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Pérez-Herrera LC, Peñaranda D, Moreno-López S, Guerra AM, Montes F, Sanchez-Franco SC, Sarmiento OL, Suetta-Lugo N, Peñaranda A. Extended high-frequency hearing loss among Afro-Colombian adolescents from a rural area in Colombia: a cross-sectional study. BMJ Open 2024; 14:e071445. [PMID: 39025814 PMCID: PMC11261701 DOI: 10.1136/bmjopen-2022-071445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 05/28/2024] [Indexed: 07/20/2024] Open
Abstract
OBJECTIVES Research trends concerning hearing loss within teen rural populations are limited and current evidence suggests that extended high-frequency audiometry can be a sensitive tool to detect subclinical hearing loss. Moreover, current research emphasises the importance of representing different ethnic populations in science. This study aimed to determine the prevalence of acquired hearing loss through conventional pure-tone (0.25-8 kHz) and extended high frequency (EHF) (9-20 kHz) audiometry in Afro-Colombian adolescents from a rural area in Colombia. DESIGN Observational, cross-sectional study. PARTICIPANTS 230 Afro-Colombian adolescents aged 13-17 years who attended high school in a rural population from Cartagena, Colombia. INTERVENTIONS Otoscopic examination, conventional (0.25-8 kHz) and EHF (9-20 kHz) audiometry tests were performed during February-March 2021. Sociodemographic and associated factor questionnaires were also applied to assess probable factors associated with EHF hearing loss. MAIN OUTCOME MEASURES Prevalence of acquired hearing loss using conventional and EHF audiometry, and factors associated with hearing loss. RESULTS Of 230 adolescents who met the eligibility criteria, 133 (57.82%) were female. The mean age was 15.22 years (SD: 1.62). The prevalence of hearing loss in at least one ear assessed with conventional audiometry was 21.30% and with EHF audiometry 14.78%. The main abnormal otoscopic findings included: neotympanum (1.30%), myringosclerosis (0.87%) and monomeric scars (0.43%). Factors associated with a higher probability of EHF hearing loss found through logistic regression were older age (prevalence ratio (PR): 1.45; 95% CI 1.16 to 1.80), attending the 'Picó' four or more times a month (PR: 6.63; 95% CI 2.16 to 20.30), attending bars more than three times a month (PR: 1.14; 95% CI 1.03 to 1.59) and self-reported hearing difficulties (PR: 1.24; 95% CI 1.22 to 4.05). CONCLUSIONS Our results suggest that acquired hearing loss is already widespread among this young rural population.
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Affiliation(s)
- Lucia C Pérez-Herrera
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Otolaryngology and Allergy Research Groups, UNIMEQ-ORL, Bogotá, Colombia
| | - Daniel Peñaranda
- Otolaryngology and Allergy Research Groups, UNIMEQ-ORL, Bogotá, Colombia
- Department od Otolaryngology, Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Sergio Moreno-López
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Otolaryngology and Allergy Research Groups, UNIMEQ-ORL, Bogotá, Colombia
| | - Ana Maria Guerra
- Department of Industrial Engineering, Universidad de los Andes, Bogota, Colombia
| | - Felipe Montes
- Department of Industrial Engineering, Universidad de los Andes, Bogota, Colombia
| | | | | | | | - Augusto Peñaranda
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Otolaryngology and Allergy Research Groups, UNIMEQ-ORL, Bogotá, Colombia
- Department of Otolaryngology, Fundacion Santa Fe de Bogota, Bogota, Colombia
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Kapalamula G, Gordie K, Khomera M, Porterfield JZ, Toman J, Vallario J. Hearing Health Awareness and the Need for Educational Outreach Amongst Teachers in Malawi. Audiol Res 2023; 13:271-284. [PMID: 37102774 PMCID: PMC10135795 DOI: 10.3390/audiolres13020024] [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: 01/26/2023] [Revised: 03/04/2023] [Accepted: 03/10/2023] [Indexed: 04/28/2023] Open
Abstract
Malawi, as a low-income country in southeastern Africa, severely lacks early identification, diagnosis and intervention measures for hearing loss. Due to its constrained resources, an educational awareness campaign targeted at professionals can be a cost-effective instrument in promoting good health care through awareness, prevention, and early identification of hearing loss. The aim of this study is to assess school teachers' knowledge of hearing health, audiology services, identification, and management of hearing issues before and after an educational intervention. METHODS A Pre-Survey, followed by an educational intervention, and a Post-Survey were completed by teacher participants. A similar World Health Organization-derived survey was also administered to compare to our locally adapted survey. Trends related to efficacy, performance, and survey improvement were evaluated. RESULTS A total of 387 teachers participated. The average score on the Post-Survey was significantly improved compared to the Pre-Survey (71% to 97% correct responses) with the educational intervention. The only predictive variable related to performance was the location of the school within the capital of Lilongwe compared to rural sites outside of the capital. Our locally adapted survey compared favorably to the WHO survey. CONCLUSIONS The results suggest that there is a statistically significant improvement in the implementation of an educational program to increase the knowledge and awareness of hearing health care among teachers. Some topics were more poorly understood than others, suggesting the need for targeted awareness interventions. Location within the capital city had some effect on performance but a high rate of correct responses was achievable across the participants independent of age, teaching experience, or gender. Our data support the idea that hearing health awareness interventions can be an effective and low-cost option to equip teachers to effectively serve as an advocate for improved identification, early diagnosis and appropriate referral of students with hearing loss.
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Affiliation(s)
| | - Kelly Gordie
- Department of Audiology, School of Communication Sciences & Disorders, College of Behavioral & Community Sciences, University of South Florida, Tampa, FL 33612, USA
| | - Memory Khomera
- African Bible College, Area 47, Lilongwe P.O. Box 1028, Malawi
| | - J Zachary Porterfield
- Department of Microbiology, Immunology and Molecular Genetics, University of Kentucky, Lexington, KY 40508, USA
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Kentucky, Lexington, KY 40508, USA
| | - Julia Toman
- Department of Otolaryngology, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Jenna Vallario
- African Bible College, Area 47, Lilongwe P.O. Box 1028, Malawi
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Borre ED, Dubno JR, Myers ER, Emmett SD, Pavon JM, Francis HW, Ogbuoji O, Sanders Schmidler GD. Model-Projected Cost-Effectiveness of Adult Hearing Screening in the USA. J Gen Intern Med 2023; 38:978-985. [PMID: 35931909 PMCID: PMC10039166 DOI: 10.1007/s11606-022-07735-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/28/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND While 60% of older adults have hearing loss (HL), the majority have never had their hearing tested. OBJECTIVE We sought to estimate long-term clinical and economic effects of alternative adult hearing screening schedules in the USA. DESIGN Model-based cost-effectiveness analysis simulating Current Detection (CD) and linkage of persons with HL to hearing healthcare, compared to alternative screening schedules varying by age at first screen (45 to 75 years) and screening frequency (every 1 or 5 years). Simulated persons experience yearly age- and sex-specific probabilities of acquiring HL, and subsequent hearing aid uptake (0.5-8%/year) and discontinuation (13-4%). Quality-adjusted life-years (QALYs) were estimated according to hearing level and treatment status. Costs from a health system perspective include screening ($30-120; 2020 USD), HL diagnosis ($300), and hearing aid devices ($3690 year 1, $910/subsequent year). Data sources were published estimates from NHANES and clinical trials of adult hearing screening. PARTICIPANTS Forty-year-old persons in US primary care across their lifetime. INTERVENTION Alternative screening schedules that increase baseline probabilities of hearing aid uptake (base-case 1.62-fold; range 1.05-2.25-fold). MAIN MEASURES Lifetime undiscounted and discounted (3%/year) costs and QALYs and incremental cost-effectiveness ratios (ICERs). KEY RESULTS CD resulted in 1.20 average person-years of hearing aid use compared to 1.27-1.68 with the screening schedules. Lifetime total per-person undiscounted costs were $3300 for CD and ranged from $3630 for 5-yearly screening beginning at age 75 to $6490 for yearly screening beginning at age 45. In cost-effectiveness analysis, yearly screening beginning at ages 75, 65, and 55 years had ICERs of $39,100/QALY, $48,900/QALY, and $96,900/QALY, respectively. Results were most sensitive to variations in hearing aid utility benefit and screening effectiveness. LIMITATION Input uncertainty around screening effectiveness. CONCLUSIONS We project that yearly hearing screening beginning at age 55+ is cost-effective by US standards.
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Affiliation(s)
- Ethan D Borre
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA
| | - Judy R Dubno
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Evan R Myers
- Division of Women's Community and Population Health, Department of Obstetrics & Gynecology, Duke University School of Medicine, Durham, NC, USA
| | - Susan D Emmett
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Juliessa M Pavon
- Department of Medicine, Division of Geriatrics, Duke University School of Medicine, Durham, NC, USA
| | - Howard W Francis
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Osondu Ogbuoji
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, USA
| | - Gillian D Sanders Schmidler
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA.
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
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Lund E, Brock N, Werfel KL. Location Effects on Spoken Language and Literacy for Children who are DHH. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2021; 27:48-61. [PMID: 34586385 PMCID: PMC8682316 DOI: 10.1093/deafed/enab030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 06/13/2023]
Abstract
The purpose of this study was to consider how living in an area that qualifies for a rural health grant interacts with a child's hearing status to affect early language and literacy development. Four-year-old children with hearing aids (n = 45), cochlear implants (n = 47), and with typical hearing (n = 66) completed measures of spoken language knowledge and of emergent literacy skills as part of a larger longitudinal investigation. A significant interaction effect between location (rural or urban/suburban) and amplification group was detected for letter knowledge: children with hearing aids exhibit a performance that is particularly affected by rural location. Overall, children with cochlear implants performed lower across all measures than children with typical hearing, and children with hearing aids performed lower than children with typical hearing on measures of phonological awareness, vocabulary, omnibus language knowledge and articulation.
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Affiliation(s)
- Emily Lund
- Davies School of Communication Sciences and Disorders, Texas Christian University, Fort Worth, TX, USA
| | - Nicholas Brock
- Davies School of Communication Sciences and Disorders, Texas Christian University, Fort Worth, TX, USA
| | - Krystal L Werfel
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
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Peñaranda D, Pérez-Herrera LC, Hernández D, Moreno-López S, Perea I, Jacome M, Suetta-Lugo N, García JM, Peñaranda A. Prevalence of extended high-frequency hearing loss among adolescents from two rural areas in Colombia. Int J Audiol 2020; 60:365-373. [PMID: 33043728 DOI: 10.1080/14992027.2020.1828631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Worldwide research trends on the prevalence of hearing loss within young rural populations are scarce. Current evidence suggests extended high-frequency audiometry could be a sensitive predictor to detect subclinical hearing loss. This study aimed to determine the prevalence of hearing loss through conventional pure tone (0.25-8 kHz) and extended high-frequency (9-20 kHz) audiometry tests in a group of adolescents aged 13 to 19 years old from two rural areas of Colombia. A sociodemographic and associated factor for hearing loss questionnaire was applied. DESIGN Cross-sectional study. STUDY SAMPLE Three hundred sixty-six adolescents aged 13 to 19 years old from two rural municipalities in Colombia: Soracá, and Palmas del Socorro. RESULTS Hearing loss prevalence assessed through pure tone audiometry was 3.28% in right ears and 3.83% in left ears while through extended high-frequency audiometry was 14.21% and 13.11%, respectively. Associated factors found by the logistic regression were age (OR: 1.36; CI 95% 1.13-1.64) and obesity (OR: 3.74; CI 95% 1.07-13.11). CONCLUSIONS Using 15 dB as the normal hearing threshold parameter for audiometric frequencies, our results suggest that extended high-frequency hearing loss is already widespread among rural adolescents. This highlights the need for research on extended high-frequency audiometry in rural school-aged children.
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Affiliation(s)
- Daniel Peñaranda
- Otolaryngology Department, Fundación Universitaria de Ciencias de la Salud - Hospital de San José, Bogotá, Colombia
| | | | | | | | - Ilene Perea
- Otolaryngology Department, Fundación Universitaria de Ciencias de la Salud - Hospital de San José, Bogotá, Colombia
| | - Mario Jacome
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
| | - Nancy Suetta-Lugo
- Audiology Deparment, Universidad Nacional de Colombia Bogotá Bogotá, Colombia
| | - Juan Manuel García
- Otolaryngology Department, Fundación Universitaria de Ciencias de la Salud - Hospital de San José, Bogotá, Colombia.,School of Medicine, Universidad de Los Andes, Bogotá, Colombia.,Otolaryngology Section, Hospital Universitario Fundación Santa Fe, Bogotá, Colombia
| | - Augusto Peñaranda
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia.,Otolaryngology Section, Hospital Universitario Fundación Santa Fe, Bogotá, Colombia
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Elmalik S, Alshawi S, AlQahtani AM, AlShammasi HS, Alruwaili A, Aldughaim A, Alkhalifa SA. Descriptive Patterns of Deafness Among Pre-School Saudi Children Aged Two to Five Years Visiting Neurology Clinic From 2012 to 2017. Cureus 2020; 12:e10893. [PMID: 33194462 PMCID: PMC7654562 DOI: 10.7759/cureus.10893] [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] [Indexed: 11/05/2022] Open
Abstract
Background Early childhood years are very important and crucial periods for developing different developmental milestones. Hearing loss is considered to be one of the most commonly detectable problems, which often goes unnoticed or not given proper attention due to the lack of screening modalities or the inability of parents or guardians to recognize it in early stages. Therefore, it is necessary to determine the pattern of differences pertaining to hearing loss among pre-school children of various age groups to better approach this issue in a systemic and fundamental manner, so that better care and treatment can be provided to children suffering from deafness. Methods This study involved a descriptive, retrospective chart review in two hospital settings, and it was conducted at the department of physiology (neurophysiology) of King Abdulaziz and King Khalid University Hospitals at the King Saud University (KSU) in Riyadh during the period of 2012-2017. A total of 324 pre-school Saudi children from the age of two to five years were involved and tested by brainstem auditory evoked potentials (BAEPs) to assess deafness. Results A total of 324 patients underwent the BAEP test; of them, 199 (61.4%) were males and 125 (38.6%) were females. Regarding the age groups, the most common age group was that of two-year-olds with 117 (36.1%) participants, followed by three-year-olds with 80 (24.7%) children, four-year-olds with 73 (22.5%) patients, and five-year-olds with 54 (16.7%) participants. Furthermore, there were 220 (67.9%) patients with sensorineural hearing loss (SNHL), 92 (28.4%) with conductive hearing loss (CHL), four (1.2%) with mixed hearing loss (MHL), and eight (2.5%) with normal audiometry. The normal hearing threshold was determined to be 20 dB, and the mean value for the hearing threshold of the SNHL in the right ear was found to be 43.45 ± 25.85, while the left-ear mean value was 44.54 ± 28.78. The mean value of the hearing threshold in CHL of the right ear was 50.96 ± 22.23, while that of the left ear was 47.85 ± 22.74. Lastly, the mean value of the hearing threshold in MHL of the right ear was 80.00 ± 21.21, while that of the left ear was 73.75 ± 18.87. Conclusion SNHL was the most common type (67.9%) of pre-school hearing loss in Saudi Children attending the neurophysiology clinic at KSU hospitals between 2012-2017, while MHL constituted the most severe cases.
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Affiliation(s)
| | - Saleh Alshawi
- Medicine, College of Medicine, King Saud University, Riyadh, SAU
| | | | | | - Ahmed Alruwaili
- Medicine, College of Medicine, King Saud University, Riyadh, SAU
| | - Ahmad Aldughaim
- Medicine, College of Medicine, King Saud University, Riyadh, SAU
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