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. 2024 Nov 5;8(1):e002794. doi: 10.1136/bmjpo-2024-002794

Table 2. Hearing screening programmes for older children in non-Asian low-income and middle-income countries.

Citation First author and year Country Age in years No of samples screened Service delivery model (hospital/community/school) Use of ICT in any phase of model Screening test/tool used (stage 1+
stage 2+
stage 3)
Person performing screening Person performing diagnostic evaluation Diagnostic test used Site of diagnostic testing Intervention details (medical/surgical/rehab) Refer rate Identification rate Rehab rate
Sub-Saharan Africa
69 Eksteen et al, 2022 South Africa - Sub-Saharan Africa (UMI) 4–7 years 10 390 Community mHealth app-based screening Cloud-based data storage management PTA screening (HearScreen) CHWs Audiologist Otoscopy, PTA School HA, medical management, Healthcare centre 5.6% 2.30% NA
28 Shinn et al, 2021 Kenya - Sub-Saharan Africa (LMI) 2–16 years 127 School No PTA screening (HearScreen) Teachers NA NA NA NA 20% 6.20% NA
70 Dawood et al, 2020 South Africa - Sub-Saharan Africa (UMI) 3–10 years 6805 School mHealth app-based screening Cloud storage data management PTA screening (HearScreen) Nurses, CHWs NA NA NA NA 3–5 years: 7.6% 6–10 years: 4% NA NA
65 Larsen-Reindorf et al, 2019 Ghana - Sub-Saharan Africa (LMI) 3–15 years children 341 Community mHealth based screening LittleEars auditory questionnaire/otoscopy/PTA screening (Shoebox tablet audiometer) Audiology students, audiologist Audiologist NA Hospital Medical management (wax removal) 2.2% 1.1% (0.4% CHL, 0.7% SNHL) NA
39 Shinn et al, 2019 Kenya - Sub-Saharan Africa (LMI) 2–16 years children 104 School mHealth app-based screening PTA screening (HearX) CHWs Audiologist NA NA NA 7% NA NA
66 Yancey et al, 2019 Kenya - Sub-Saharan Africa (LMI) 5–16 years (suspected with HI) 155 School Cloud storage data management (Electronic medical record) Video otoscopy/PTA screening Nurses, CHWs CHWs monitored by ENT doctors PTA NA Medical and surgical management, Hospital 18% 10% NA
58 Eksteen et al, 2019 South Africa - Sub-Saharan Africa (UMI) 4–7 years 8023 School mHealth app-based screening Cloud storage data management PTA screening (HearScreen)+
Otoscopy
CHWs, Audiologist Audiologist PTA NA HA, spectacles, medical management, Public health services 5.4% 0.70% NA
43 Osei et al, 2018 Ghana - Sub-Saharan Africa (LMI) 5–17 years 210 School No Otoscopy/PTA screening Audiologist, Audiology technician NA NA NA Medical management (wax removal, middle ear pathology management) 21% 11.90% NA
31 Jayawardena et al, 2018 Kenya - Sub-Saharan Africa (LMI) Any age group 174 ears from 87 patients Community screening (head and neck surgical mission) No Otoscopy/PTA screening Nurses, CHWs Nurses, CHWs PTA NA NA NA 61.43% NA
29 Govender et al, 2018 South Africa - Sub-Saharan Africa (UMI) 6–12 years 146 School screening No Otoscopy/PTA screening (Kuduwave automated audiometry) + tymp Trained non-specialist Audiologist PTA NA NA NA 16% (12% unilateral, 4% bilateral) NA
59 Yousuf Hussein et al, 2018 South Africa - Sub-Saharan Africa (UMI) 3–6 years 6424 Community Asynchronous screening Cloud-based data storage management PTA screening+PTA screening (HearScreen) CHWs NA NA Local clinic NA 40.5% NA NA
71 Yousuf Hussein et al, 2018 South Africa - Sub-Saharan Africa (UMI) Preschool children 6424 Community (early childhood development centres) mHealth app-based screening Cloud-based data management PTA screening (HearScreen) CHWs Audiologist NA Local clinic Medical management (wax removal) 24.9% 18.7% (65.2% CHL, 28.2% SNHL, 6.5% MHL) 9.3% were treated for cerumen
60 Tataryn et al, 2017 Malawi - Sub-Saharan Africa (LI) School children 7220 Community Yes (no information) Less than 5 - questionnaire+OAE More than 5 - PTA screening+
otoscopy
ENT clinical officer, Audiologist NA NA NA NA NA 27% NA
67 Hunt et al, 2017 Malawi - Sub-Saharan Africa (LI) 4–6 years 281 Community mHealth app-based screening Questionnaire/video otoscopy/PTA screening (HearScreen) ENT clinical officer Trained non-specialist monitored by ENT doctors NA Tertiary hospital Medical management (wax removal) NA 46% (24.5% unilateral, 12.5% bilateral) NA
72 Mahomed Asmail et al, 2016 South Africa - Sub-Saharan Africa (UMI) Grade 1–3 children 1070 School No (Otoscopy/PTA screening/tymp) Audiology students Audiologist PTA NA NA 11.6% 2.20 (57.1% CHL, 22% MHL, 20% SNHL, 37.1% unilateral, 31.4% bilateral) NA
40 Simões et al, 2016 Kenya - Sub-Saharan Africa (LMI) 2–15 years 13 109 School No (Otoscopy/tymp) + PTA screening ENT clinical officer ENT clinical officer PTA School Surgical management (perforated ear drums), HA NA 1.50% NA
41 Adedeji et al, 2015 Nigeria - Sub-Saharan Africa (LMI) 1–15 years age children with HL 223 Hospital No PTA screening/AABR NA NA PTA, ABR Hospital CI for profound HI, HA fitting with auditory and speech training, 20.6% had enrolled at school for the deaf 67.% NA Less than 5% had HA followed by auditory and speech training
73 Govender et al, 2015 South Africa - Sub-Saharan Africa (UMI) Grad1 toddlers 378 School No (Otoscopy/PTA screening/tymp) Audiology students Audiologist NA Hospital Medical management (wax removal, middle ear pathology management) NA NA NA
30 Cloete et al, 2015 South Africa - Sub-Saharan Africa (UMI) 6–7 years 100 School No DPOAE screening Nurses Audiologist PTA Hospital NA NA NA
68 Adebola et al, 2013 Nigeria - Sub-Saharan Africa (LMI) 3.5–6 years 101 School No Otoscopy/PTA screening ENT doctor, Audiologist NA NA NA Medical management (wax removal, middle ear pathology management) 21.3% NA Improved to 88.6% otoscopic pass rate after ENT intervention
Latin America and Caribbean
61 Urban et al, 2022 Dominican Republic - Latin America and Caribbean (UMI) 5–7 years 528 Hospital No (Otoscopy/PTA screening) + (DPOAE/tymp) Audiology students NA NA NA Medical management (myringotomy, pressure equalising tubes), HA candidacy assessment, Hospital 3.8% 1.90% NA
44 Jayawardena et al, 2020 Haiti - Latin America (LI) 5–18 years 127 School screening No PTA screening CHWs NA PTA, otoscopy NA NA 25% NA NA
62 Magro et al, 2019 Nicaragua - Latin America (LMI) School children 120 School mHealth based screening PTA screening+PTA screening (WAHTS - automated/manual) Audiometric technician Audiometric technician NA Hospital NA NA 5% NA
63 Samelli et al, 2012 Brazil - Latin America and Caribbean (UMI) 3–6 years 507 School No Questionnaire+tymp NA NA NA NA NA 38.7% NA NA
42 Samelli et al, 2011 Brazil - Latin America and Caribbean (UMI) 2–10 years 214 Community No Questionnaire/otoscopy/PTA screening/tymp NA NA NA NA NA NA 46% (39.2% CHL, 7.48% SNHL) NA
Middle East and North Africa
74 Elbeltagy et al, 2020 Egypt - Middle east and North Africa (LMI) 6–9 years) 100 School No PTA screening/tymp/SIFTER questionnaire NA NA PTA Hospital NA NA 23% (17% CHL, 6% SNHL, 7% Unilateral, 6% bilateral) NA
64 Mahmoud et al, 2016 Egypt - Middle east and North Africa (LMI) 4–7 years 4500 School No Otoscopy/PTA screening/tymp) + (otoscopy/PTA screening/tymp) Audiologist Audiologist PTA, ABR Hospital NA 20% 5.80% NA

AABRautomated auditory brainstem responseABRauditory brainstem responsesCHLconductive hearing lossCHWcommunity health workersCIcochlear implantationDPOAEDistortion Product Otoacoustic EmissionsHAhearing aidsHIhearing impairmentLIlow incomeLMIlower middle incomeMHLmixed hearing lossNAnot availablePTApure tone audiometrySNHLsensorineural hearing lossTymptympanometryUMIupper middle income