Rationale and feasibility of a combined rapid assessment of avoidable blindness and hearing loss protocol

Bright, Tess; McCormick, Ian; Phiri, Mwanaisha; Mulwafu, Wakisa; Burton, Matthew J.; Polack, Sarah; Mactaggart, Islay; Yip, Jennifer; Swanepoel, De Wet; Kuper, Hannah

doi:10.1371/journal.pone.0229008

Cited by 9 publications

(16 citation statements)

References 22 publications

(29 reference statements)

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“…Automated test protocols and intuitive user interfaces on these smartphone screening apps allow lay health workers (LHWs) or community health workers (CHWs) to facilitate hearing and vision testing (Bright et al, 2020;Eksteen et al, 2019;Jayawardena et al, 2020;Rono et al, 2018;Yousuf Hussein et al, 2016;. A recent study confirmed that training CHWs in primary ear and hearing care identification can be feasible and accurate (Bright et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Community-Based Hearing and Vision Screening in Schools in Low-Income Communities Using Mobile Health Technologies

Manus

Linde

Kuper

et al. 2021

LSHSS

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Introduction Globally, more than 50 million children have hearing or vision loss. Most of these sensory losses are identified late due to a lack of systematic screening, making treatment and rehabilitation less effective. Mobile health (mHealth), which is the use of smartphones or wireless devices in health care, can improve access to screening services. mHealth technologies allow lay health workers (LHWs) to provide hearing and vision screening in communities. Purpose The aim of the study was to evaluate a hearing and vision school screening program facilitated by LHWs using smartphone applications in a low-income community in South Africa. Method Three LHWs were trained to provide dual sensory screening using smartphone-based applications. The hearScreen app with calibrated headphones was used to conduct screening audiometry, and the Peek Acuity app was used for visual acuity screening. Schools were selected from low-income communities (Gauteng, South Africa), and children aged between 4 and 9 years received hearing and vision screening. Screening outcomes, associated variables, and program costs were evaluated. Results A total of 4,888 and 4,933 participants received hearing and vision screening, respectively. Overall, 1.6% of participants failed the hearing screening, and 3.6% failed visual acuity screening. Logistic regression showed that female participants were more likely to pass hearing screening ( OR = 1.61, 95% CI [1.11, 2.54]), while older children were less likely to pass visual acuity screening ( OR = 0.87, 95% CI [0.79, 0.96]). A third (32.5%) of referred cases followed up for air-conduction threshold audiometry, and one in four (25.1%) followed up for diagnostic vision testing. A high proportion of these cases were confirmed to have hearing (73.1%, 19/26) or vision loss (57.8%, 26/45). Conclusions mHealth technologies can enable LHWs to identify school-age children with hearing and/or vision loss in low-income communities. This approach allows for low-cost, scalable models for early detection of sensory losses that can affect academic performance.

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Section: Introductionmentioning

confidence: 99%

Community-Based Hearing and Vision Screening in Schools in Low-Income Communities Using Mobile Health Technologies

Manus

Linde

Kuper

et al. 2021

LSHSS

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“…This combination of VI and HI in an individual is called dual sensory impairment (DSI) 13 . A rapid assessment study of VI and HI conducted among 50 years or older population reported a DSI prevalence of 4.7% 14 . A community-based study from India identified that over one-third of the elderly had DSI 15 .…”

Section: Introductionmentioning

confidence: 99%

Depression, combined visual and hearing impairment (dual sensory impairment): a hidden multi-morbidity among the elderly in Residential Care in India

Marmamula

Kumbham

Modepalli

et al. 2021

Sci Rep

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To report the prevalence of depression and its association with combined visual (VI) and hearing impairment (HI) in the elderly in residential care in India. Participants aged ≥ 60 years were recruited from 41 homes. Data on personal and sociodemographic information were obtained. Visual acuity was measured using the logMAR chart. Patient Health Questionnaire (PHQ-9) was used to assess depression, and the Hearing Handicap Inventory for the Elderly Screening (HHIE) was administered to assess hearing status. Data of all 867 eligible elderly participants were analysed. The mean age of the participants was 74.2 years (standard deviation: 8.2 years) and included 537 (61.9%) women and 117 (13.5%) participants who had no education. The prevalence of depression was 60.0% (95% CI: 45.2–73.4) in the elderly with combined VI and HI compared to 20.9% (95% CI:14.4–28.8) among those with VI only and 37.8% (95% CI: 26.6–46.5) among those with HI only. On multiple logistic regression analyses, depression was approximately 5 times higher among the participants with DSI after adjusting for other covariates. Six out of ten elderly with combined HI and VI had depression highlighting the need for screening and referral when elderly present with combined vision and hearing loss.

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“…In addition, combined screening can be cost- and time efficient compared to conducting separate screenings. Only three studies indicated the time efficiency of a combined approach ( 11 , 19 , 20 ). For preschool and school-aged children, combined screening can be completed within ~3–8 mins ( 11 , 20 ).…”

Section: Discussionmentioning

confidence: 99%

“…A combined service can extend the value of available resources as the population groups most affected by hearing problems are often the same as those with the highest burden of vision problems, i.e., older adults and children of school-going age. Furthermore, using the same screening personnel may reduce time, and associated costs as screeners can receive combined training and share resources ( 19 ). Recent studies have demonstrated that identification and diagnosis of hearing and vision impairments is possible in community-based programs ( 11 , 20 ).…”

Section: Introductionmentioning

confidence: 99%

Combined hearing and vision screening programs: A scoping review

Oosthuizen

Frisby

Chadha

et al. 2023

Front. Public Health

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Background and aimThe World Health Organization (WHO) estimates that 1.5 billion and 2.2 billion people have hearing and vision impairment, respectively. The burden of these non-communicable diseases is highest in low- and middle-income countries due to a lack of services and health professionals. The WHO has recommended universal health coverage and integrated service delivery to improve ear and eye care services. This scoping review describes the evidence for combined hearing and vision screening programs.MethodA keyword search of three electronic databases, namely Scopus, MEDLINE (PubMed), and Web of Science, was conducted, resulting in 219 results. After removing duplicates and screening based on eligibility criteria, data were extracted from 19 included studies. The Joanna Briggs Institute Reviewer Manual and the Preferred Reporting Items for Systematic Reviews and Meta-analyzes (PRISMA) Extension for Scoping Reviews were followed. A narrative synthesis was conducted.ResultsMost studies (63.2%) were from high-income countries, with 31.6% from middle-income and 5.2% from low-income countries. The majority of studies (78.9%) involved children and the four studies reporting on adults all included adults above 50 years of age. Vision screening was most commonly performed with the “Tumbling E” and “Snellen Chart,” while hearing was typically screened using pure tone audiometry. Studies reported referral rates as the most common outcome with sensitivity and specificity rates not reported in any included articles. Reported benefits of combined vision and hearing screenings included earlier detection of vision and hearing difficulties to support functioning and quality of life as well as resource sharing for reduced costs. Challenges to combined screening included ineffective follow-up systems, management of test equipment, and monitoring of screening personnel.ConclusionsThere is limited research evidence for combined hearing and vision screening programs. Although potential benefits are demonstrated, especially for mHealth-supported programs in communities, more feasibility and implementation research are required, particularly in low- and middle-income countries and across all age groups. Developing universal, standardized reporting guidelines for combined sensory screening programs is recommended to enhance the standardization and effectiveness of combined sensory screening programs.

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Rationale and feasibility of a combined rapid assessment of avoidable blindness and hearing loss protocol

Cited by 9 publications

References 22 publications

Community-Based Hearing and Vision Screening in Schools in Low-Income Communities Using Mobile Health Technologies

Community-Based Hearing and Vision Screening in Schools in Low-Income Communities Using Mobile Health Technologies

Depression, combined visual and hearing impairment (dual sensory impairment): a hidden multi-morbidity among the elderly in Residential Care in India

Combined hearing and vision screening programs: A scoping review

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