SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS最新文献

Background:  Hearing aid verification is required to objectively measure hearing aid outputs by ensuring that the amplified speech spectrum closely approximates the prescription goals.

Objectives:  This study aimed to determine audiologists' perceptions and practices regarding hearing aid verification and identify facilitators and barriers to its use.

Method:  A cross-sectional national e-survey included questions related to demographics, perceptions of verification, verification practices and two open-ended questions regarding the facilitators and barriers to conducting hearing aid verification in South Africa.

Results:  Seventy-eight South African audiologists, with experience ranging from less than a year to 34 years, completed the online survey. Of these, 76.3% conduct hearing aid verification, while 23.7% seldom or never perform this verification. Among the audiologists who conducted verification, 81.0% reported performing it on both adults and children. More than three-quarters (86.6%) indicated that they conduct verification only during the initial fitting, while half (53.8%) do so only when a problem arises. Thematic analysis revealed the following barriers to verification: improper equipment, a lack of equipment, non-standard clinical practices and time constraints.

Conclusion:  There are several challenges faced by South African audiologists in performing verification. It may be feasible to address these barriers by raising awareness about the value of verification, offering training, and advocating for the purchase and utilisation of verification equipment.Contribution: This study's findings provide information on the current practices of hearing aid verification in a socioeconomically diverse setting. Furthermore, it highlights important challenges such as a lack of equipment as well as time constraints.

Background:  Hearing loss in children is a global concern. Early identification and intervention are critical for minimising the adverse effects of hearing loss. Despite the implementation of hearing screening programmes in Saudi Arabia, more research is needed on the audiological profiles of first-grade students.

Objectives:  This study aimed to characterize the audiological profile of first-grade students in Saudi Arabia and to raise awareness among parents, schools, and decision-makers about the need for hearing screening programs and the implementation of an effective monitoring and management system in the country.

Method:  This cross-sectional descriptive study assessed the audiological profile of 308 first-grade students in Riyadh, the capital of Saudi Arabia, using pure-tone audiometry (PTA) and tympanometry. Additionally, two questionnaire-based assessments, one for parents and one for the home teacher, were developed to predict students who failed PTA.

Results:  Among the students screened, 26.3% failed PTA. Tympanometry identified abnormal middle ear function in 30.5% of the students. The discrimination capacity of both questionnaires in identifying students who failed PTA screening was poor.

Conclusion:  A 26.3% prevalence rate of PTA screening failure, and a 30.5% of middle ear pathologies were noted. Both parent and teacher questionnaires were ineffective tools for identifying hearing loss among first-grade children who failed PTA screening.Contribution: This pilot study recommends that primary schools incorporate hearing screening as a regular practice of their preventative healthcare system. The study emphasises the importance of establishing international standards for school-based hearing screening to enhance its efficacy and develop more effective hearing screening questionnaires.

Background:  Platinum-based chemotherapy poses a risk of ototoxic hearing loss, the effects of which can be devastating in paediatrics with cancer. Childhood hearing loss significantly impacts speech and language acquisition, and educational, psychosocial and emotional development, consequently negatively impacting quality of life. Adequate knowledge and effective management by healthcare professionals in the team managing paediatrics with cancer are, therefore, pivotal to mitigating the severity and impact on quality of life.

Objectives:  To describe the knowledge and practices of healthcare professionals on the management of ototoxic hearing loss in children receiving platinum-based chemotherapy drugs.

Method:  Using a descriptive survey design, data were collected from self-administered questionnaires completed by 74 healthcare professionals from two hospitals in KwaZulu-Natal, South Africa.

Results:  While 45 participants (60.8%) identified ototoxicity as a side effect of platinum-based chemotherapeutic drugs, 43 (58.1%) identified dose, duration and mode of administration as risk factors, and 43 participants (72.9%) did not know the duration of an ototoxicity monitoring programme post-treatment. Fifty participants (68%) accurately identified most of their roles within the ototoxicity monitoring programme. Most participants (n = 73; 99%) did not fully adhere to Health Professions Council of South Africa (HPCSA) ototoxicity monitoring guidelines. However, a positive outcome was that 70 participants (94.6%) acknowledged the importance of the ototoxicity monitoring programme for children receiving platinum-based chemotherapy.

Conclusion:  The current study demonstrates a clear correlation between healthcare professionals' practices and their level of knowledge. These findings underscore the importance of improving the knowledge base of healthcare professionals involved in ototoxicity monitoring programme to enhance their practices effectively.Contribution: This study identified areas requiring improvement in managing ototoxicity in this patient group, prompting the inclusion of ototoxicity training. This study supports audiologists in effectively implementing and overseeing ototoxicity monitoring programme.

Background:  In South Africa, the prevalence of tinnitus and its associated clinical and audiological characteristics remain underexplored, posing challenges in the assessment and management of the condition. This knowledge gap affects clinician preparedness and effectiveness in treating tinnitus.

Objectives:  This study aimed to explore the clinical and audiological characteristics of adult patients reporting tinnitus at a tertiary academic hospital in South Africa.

Method:  A quantitative, non-experimental, retrospective review of 129 patient audiological records from the Audiology Department at Helen Joseph Hospital was conducted. Among these, 71 records were of patients who reported experiences of tinnitus.

Results:  Tinnitus was reported by 55% of patients, with a higher prevalence in females (76%). The mean age of patients was 51.9 years. Unilateral tinnitus was present in 28% of cases, while 78% of patients had hearing loss, predominantly sensorineural. Common audiological characteristics included vertigo (24%), otalgia (14%), otorrhea (17%) and perforated tympanic membrane (15%). Clinical conditions associated with tinnitus included hypertension (32%), heart disease (28%), diabetes (9%) and head trauma (9%). Findings regarding age and gender differences in the clinical and audiological manifestations of tinnitus are presented.

Conclusion:  Further research with larger, diverse samples and prospective designs is necessary to confirm these findings and explore possible underlying causes.Contribution: The findings highlight the significant prevalence of tinnitus and its association with various clinical and audiological conditions in the South African context. Understanding these characteristics will enhance the clinician's ability to accurately assess, diagnose and manage tinnitus, leading to improved treatment outcomes.

Background:  Community-based universal newborn hearing screening (UNHS) has not been fully realised in South Africa despite the availability of contextually relevant early hearing detection and intervention guidelines. Research has confirmed the feasibility of implementing UNHS programmes in urban contexts; however, limited information exists for rural contexts.

Objectives:  The aim of the study was to describe the outcomes in terms of coverage rate, referral rate and follow-up rate of a 1-year UNHS pilot programme implemented at three primary health care (PHC) clinics in the Limpopo province.

Method:  A descriptive retrospective review of 2 302 audiological records of infants who underwent NHS between July 2014 to June 2015 was conducted.

Results:  The mean age at first-stage screen was 112 days (16 weeks). The coverage rate was 87% for the infants screened at 3- and 10- days clinic visits and 27% for infants screened at the 6-week immunisation visit. The first-stage referral rate was 33.9% and 8.3% for the overall second stage referral for diagnostic audiology services. The follow-up rate for rescreens at the clinical level was 77%, while for initial diagnostic assessments, it was 26%.

Conclusion:  Although not all benchmarks were met within the first year of implementation, the high coverage- and low referral rates, especially in the last 6 months, are the first steps in improving the outcomes of the screening programme.Contribution: The findings confirm the feasibility of implementing community-based UNHS programmes in rural areas in South Africa. Regular monitoring and evaluation contribute to the success of screening programmes.

Adhering to Early Hearing Detection and Intervention (EHDI) guidelines is critical for the timely identification and management of infants with hearing impairment. Early intervention specifically focusses on family-centred communication interventions, of which the Listening and Spoken Language-South Africa (LSL-SA) approach is available for children with hearing impairment in South Africa. Studies have evidenced significant benefits for children with hearing impairment enrolled in LSL-SA compared to those enrolled in Traditional Speech-Language Therapy (TSLT), that is, age-equivalent communication outcomes, shorter duration of therapy until discharge, meritorious academic performance and integration into a hearing society. Despite these positive outcomes related to the LSL-SA approach, significant contextual barriers hinder effective implementation nationwide.Contribution: The successful implementation of EHDI guidelines in South Africa hinges on overcoming barriers through tailored healthcare strategies and contextualised delivery. Adapting frameworks such as LSL-SA to fit the local context is crucial for advancing equitable access to EHDI services, positively impacting children with hearing impairment and their families. This article highlights the systemic challenges in South Africa in optimising resources by adopting linguistically appropriate and culturally responsive early intervention approaches to champion hearing healthcare initiatives. Effective collaboration among diverse stakeholders is essential for enhancing the uptake of EHDI guidelines and translating policy into impactful communication interventions. Implementing the core principles of the LSL-SA approach will not only ensure access to this specialised service for suitable candidates but may also alleviate specific barriers to EHDI implementation within TSLT approaches.

Background:  Animal audiology utilizes brainstem auditory evoked responses (BAER) as a non-invasive tool to assess hearing in animals, including Holstein dairy cows. Understanding cows' auditory capabilities is critical for their welfare, especially given their exposure to farm noise.

Objectives:  This study provides preliminary normative BAER data for Holstein cows by focusing on absolute and interpeak wave latencies. The objective is to assess the impact of farm noise and expand audiologists' practice scope.

Method:  Ten Holstein cows were tested using monoaural broadband click stimuli with contralateral masking. Earphones with foam ear tips were used to minimize environmental noise interference. The BAER responses were recorded via subdermal needle electrodes placed at standardized locations on the cows' heads. The data were analysed using descriptive statistics to determine auditory thresholds and wave latencies.

Results:  The cows exhibited auditory thresholds at 90 dB SPL (55 dB nHL). Detailed wave and interpeak latencies were recorded at intensities from 85 to 105 dB SPL. At 90 dB SPL, the average latency for wave V was 5.17 ms, marking the auditory threshold for Holstein cows.

Conclusion:  These findings provide key insights into the auditory sensitivity of Holstein cows, highlighting BAER's potential for monitoring auditory health and evaluating the effects of noise pollution on animal welfare. This research underscores the value of integrating animal audiology into the audiologist's scope, ultimately enhancing both animal welfare and farming sustainability.Contribution: This study adds to the limited literature on farm animal auditory health and suggests strategies to improve welfare through better auditory management.

Background:  Hyperbilirubinaemia is a contributing condition to the prevalence of neonatal hearing loss. Because of its pathophysiology, the use of Otoacoustic Emissions (OAE) and Automated Auditory Brainstem Response (AABR) testing is essential in diagnosing hearing loss. Two-tier screening models are typically used in developing world contexts; however, a combined approach to testing (using both tests) should be used for early detection. Blood serum levels should also be monitored to determine how they impact audiological test results.

Objectives:  To determine the outcomes of using a combined testing approach of both OAE and Auditory Brainstem Response (ABR) for both screening and diagnostic testing of neonates with hyperbilirubinaemia and studying the relationship between the test results and the serum bilirubin levels.

Method:  A cross-sectional, comparative design was utilised. Forty neonates were tested (80 ears). Neonates underwent hearing screening and diagnostic testing (ABR and/or AABR and DPOAE tests). The study was conducted at a hospital in South Africa.

Results:  One-third (32.5%) of the neonates had comorbidities. Screening results indicated that the AABR test could identify more cases of abnormalities than DPOAEs (p = 0.001). Participants with a serum level greater than 10 mg/dL presented with abnormal diagnostic ABR test results while passing the DPOAE test (p  0.001).

Conclusion:  Combined use of ABR and DPOAE testing yielded a greater identification of auditory pathology than using either test alone. Serum bilirubin levels can be used as an indicator for combination testing.Contribution: Combined use of ABR and DPOAE testing leads to greater identification of auditory pathology.

Background:  Public awareness of auditory pathologies, has been explored in the literature. However, there is limited evidence regarding public awareness of middle ear pathologies and their risk factors in South African communities.

Objectives:  The aim of this study was to describe public awareness regarding middle ear pathologies and their associated risk factors in the community of Giyani, Limpopo province, South Africa.

Method:  A quantitative cross-sectional survey design was conducted among 94 adults aged 18 years and older living in Giyani, Limpopo province. A questionnaire was used to collect data. Descriptive statistics was used to summarise the data, while a Chi-squared test was used to determine if there is any association between awareness and independent variables with categorised outcomes.

Results:  Adults aged between 18 and 65 years participated in this study. Most participants were aware of aural itchiness (71.3%) and pain (35%) as symptoms related to middle ear pathologies. The use of cotton buds (51.1%) and other illnesses (35.5%) were primarily reported as risk factors for middle ear pathologies. There were varied responses with regard to awareness of which professionals manage middle ear pathologies, indicating a general lack of awareness. No statistically significant association was found between the dependent and independent variables (p  0.005).

Conclusion:  The study indicated a general lack of public awareness regarding middle ear pathologies and their associated risk factors among Giyani community.Contribution: The study raises implications for public awareness campaign that educates communities about middle ear pathologies, risk factors and social determinants of health associated with these pathologies.