Department of Speech-Language Pathology and Audiology, University of Pretoria, Lynnwood Rd, Hatfield, Pretoria, Gauteng, South Africa.
Ear Science Institute Australia, Subiaco, Australia.
BMC Pediatr. 2022 Jan 5;22(1):22. doi: 10.1186/s12887-021-03095-z.
The majority of children with sensory impairments live in low- and middle-income countries. More studies of hearing and vision impairment prevalence are needed, in order to generate more accurate estimates of trends in sensory impairments. This study aimed to estimate the prevalence and describe the characteristics of hearing and vision loss among preschool children (4-7 years) in an underserved South African community following community-based mobile health (mHealth) supported hearing and vision services.
A screening program of sensory impairments was undertaken of children attending preschools in the communities of Khayelitsha and Mitchell's Plain, Cape Town, from September 2017 until June 2019. Hearing and vision screening were done by trained community health workers using mHealth technology. Children who failed hearing and vision screening were seen for follow-up assessments at their preschools. Follow-up assessments were conducted using smartphones that host point-of-care validated and calibrated hearing and vision testing applications (hearTest app, hearX Group, South Africa and PeekAcuity app, Peek Vision, United Kingdom). Descriptive statistical analysis and logistic regression analysis were conducted after extracting data from a secure cloud-based server (mHealth Studio, hearX Group) to Microsoft Excel (2016).
A total of 10,390 children were screened at 298 preschools over 22 months. Of the children screened, 5.6 and 4.4% of children failed hearing and vision screening respectively. Community-based follow-up hearing tests were done at the preschools on 88.5% (514) of children of whom 240 children (54.2% female) presented with hearing loss. A preschool-based follow-up vision test was done on 400 children (88.1%). A total of 232 children (46.1% female) had a vision impairment, and a further 32 children passed the test but had obvious signs of ocular morbidity. Logistic regression analysis found that age was a significant predictor of vision loss (p < 0.05), but not for hearing loss (p = 0.06). Gender was not a significant predictor of hearing (p = 0.22) or vision loss (p = 0.20).
Hearing loss is prevalent in at least 22 per 1000 and vision loss in at least 23 per 1000 preschool children in an underserved South African community. Timely identification of sensory losses can be facilitated through community-based hearing and vision services supported by mHealth technology.
大多数有感官障碍的儿童生活在中低收入国家。为了更准确地估计感官障碍的趋势，需要更多的听力和视力障碍流行率研究。本研究旨在评估在一个服务不足的南非社区，通过基于社区的移动健康 (mHealth) 支持的听力和视力服务，对 4-7 岁学龄前儿童的听力和视力丧失的流行率和特征进行估计。
从 2017 年 9 月至 2019 年 6 月，对开普敦的 Khayelitsha 和 Mitchell's Plain 社区的学龄前儿童进行了感官障碍筛查计划。由经过培训的社区卫生工作者使用 mHealth 技术进行听力和视力筛查。未能通过听力和视力筛查的儿童在其幼儿园接受后续评估。使用托管了经过临床验证和校准的听力和视力测试应用程序（hearTest 应用程序，hearX Group，南非和 PeekAcuity 应用程序，Peek Vision，英国）的智能手机在幼儿园进行后续评估。从一个安全的基于云的服务器（mHealth Studio，hearX Group）提取数据到 Microsoft Excel（2016）后，进行描述性统计分析和逻辑回归分析。
在 22 个月内，对 298 所幼儿园的 10390 名儿童进行了筛查。在接受筛查的儿童中，分别有 5.6%和 4.4%的儿童听力和视力筛查失败。对 88.5%（514 名）的儿童在幼儿园进行了基于社区的后续听力测试，其中 240 名儿童（54.2%为女性）患有听力损失。对 400 名儿童（88.1%）进行了基于幼儿园的后续视力测试。共有 232 名儿童（46.1%为女性）视力受损，另有 32 名儿童通过了测试，但有明显的眼部疾病迹象。逻辑回归分析发现，年龄是视力丧失的一个显著预测因素（p<0.05），但不是听力丧失的预测因素（p=0.06）。性别不是听力（p=0.22）或视力丧失（p=0.20）的显著预测因素。
在一个服务不足的南非社区，至少有 22/1000 的学龄前儿童有听力损失，至少有 23/1000 的学龄前儿童有视力损失。通过基于社区的听力和视力服务，结合 mHealth 技术，可以更方便地及时发现感官丧失。
