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