intelligence for Action in Health, Pan American Health Organization, PAHO/WHO, Washington, District of Columbia, USA
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Claudia M Moreno
- Pan American Health Organization, Washington, District of Columbia, USA
| | - Carolina Der
- Facultad de Medicina Universidad del Desarrollo, Clínica Alemana de Santiago, Santiago, Chile
| | | | - Ericka Lara Ovares
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | | | | | - Shelly Chadha
- WHO Programme for Prevention of Deafness and Hearing Loss, The World Health Organization, Geneva, Switzerland
| | - Juan Carlos Silva
- Pan American Health Organization, Washington, District of Columbia, USA
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Lukama L, Kalinda C, Aldous C. Africa's challenged ENT services: highlighting challenges in Zambia. BMC Health Serv Res 2019; 19:443. [PMID: 31266482 PMCID: PMC6604437 DOI: 10.1186/s12913-019-4267-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/17/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Diseases of the ear, nose and throat (ENT) are common and are a major cause of morbidity and mortality. In many low income countries like Zambia, the high ENT disease burden has not received the required resources for treatment. We investigated ENT service provision in hospitals in Zambia by documenting the profile of hospitals offering ENT services and examining the country's ENT services with regards to human resource, infrastructure and availability of equipment based on the levels of care of various hospitals. METHODS The study was a cross-sectional descriptive survey conducted using a structured and piloted questionnaire which was administered to the 109 Ministry of Health (MoH) registered hospitals across the country. Ethical clearance was granted by University of KwaZulu-Natal and the Zambia National Health Research Authority. Participation in the study was voluntary and all respondents signed informed consent. Descriptive statistics were used to analyse the data. RESULTS Of the 109 hospitals approached to participate in the study, 61 (55.9%) hospitals responded. This represented 83.3% (n = 5) of Third Level Hospitals (TLH), 89.5% (n = 17) of Second Level Hospitals (SLH) and 41.7% (n = 35) of First Level Hospitals (FLH) countrywide. Of the participating hospitals, 6.6% (n = 4) were unclassified. Within this sample, 8.6% (n = 3) FLH, 11.8% (n = 2) SLH and 60.0% (n = 3) TLH had an ENT examination room. Only 2.9% (n = 4) hospitals had an audiology booth and 1.6% (n = 1) had a speech therapy room. Of the second and third level hospitals, 9.1% (n = 2) had flexible rhinolaryngoscopes, 18.2% (n = 4) had operating microscopes and 68.2% (n = 15) adenotonsillectomy sets. The data revealed that there were 4 ENT surgeons, 1 Audiologist and no Speech Therapists across the country. CONCLUSION Zambia's ENT services were deficient at all levels of hospital care. There were deficiencies in infrastructure, human resource and equipment in hospitals. With the current burden of disease, critical intervention is required. These findings should be used to direct national policy on the improvement of ENT service provision in Zambia.
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Affiliation(s)
- Lufunda Lukama
- College of Health Sciences, Nelson R. Mandela School of Clinical Medicine, Discipline of Otorhinolaryngology, University of KwaZulu-Natal, Durban, 4001 South Africa
| | - Chester Kalinda
- University of Namibia, Katima Mulilo Campus, Private Bag, Katima Mulilo, 1096 Namibia
- College of Health Sciences, Howard College Campus, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, 4001 South Africa
| | - Colleen Aldous
- College of Health Sciences, Nelson R. Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, 4001 South Africa
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Stephenson KA, Ramdhani D, Fournier I, Ayad T. Global Professional Behaviours and Networking Preferences of Young Otolaryngologists - An International Survey. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:S75-S78. [PMID: 30143397 DOI: 10.1016/j.anorl.2018.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 06/20/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022]
Abstract
AIMS An international survey was conducted to explore the professional and regional spread of "young" otolaryngologists, their society membership and networking preferences, with relevance to global health and future initiatives. MATERIAL AND METHODS Otolaryngologists under the age of 45 years who had attended the 2017 International Federation of Otorhinolaryngological Societies (IFOS) meeting were invited by e-mail to participate in an online survey. Basic demographic data and information regarding career geography and networking preferences was requested. RESULTS A total of 928 responses (including 635 certified otolaryngologists and 268 trainees) were received from 2787 individuals invited to complete the survey. The overall response rate was 33.3%. Most otolaryngologists were based in an academic hospital. The spread of respondents likely reflects the European location of the meeting from which participants were identified; 61.2% of all respondents were based in Europe. International movement between career stages was evident. The principal preferred networking methods involved face-to-face contact whilst social media use was the method of choice for 13%. CONCLUSION This survey offers a present-day snapshot and is hoped to serve as a platform for further work. Little is known on a global scale regarding the professional behaviours and networking preferences of otolaryngologists. A greater understanding will facilitate not only education and research but also enable networking and global health work.
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Affiliation(s)
- K A Stephenson
- Birmingham Children's Hospital, Steelhouse Lane, B4 6NH, Birmingham, UK.
| | - D Ramdhani
- University of the Free State, Universities Academic Hospital, Bloemfontein, South Africa
| | - I Fournier
- University of Montreal, Montreal, Canada
| | - T Ayad
- Centre Hospitalier de l'Université de Montréal, Montreal, Canada
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Master A, Wilkinson E, Wagner R. Management of Chronic Suppurative Otitis Media and Otosclerosis in Developing Countries. Otolaryngol Clin North Am 2018. [DOI: 10.1016/j.otc.2018.01.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Regional Overview of Specific Populations, Workforce Considerations, Training, and Diseases in Latin America. Otolaryngol Clin North Am 2018; 51:651-658. [DOI: 10.1016/j.otc.2018.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Davey S, Maheshwari C, Raghav SK, Singh N, Muzammil K, Pandey P. Impact of indian public health standards for rural health care facilities on national programme for control of deafness in India: The results of a cohort study. J Family Med Prim Care 2018; 7:780-786. [PMID: 30234053 PMCID: PMC6132018 DOI: 10.4103/jfmpc.jfmpc_115_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction: In National Programme for Prevention and Control of Deafness (NPPCD), the management of ear diseases of rural India is now guided by Revised Indian Public Health Standards (IPHS) for Rural Health Facilities for providing quality ear care. However, despite the IPHS existence, coverage and quality ear care is questionable. Moreover, this issue has not yet been studied till now in the Indian context. The objective of the study was to assess the role of Private Medical College Training Center (Rural Health Training Centre [RHTC]) in augmenting quality of ear care services in NPPCD at district level by adopting IPHS Standards. Materials and Methods: A combined retrospective and prospective cohort study was done at RHTC of a Medical College in West Uttar Pradesh from January 1, 2013, to December 31, 2017, by retrospective approach of selecting all ear patients (n = 3840) and prospective way of assessing the impact of IPHS for ear care. The semi-structured Pro forma was used in exploring the coverage and quality of ear care. The data were analyzed by Epi Info version 7.2. Results: Out of total 4817 ear, nose, and throat (ENT) patients, the majority of ear patients (n = 3840) were initially dissatisfied with coverage and quality of ear services provided by ENT specialists at RHTC. However, when IPHS exposure was given from July 1, 2015 to December 31, 2017, not only majority of patients were satisfied (n = 3110, 81%) but also ear curative treatment was significantly higher (n = 2120, 68.1% vs. n = 130, 17.8%, odds ratio = 9.8, RR = 1.5, P < 0.00001). Conclusions: Adherence to IPHS in NPPCD is essential for delivering better ear care by RHTC through primary health-care approach.
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Affiliation(s)
- Sanjeev Davey
- Department of Community Medicine, Muzaffarnagar Medical College and Hospital, Muzaffarnagar, Uttar Pradesh, India
| | - Chaitanya Maheshwari
- Department of Community Medicine, Muzaffarnagar Medical College and Hospital, Muzaffarnagar, Uttar Pradesh, India
| | - Santosh Kumar Raghav
- Department of Community Medicine, Muzaffarnagar Medical College and Hospital, Muzaffarnagar, Uttar Pradesh, India
| | - Nirankar Singh
- Department of Community Medicine, Muzaffarnagar Medical College and Hospital, Muzaffarnagar, Uttar Pradesh, India
| | - Khursheed Muzammil
- Department of Community Medicine, Muzaffarnagar Medical College and Hospital, Muzaffarnagar, Uttar Pradesh, India
| | - Prakhar Pandey
- Department of Community Medicine, Muzaffarnagar Medical College and Hospital, Muzaffarnagar, Uttar Pradesh, India
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Survey of otolaryngology services in Ukraine and neighbouring Central and Eastern European countries. The Journal of Laryngology & Otology 2017; 131:1002-1009. [PMID: 29081305 DOI: 10.1017/s0022215117002134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The present humanitarian crisis in Ukraine is putting strains on its healthcare system. This study aimed to assess services and training in otolaryngology, audiology and speech therapy in Ukraine and its geographical neighbours. METHOD Survey study of 327 otolaryngologists from 19 countries. RESULTS Fifty-six otolaryngologists (17 per cent) from 15 countries responded. Numbers of otolaryngologists varied from 3.6 to 12.3 per 100 000 population (Ukraine = 7.8). Numbers of audiologists varied from 0, in Ukraine, to 2.8 per 100 000, in Slovakia, and numbers of speech therapists varied from 0, in Bulgaria, to 4.0 per 100 000, in Slovenia (Ukraine = 0.1). Ukraine lacks newborn and school hearing screening, good availability of otological drills and microscopes, and a cochlear implant programme. CONCLUSION There is wide variation in otolaryngology services in Central and Eastern Europe. All countries surveyed had more otolaryngologists per capita than the UK, but availability of audiology and speech and language therapy is poor. Further research on otolaryngology health outcomes in the region will guide service improvement.
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Ciaccia KA, John RM. Unaccompanied Immigrant Minors: Where to Begin. J Pediatr Health Care 2016; 30:231-40. [PMID: 26858232 DOI: 10.1016/j.pedhc.2015.12.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 12/22/2015] [Accepted: 12/30/2015] [Indexed: 11/18/2022]
Abstract
The number of unaccompanied immigrant minors (UIMs) from Central America significantly increased in 2014. Nearly 50,000 children from El Salvador, Guatemala, and Honduras crossed the United States-Mexico border in 2014, compared with 3,933 in 2011. Few resources exist to guide pediatric nurse practitioners (PNPs) in their care of UIM. The multifactorial reasons behind migration and the state of children's health in Central America provide insight into the needs of UIMs. Guidelines for similar groups such as foreign-born children and refugees offer direction for the health care considerations of UIMs. This article provides demographic information on UIMs, highlights the unique and challenging medical and mental health issues facing UIMs, and discusses the role of the PNP. A UIM's initial visit with a PNP serves as an opportunity to build trust through culturally competent, trauma-informed care, provide preventive care, assess for unmet health needs, and screen for mental health conditions.
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