Preventive audiology: Ramping up efforts towards an ear-and-hearing healthy nation

Abstract

Peer review declarationThe publisher (AOSIS) endorses the South African 'National Scholarly Book Publishers Forum Best Practice for Peer Review of Scholarly Books'. The manuscript underwent an evaluation to compare the level of originality with other published works and was subjected to rigorous two-step peer review before publication, with the identities of the reviewers not revealed to the editor(s) or author(s). The reviewers were independent of the publisher, editor(s), and author(s). The publisher shared feedback on the similarity report and the reviewers' inputs with the manuscript's editor(s) or author(s) to improve the manuscript. Where the reviewers recommended revision and improvements, the editor(s) or author(s) responded adequately to such recommendations. The reviewers commented positively on the scholarly merits of the manuscript and recommended that the manuscript be published. v Research justificationPreventive health care, where preventive audiology is positioned, contains strategies adopted and implemented for disease and disorder prevention. Hearing function can be negatively impacted by numerous factors, including lifestyle choices, environmental factors, genetic predisposition, the burden of disease and other causes. Frequently, hearing impairment can be prevented and its consequences significantly minimised by preventive measures. Such prevention commands conscientiously deliberate anticipatory actions that can fall under primordial, primary, secondary or tertiary levels of prevention. South Africa, as a resource-constrained low-and middle-income country (LMIC), still has a challenge of high numbers of individuals with preventable hearing impairment from the cradle to the grave. Numerous strategies exist for the prevention of hearing impairment across all ages and in various contexts. Preventive Audiology: An African Perspective is an original scholarly book that introduces the concept of preventive audiology, with a specific focus on the African context, which is in line with the South African re-engineered primary health care strategy and the World Health Organization's approach. The book reflects on contextually relevant and responsive evidence-based perspectives, grounded in an African context on preventive audiology, in four major ear-and-hearing burdens of disease within the South African context, namely, (1) early hearing detection and intervention (EHDI), (2) middle ear pathologies, (3) ototoxicity and (4) noise-induced hearing loss (NIHL). The book represents innovative research, seen from both South African and global perspectives. It offers new discourse and argues for a paradigm shift in how audiology is theorised and performed, particularly in LMIC contexts. The goal of this book is to motivate for a paradigm shift in how ear-and-hearing health care is approached within this LMIC context, while also arguing for Afrocentric best practice evidence that leads to next practice. For Afrocentric epistemology, which is a different narrative that is deliberately removed from Western epi...

Social determinants of health in non-communicable diseases prevention policies in South Africa

“…The author of this chapter believes that LMICs should prioritise this level of prevention in their preventive health care models as this level focuses on the future possible disease before the disease presents itself. It is at this primordial level where factors that are known to increase the future risk of exposure to ototoxicity, such as environmental, economic, social and behavioural risk factors are prevented from developing, including the addressing of health determinants (Khoza-Shangase 2022a). This level of prevention focuses on changing determinants at the systemic level rather than at the personal risk factors level, which is where the primary level of prevention focuses (WHO 2020).…”

“…This level of prevention focuses on changing determinants at the systemic level rather than at the personal risk factors level, which is where the primary level of prevention focuses (WHO 2020). Khoza-Shangase (2022a) provides examples of preventive audiology initiatives at this level with those appropriate for ototoxicity prevention. These include: (1) vaccination and immunisation of everyone from infants to the elderly, as well as postexposure prophylaxis or vaccination for individuals exposed to communicable diseases (WHO 2020), all these with the aim of preventing conditions that would require treatment with potentially ototoxic medications;…”

“…Also implemented at this level are initiatives such as evidence-based screening programmes for early detection of hearing or vestibular impairment or ear disease (ototoxicity screening and monitoring) and preventive drug therapies, as well as other interventions of proven effectiveness when administered or implemented at an early stage of the disease, such as the use of otoprotective agents in ototoxicity. Khoza-Shangase (2022a) argues that because secondary prevention refers to the use of measures that may lead to earlier diagnosis and treatment of health conditions, advocacy for mandating such measures (e.g. government mandating of ototoxicity monitoring as part of TB treatment) is pivotal for both initial implementation and sustainability of such programmes.…”

“…There are risk factors, other than excessive noise exposure, that are associated with ONIHL, and these can be classified as modifiable and nonmodifiable risk factors (Khoza-Shangase 2022a). Modifiable risk factors include, for example, occupational exposures such as dust, nitrogen sulphide and carbon monoxide, recreational noise and smoking (Campo et al 2013;Gates et al 2000;Khoza-Shangase 2022a;Oliveira, Cacodcar & Motghare 2014;Tao et al 2013). Non-modifiable risk factors include ageing, sex, genetic susceptibility, race, history of ear-related conditions (e.g.…”

“…Non-modifiable risk factors include ageing, sex, genetic susceptibility, race, history of ear-related conditions (e.g. ear infections and neurological ear diseases) and treatments for TB and HIV , 2022aStrauss et al 2014;. Studies conducted in South African mines have not classified the risk factors as modifiable or nonmodifiable but have highlighted the most common risk factors associated with ONIHL, for example, noise, age, sex, race, TB and HIV .…”