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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 2024:34894241266482. [PMID: 39054809 DOI: 10.1177/00034894241266482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [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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Patel C, Sargent GM, Tinessia A, Mayfield H, Chateau D, Ali A, Tuibeqa I, Sheel M. Measuring what matters: Context-specific indicators for assessing immunisation performance in Pacific Island Countries and Areas. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003068. [PMID: 39052626 PMCID: PMC11271932 DOI: 10.1371/journal.pgph.0003068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/18/2024] [Indexed: 07/27/2024]
Abstract
Increasing countries' access to data can improve immunisation coverage through evidence-based decision-making. However, data collection and reporting is resource-intensive, so needs to be pragmatic, especially in low-and-middle-income countries. We aimed to identify which indicators are most important for measuring, and improving, national immunisation performance in Pacific Island Countries (PICs). We conducted an expert elicitation study, asking 13 experts involved in delivering immunisation programs, decision-makers, health information specialists, and global development partners across PICs to rate 41 indicators based on their knowledge of the feasibility and relevance of each indicator. We also asked experts their preferences for indicators to be retained or removed from a list of indicators for PICs. Experts participated in two rating rounds, with a discussion on the reasons for ratings before the second round. We calculated mean scores for feasibility and relevance, and ranked indicators based on experts' preferences and mean scores. We used framework analysis to identify reasons for selecting indicators. Experts agreed that certain indicators were essential to measure (e.g. data use in program planning and measles vaccination coverage), but preferences varied for most indicators. Preferences to include indicators in a set of indicators for PICs moderately correlated with scores for relevance (r = 0.68) and feasibility (r = 0.56). In discussions, experts highlighted usefulness for decision-making and ease of data collection, reporting and interpretation as the main reasons driving indicator selection. Country-specific factors such as health system factors, roles and influence of various immunisation actors, and macro-level factors (namely population size, distribution and mobility) affected relevance and feasibility, leading us to conclude that a single set of indicators for all PICs is inappropriate. Rather than having a strict set of indicators that all countries must measure and report against, performance indicators should be flexible, country-specific, and selected in consultation with immunisation actors who collect and use the data.
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Affiliation(s)
- Cyra Patel
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Ginny M. Sargent
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Adeline Tinessia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Helen Mayfield
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Dan Chateau
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Akeem Ali
- World Health Organization, Seoul, Republic of Korea
| | - Ilisapeci Tuibeqa
- Department of Paediatrics, Colonial War Memorial Hospital, Suva, Fiji
| | - Meru Sheel
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Sydney Institute for Infectious Diseases, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
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Vaai-Bartley CS, Bennett E, Arasi F, Kaspar A. Characteristics of patients admitted to the intensive care unit during the 2019 measles epidemic in Samoa: A retrospective clinical case series. Trop Doct 2024:494755241266673. [PMID: 39043033 DOI: 10.1177/00494755241266673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Our report describes the characteristics of patients admitted to the intensive care unit of the National Hospital of Samoa during the 2019-2020 measles epidemic. The study design was a retrospective review of clinical records; the age range was 2 months to 51 years, with the majority of cases in the 2-23 month age group (71%). Vaccination status was unknown or unrecorded for 17 (24%). Of the 54 (75%) who were not fully vaccinated, 35 (65%) did not survive. Almost all (98%) presented with multiple complications on admission, mostly pneumonia (91%). The mortality rate was 61%, implying a low survival rate particularly among young infants and toddlers, even when optimal care was available and administered.
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Affiliation(s)
- Cecilia S Vaai-Bartley
- Anaesthetist, Anaesthesia & Intensive Care Unit, Tupua Tamasese Meaole Hospital Ministry of Health, Apia, Samoa
- Anaesthetist, College of Medicine Nursing & Health Sciences, Fiji National University, Nasinu, Fiji
| | - Elizabeth Bennett
- MMED Research Project Advisor, College of Medicine Nursing & Health Sciences, Fiji National University, Nasinu, Fiji
| | - Faamuamua Arasi
- Anaesthetist, Anaesthesia & Intensive Care Unit, Tupua Tamasese Meaole Hospital Ministry of Health, Apia, Samoa
| | - Annette Kaspar
- Audiologist & Health Researcher, ENT Clinic, Tupua Tamasese Meaole Hospital Ministry of Health, Samoa
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Pledger M, Mohan N, Silwal P, Irurzun-Lopez M. The enrolment gap and the COVID-19 pandemic: an exploration of routinely collected primary care enrolment data from 2016 to 2023 in Aotearoa New Zealand. J Prim Health Care 2023; 15:316-323. [PMID: 38112703 DOI: 10.1071/hc23128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 11/23/2023] [Indexed: 12/21/2023] Open
Abstract
Introduction For many countries, primary health care (PHC) serves as the gateway for individuals to access healthcare services. It has been shown to not only improve health but also health equity. To maximise this benefit, a substantial proportion of the population needs to be connected with PHC. The aim here was to assess the degree and evolution of enrolment in light of the coronavirus disease 2019 (COVID-19) pandemic in Aotearoa New Zealand. Methods We examined data on the enrolment of people in PHC organisations between 2016 and 2023. This analysis included breakdowns by sex, age groups, ethnicity, and socioeconomic deprivation levels. Poisson regression models were used to explore whether enrolment changed because of the COVID-19 pandemic. Results In 2016, Māori, young people and the most deprived had lower enrolment rates relative to their peers. Although young people's enrolment rate increased over time, especially during the COVID-19 pandemic, the Māori enrolment rate declined, as did the rate for Pacific people, and those who were the most deprived. The groups who had increases in enrolment rates were those with the lowest levels of socioeconomic deprivation and those in the 'Other' ethnic category, predominantly made up of European New Zealanders. Conclusion Enrolment statistics reveal disparities across sociodemographic lines. The COVID-19 pandemic was associated with changed patterns of enrolment that appear to have consequences for population health.
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Affiliation(s)
- Megan Pledger
- Te Hikuwai Rangahau Hauora - Health Services Research Centre, Te Wahanga Tatai Hauora - Wellington Faculty of Health, Te Herenga Waka - Victoria University of Wellington, Rutherford House, Pipitea Campus, Bunny Street, Wellington 6011, New Zealand
| | - Nisa Mohan
- Te Hikuwai Rangahau Hauora - Health Services Research Centre, Te Wahanga Tatai Hauora - Wellington Faculty of Health, Te Herenga Waka - Victoria University of Wellington, Rutherford House, Pipitea Campus, Bunny Street, Wellington 6011, New Zealand
| | - Pushkar Silwal
- Te Hikuwai Rangahau Hauora - Health Services Research Centre, Te Wahanga Tatai Hauora - Wellington Faculty of Health, Te Herenga Waka - Victoria University of Wellington, Rutherford House, Pipitea Campus, Bunny Street, Wellington 6011, New Zealand
| | - Maite Irurzun-Lopez
- Te Hikuwai Rangahau Hauora - Health Services Research Centre, Te Wahanga Tatai Hauora - Wellington Faculty of Health, Te Herenga Waka - Victoria University of Wellington, Rutherford House, Pipitea Campus, Bunny Street, Wellington 6011, New Zealand
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Sonder GJ, Grey C, Anglemyer A, Tukuitonga C, Hill PC, Sporle A, Ryan D. The August 2020 COVID-19 outbreak in Aotearoa, New Zealand: Delayed contact tracing for Pacific people contributes to widening health disparities. IJID REGIONS 2023; 6:177-183. [PMID: 36741984 PMCID: PMC9890878 DOI: 10.1016/j.ijregi.2023.01.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023]
Abstract
Background After COVID-19 arrived in New Zealand, a national system was developed to improve the efficiency of contact tracing. The first outbreak was followed by a period of 'COVID-19 elimination', until a community outbreak occurred in August 2020. We describe the characteristics of cases and their contacts during this outbreak, focused on the results of contact tracing. Methods COVID-19 case data from the national surveillance database were linked to contacts from the national contact tracing database. Demographic and clinical characteristics of cases, number of contacts, and timeliness of contact tracing were analysed by ethnicity. Findings Most of the 179 cases were Pacific people (59%) or Māori (25%), living in areas of high socioeconomic deprivation, who had higher rates of comorbidity and accounted for almost all (21/22) hospitalisations, all 8 ICU admissions and all 3 deaths. Only 6% belonged to the European majority ethnic group. Of 2,528 registered contacts, 46% were Pacific, 14% Māori and 19% European. Only contacts that were reached were registered. Overall, 41% of contacts were reached within 4 days of onset of disease of the case, which was significantly lower for Pacific (31%) than for other ethnic groups. Interpretation Our findings confirm the greater health burden that ethnic minorities face from COVID-19. The significant delay in the timeliness of care for Pacific people shows that the public health response was inequitable for those at highest risk. Tailored public health responses and better registration of marginalised groups are necessary to provide better access to services and to improve insights for optimal future outbreak management.
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Affiliation(s)
- Gerard Jb Sonder
- Pacific Perspectives Ltd, PO Box 8010, Wellington 6143, New Zealand.,Department of Internal Medicine, Amsterdam Infection & Immunity Institute (AIII), Amsterdam UMC, location Academic Medical Center, the Netherlands
| | - Corina Grey
- Pacific Perspectives Ltd, PO Box 8010, Wellington 6143, New Zealand.,Department of General Practice and Primary Health Care, School of Population Health, University of Auckland
| | - Andrew Anglemyer
- Department of Preventive and Social Medicine, Division of Health Sciences, University of Otago, Dunedin, New Zealand.,Health Intelligence Team, Institute for Environmental Science and Research, Wellington, New Zealand
| | - Collin Tukuitonga
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Philip C Hill
- Centre for International Health, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Andrew Sporle
- iNZight Analytics Ltd.,Department of Statistics, The University of Auckland
| | - Debbie Ryan
- Pacific Perspectives Ltd, PO Box 8010, Wellington 6143, New Zealand
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Koro L, Kaspar A. Deafness and the Tokelauan health model. J Glob Health 2023; 13:03001. [PMID: 36825606 PMCID: PMC9951125 DOI: 10.7189/jogh.13.03001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Affiliation(s)
- Latasi Koro
- Department of Audiology, University of Auckland, Auckland, New Zealand
| | - 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
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Kaspar A, Mishra A, Leach A, Pifeleti S. ENT/Audiology Department of Samoa welcomes the introduction of the Pneumococcal Conjugate Vaccine (PCV) into the national childhood immunisation program. J Glob Health 2022; 12:02002. [PMID: 35567588 PMCID: PMC9107095 DOI: 10.7189/jogh.12.02002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Annette Kaspar
- ENT Department, Tupua Tamasese Meaole Hospital, Ministry of Health, Apia, Samoa.,Ear Health Research Program, Child Health Division, Menzies School of Health Research, Darwin, Australia
| | - Akshaya Mishra
- Expanded Program on Immunisation, UNICEF - Samoa Office, Apia, SAMOA
| | - Amanda Leach
- Ear Health Research Program, Child Health Division, Menzies School of Health Research, Darwin, Australia
| | - Sione Pifeleti
- ENT Department, Tupua Tamasese Meaole Hospital, Ministry of Health, Apia, Samoa
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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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Kaspar A, Pifeleti S. Brief overview of meningitis in the Pacific Islands, and implications for public health, clinical, and rehabilitation services: A call to action. J Glob Health 2021; 11:03006. [PMID: 33643616 PMCID: PMC7897445 DOI: 10.7189/jogh.11.03006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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
| | - Sione Pifeleti
- ENT Department, Tupua Tamasese Meaole Hospital, Ministry of Health, Apia, Samoa
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Kaspar A, Pifeleti S, Driscoll C. Knowledge and attitudes of university health students in the Pacific Islands towards childhood hearing loss and hearing services: a Samoan survey study protocol. BMJ Paediatr Open 2021; 5:e000998. [PMID: 33768167 PMCID: PMC7944981 DOI: 10.1136/bmjpo-2020-000998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/14/2021] [Accepted: 02/21/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The Pacific Islands have among the highest rates of ear disease and hearing loss in the world, especially among children. Given that Ear, Nose and Throat (ENT)/audiology specialists are limited in the region, the successful implementation of ear and hearing health services will depend on the participation and support of the wider community of health professionals. There are currently no studies from the Pacific Islands investigating the knowledge and attitudes of either health students or health professionals towards childhood hearing loss and hearing services. METHODS AND ANALYSIS Survey of medical and nursing students (n=370) currently enrolled at the National University of Samoa. Students will independently and anonymously complete a 10-item questionnaire. The questions assess attitudes to childhood hearing loss (two questions), knowledge of aetiology of childhood hearing loss (three questions), and knowledge of identification and interventions for children with hearing loss (five questions). Responses are based on a 5-point Likert scale (Strongly agree/Agree/Neutral/Disagree/Strongly disagree). DISCUSSION/CONCLUSION We publish these protocols to facilitate similar studies in other low-income and middle-income countries, and especially among our Pacific Island neighbours.
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Affiliation(s)
- Annette Kaspar
- ENT Department, Tupua Tamasese Meaole Hospital, Apia, Samoa.,Hearing Research Unit for Children, University of Queensland, Brisbane, Queensland, Australia
| | - Sione Pifeleti
- ENT Department, Tupua Tamasese Meaole Hospital, Apia, Samoa
| | - Carlie Driscoll
- Hearing Research Unit for Children, University of Queensland, Brisbane, Queensland, Australia
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