EARLY HEARING DETECTION AND INTERVENTION VIRTUAL CONFERENCE
MARCH 2-5, 2021

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10/28/2018  |   9:30 AM - 10:30 AM   |  Improving Pre-school Hearing Screening Outcomes: Community-based First Line Follow-up Services   |  Kramer Lecture Theater 2

Improving Pre-school Hearing Screening Outcomes: Community-based First Line Follow-up Services

mHealth supported community-based programmes have proven to increase access to screening in developing contexts. Outcomes are often compromised due to low follow-up rates resulting from socio-economic barriers. This study investigated community-based first line follow-ups as an alternative to improve programme outcomes. Hearing screening targeting pre-school children implemented at Early Childhood Development Centres (ECDs) in underserved communities in Cape Town is being evaluated. Those referring the screening are seen by an audiologist for first line follow-up, including otoscopic examination and air-conduction threshold testing (hearTest mHealth application), at their ECD within 2 weeks. Diagnostic referrals to governmental audiology services are made based on the results. First line follow-up return rates for children seen at their ECDs is 91,5% compared to 39% achieved in an earlier pilot where children had to attend first follow-up appointments at clinics. Of all the children subsequently referred for diagnostic appointments at the government hospital, 74,1% attended their appointments. Of these children, 54% were diagnosed with a hearing loss compared to 36% of referred children in the pilot project. Decentralized first line follow-up, significantly increases follow-up return rates and positively impacts overall programme outcomes. This can be facilitated by utilizing the same mHealth devices used in the screening phase – contributing to programme affordability and sustainability. Integration of first line follow-up validates referrals - ensuring that diagnostic centres are not over-burdened.

  • Understand how community-based first line follow-up services can improve pre-school hearing screening outcomes.
  • Describe a service-delivery model that provides first line follow-up services in the community.
  • Understand how community-based first line follow-up services validates referrals to diagnostic centres.

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Presenters/Authors

Tersia de Kock (), HearX group, tersia@hearxgroup.com;
Tersia de Kock is a South African audiologist who is passionate about the development of hearing healthcare services in developing contexts. She completed her Master’s degree in this field (2016) with a focus on infant hearing screening services. In 2017, Tersia joined the hearX Group, an innovative start-up with a vision to impact the 1.2 billion globally who suffer hearing difficulties, by providing affordable access and linkage to hearing health. As project manager she oversees the development, implementation and scaling of various community-based programmes.


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Susan Eksteen (), Carel du Toit Centre, audiologist@careldutoit.co.za;
Susan is a qualified Audiologist and Speech-language Therapist. She completed her masters degree in Audiology at the University of Pretoria. She has acquired extensive clinical skills in both the public and private sector in South Africa working with children and adults. She is currently employed in her dream position as a paediatric audiologist at the Carel du Toit Centre, Cape Town. She conceptualised, implemented and manages a sustainable world first mHealth supported community based programme in collaboration with the HearXGroup and Hear The World Foundation. This programme screens the hearing and vision of 5 to 6 year old children in underserved communities (Ears and Eyes for Education- the 3E project). Susan's keen interest in global health and equitable access to health services also makes her an invaluable member during Operation Smile missions.


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De Wet Swanepoel (), University of Pretoria, Pretoria , South Africa; Ear Sciences Centre, School of Surgery , The University of Western Australia, Nedlands , Australia; Ear Science Institute Australia , Subiaco , Australia; Callier Center for Communication Disorders , University of Texas at Dallas , USA, dewet.swanepoel@up.ac.za;
De Wet Swanepoel is professor in audiology at the University of Pretoria, South Africa and a senior research fellow at the Ear Science Institute Australia with adjunct positions at the University of Texas at Dallas and the University of Western Australia. He has published more than 100 peer-reviewed articles, books and book chapters and has received numerous awards in recognition of his work. His research capitalises on the growth in information and communication technologies to explore, develop and evaluate innovative solutions to improve access to ear and hearing health care. He is lead inventor of the award winning and patented hearScreenTM smartphone hearing test. Prof Swanepoel also serves as associate editor for the International Journal of Audiology, as president-elect for the International Society of Audiology and as co-chair for the telehealth task force of the American Academy of Audiology.


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