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10/27/2018  |   2:00 PM - 3:00 PM   |  Kramer Lecture Theater 3

Large-scale screening and linkage into care for hearing related diseases in at-risk populations

At-risk populations around the world have an understudied burden of both congenital and acquired hearing loss and hearing related disease. South Africa represents a unique opportunity to better study and understand the ideal approaches to extending care to at-risk populations given the existing robust health care infrastructure which is juxtaposed with a profound burden of disease. We report our experiences in addressing chronic ear disease in South Africa and in improving and adapting screening modalities for hearing related disease for at-risk populations. This includes the recent screening of 1500 children for hearing related disease in a peri-urban township which we completed in 5 days. This large scale screening protocol uses lay personnel to administer screening under the direct or remote supervision of an audiologist or ENT surgeon and increased the number of children screened in this township dramatically. By comparison, the clinicians charged with screening this population as a subset of a much larger demographic, are able to screen only ~150 of the highest risk children a year due to the limited number of audiologists who cover this region. We found a significant burden of undiagnosed disease, including cholesteatoma, CSOM, and moderate to profound deafness that will benefit from early identification and intervention. By partnering directly with the audiologists and clinicians, we were able to link these children into care and optimize the number of high risk children being seen by the audiologist and ENT. This demonstrates the utility of using lay-personnel for the screening of at-risk populations. This methodology is generalizable and could assist in meeting the goals of universal hearing screening for children in a cost effective and robust way.

  • How to provide high-quality hearing screening using lay-personnel trained in objective screening methodologies
  • How to adapt to local infrastructure and need using a multi-disciplinary approach
  • The importance of partnering with local clinician to optimize screening and ensure linkage into care.

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J. Zachary Porterfield (Primary Presenter), tba, zach.porterfield@yale.edu;


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Financial - No relevant financial relationship exists.