Mhealth hearing screening for children by non-specialist health workers in communities

Abstract

Objectives To compare outcomes of a community-based hearing screening programme using smartphone screening audiometry operated by specialist (School Health Nurses – SHNs) and non-specialist health workers (Community Health Workers – CHWs) in school children. Design This study used a two-group comparison of screening outcomes as conducted by SHNs and CHWs using smartphone screening for children in communities. Study sample The study included 71 CHWs and 21 SHNs who conducted community-based hearing screening on 6805 children. One thousand one hundred and fifteen hearing screening tests were conducted by the CHWs and 5690 tests by the SHNs. Results No significant difference in screening outcome was evident between CHWs and SHNs using a binomial logistic regression analysis considering age, test duration and noise levels as independent variables. Final screening result was significantly affected by age (p < 0.005), duration of test (p < 0.005) and noise levels exceeding at 1 kHz in at least one ear (p < 0.005). Test failure was associated with longer test duration (p < 0.005; B: 119.98; 95% CI: 112.65–127.30). CHWs had significantly (p < 0.005) longer test durations (68.70 s; 70 SD) in comparison to SHNs (55.85 s; 66.1 SD). Conclusion Low-cost mobile technologies with automated testing facilitated from user-friendly interfaces allow minimally trained persons to provide community-based screening comparable to specialised personnel.