International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK.
Department of Surgery, College of Medicine, Blantyre, Malawi.
Int J Audiol. 2020 Aug;59(8):574-582. doi: 10.1080/14992027.2020.1739764. Epub 2020 Mar 17.
(1) To test the feasibility of the Rapid Assessment of Hearing Loss (RAHL) survey protocol in Malawi (Ntcheu); (2) To estimate the prevalence and probable causes of hearing loss (adults 50+). Cross-sectional population-based survey. Clusters ( 38) were selected using probability-proportionate-to-size-sampling. Within each cluster, 30 people aged 50+ were selected using compact-segment-sampling. All participants completed smartphone-based audiometry (hearTest). Prevalence was estimated using WHO definitions (PTA of thresholds 0.5, 1, 2, 4 kHz in the better ear of >25 dB HL (any) and >40 dB HL (≥moderate)). Otoscopy and questionnaire were used to assess probable causes. Participants with hearing loss and/or ear disease were asked about care-seeking and barriers. Four teams completed the survey in 24 days. 1080 of 1153 (93.7%) participants were examined. The median time to complete the protocol was 24 min/participant. Prevalence of hearing loss was 35.9% (95% CI = 31.6-40.2) (any level); and 10.0% (95% CI = 7.9-12.5) (≥moderate). The majority was classified as probable sensorineural. Nearly one third of people (30.9%) needed diagnostic audiology services and possible hearing aid fitting. Hearing aid coverage was <1%. Lack of perceived need was a key barrier. The RAHL is simple, fast and provides information about the magnitude and probable causes of hearing loss to plan services.
(1) 在马拉维（恩特切乌）测试听力损失快速评估（RAHL）调查方案的可行性；(2) 估计听力损失（50 岁以上人群）的患病率和可能原因。横断面基于人群的调查。使用概率比例大小抽样选择集群（ 38）。在每个集群中，使用紧凑段抽样选择 30 名 50 岁以上的人。所有参与者都完成了基于智能手机的听力测试（hearTest）。使用世界卫生组织的定义（较好耳中阈值为 0.5、1、2、4 kHz 的听力损失率>25 dB HL（任何）和>40 dB HL（≥中度））估计患病率。耳镜检查和问卷调查用于评估可能的原因。有听力损失和/或耳部疾病的参与者被问及寻求护理和障碍。四支队伍在 24 天内完成了调查。在 1153 名参与者中，有 1080 名接受了检查。完成方案的中位数时间为 24 分钟/参与者。听力损失的患病率为 35.9%（95% CI = 31.6-40.2）（任何程度）；10.0%（95% CI = 7.9-12.5）（≥中度）。大多数被归类为可能的感音神经性。将近三分之一的人（30.9%）需要诊断性听力学服务和可能的助听器适配。助听器的覆盖率<1%。缺乏感知需求是一个关键障碍。RAHL 简单、快速，可提供有关听力损失程度和可能原因的信息，以规划服务。
