Sebothoma Ben, Khoza-Shangase Katijah, Masege Dipuo, Mol Duane
Department of Speech Pathology and Audiology, School of Human and Community Development, Faculty of Humanities, University of the Witwatersrand, Private bag X3, Wits, Johannesburg, 2050 South Africa.
Department of Otorhinolaryngology Head and Neck Surgery, Baragwanath Academic Hospital, Johannesburg, South Africa.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):3118-3125. doi: 10.1007/s12070-021-02836-x. Epub 2021 Sep 5.
Coronavirus disease (COVID-19) pandemic is the latest threat to global health that causes severe acute respiratory syndrome (SARS). Tele-practice has inadvertently sprung to the forefront to become a common practice amongst healthcare providers during COVID-19. Limited evidence exists on the use of tele-practice in assessing middle ear function in adults living with HIV during the COVID-19 pandemic. The aims of this study were to investigate the use of tele-practice for assessment of middle ear function in adults with HIV during the COVID-19 pandemic. A quantitative observational, cross-sectional design was adopted. A total of 134 adults diagnosed with HIV were purposively selected from the HIV clinic. An audiology researcher, in the role of site-facilitator, captured video otoscopic images of the tympanic membrane using a video otoscopy for all participants through asynchronous tele-practice. All captured images were sent to two independent otorhinolaryngologists for diagnosis. Findings of this study indicated that tele-practice can be used to assess middle ear function in adults living with HIV during COVID-19 pandemic. When asynchronous tele-practice was used, there was a moderate diagnostic agreement (k = 0.58) between the two otorhinolaryngologists on abnormality versus normality, but poor agreement (k = 0.15) on the nature of abnormality (e.g. OME vs CSOM). Current findings highlight the urgent need for a widespread use of tele-practice during the continued clinical follow up and management of adults living with HIV, and the implementation of tele-practice, particularly in low- and middle-income countries (LMICs) where capacity versus demand challenges related to ear and hearing care continue to exists.
冠状病毒病（COVID-19）大流行是对全球健康的最新威胁，会导致严重急性呼吸综合征（SARS）。远程医疗在不经意间走到了前沿，成为COVID-19期间医疗服务提供者之间的一种常见做法。关于在COVID-19大流行期间使用远程医疗评估感染艾滋病毒的成年人中耳功能的证据有限。本研究的目的是调查在COVID-19大流行期间使用远程医疗评估感染艾滋病毒的成年人中耳功能的情况。采用了定量观察性横断面设计。从艾滋病毒诊所中有意选取了134名被诊断为感染艾滋病毒的成年人。一名听力学研究人员担任现场协助人员，通过异步远程医疗，使用视频耳镜为所有参与者拍摄鼓膜的视频耳镜图像。所有拍摄的图像都被发送给两名独立的耳鼻喉科医生进行诊断。本研究结果表明，在COVID-19大流行期间，远程医疗可用于评估感染艾滋病毒的成年人的中耳功能。当使用异步远程医疗时，两名耳鼻喉科医生在异常与正常方面的诊断一致性中等（k = 0.58），但在异常性质（如中耳炎与慢性化脓性中耳炎）方面的一致性较差（k = 0.15）。当前研究结果凸显了在对感染艾滋病毒的成年人进行持续临床随访和管理期间广泛使用远程医疗的迫切需求，以及实施远程医疗的必要性，特别是在低收入和中等收入国家（LMICs），那里与耳和听力保健相关的能力与需求挑战仍然存在。
