Subscribe to RSS
DOI: 10.3766/jaaa.17059
Interregional Newborn Hearing Screening via Telehealth in Ghana
Publication History
01 May 2017
24 December 2017
Publication Date:
26 May 2020 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00046128/201903/lookinside/thumbnails/10-3766-jaaa-17059_00178-1.jpg)
Abstract
Background:
Newborn hearing screening is a vital aspect of the Early Hearing Detection and Intervention program, aimed at detecting hearing loss in children for prompt treatment. In Ghana, this kind of pediatric hearing service is available at only one health care facility located in the Greater Accra Region. The current practice in effect has virtually cut-off infants in the other regions from accessing hearing screening and other pediatric audiological services. This has prompted a study into alternative methodologies to expand the reach of such services in Ghana. The present study was designed to assess the feasibility of using telehealth to deliver newborn hearing screening across Ghana.
Purpose:
To assess the feasibility of using telehealth to extend newborn hearing screening services across the ten regions of Ghana.
Research Design:
A correlational study was designed to determine the extent of association between test results of telehealth and the conventional on-site methods (COMs) for conducting newborn hearing screening. The design also allowed for testing duration between the two methods to be compared.
Study Sample:
Fifty infants from the Brong-Ahafo Regional Hospital (BARH) were enrolled. The infants aged between 2 and 90 days were selected through convenience sampling. There were 30 males and 20 females.
Procedure:
Newborn hearing screening using distortion product otoacoustic emissions were performed via telehealth. By adopting the synchronous telehealth model, an audiologist located at the Korle-Bu Teaching Hospital conducted real-time hearing screening tests over the internet on infants who were at the BARH. The former and latter hospitals are located in the Greater Accra and the Brong-Ahafo Regions, respectively. As a control, similar hearing screening tests were conducted on the same infants at BARH using the conventional face-to-face on-site hearing screening method.
Data Collection and Analysis:
The test results and testing duration of the telehealth method and the conventional on-site approach were compared and subjected to statistical analysis. Here, the Spearman’s correlation coefficient (r s) was used to determine the level of correlation between the test results, whereas the paired t-test statistic was used to test the level of significance between the testing duration of the two methods.
Results:
Analysis of the test results showed a significantly high positive correlation between the telehealth and the COMs (r s = 0.778, 0.878, 0.857, 0.823, p < 0.05 @ 2.0, 3.0, 4.0, and 5.0 kHz respectively). Also, the difference in testing duration of the two methods was not statistically significant [t (99) = 1.309, p > 0.05]. The mean testing duration (in seconds) of telehealth was 27.287 (standard deviation = 27.373) and that of the COM was 24.689 (standard deviation = 27.169).
Conclusion:
The study showed the feasibility of establishing an interregional network of newborn hearing screening services across Ghana using telehealth. It is more efficient to deploy telehealth for pediatric hearing services than to have patients travel many hours to the Greater Accra Region for similar services. Poor road network, high transportation costs, and bad weather conditions are a few of the reasons for avoiding long distance travel in Ghana.
Key Words
Africa - audiology - Brong-Ahafo Regional Hospital - childhood hearing loss - distortion product otoacoustic emissions - distortion product otoacoustic emissions screening - Ghana - hearing screening - infant hearing screening - Korle-Bu Teaching Hospital - newborn hearing screening - otoacoustic emissions screening - sub-Saharan Africa - synchronous telehealth model - tele-audiology - telehealth - telemedicine-
REFERENCES
- Afari-Kumah E, Addo H. 2010 Understanding Contextual Issues in the Adoption of ICT in Health: The Case of Telemedicine in Ghana Accra Institute of Technology/Open University of Malaysia, Greater Accra Region, Ghana
- Choi J, Lee H, Park C, Oh S, Park K. 2007; PC-based tele-audiometry. Telemed E Health 13 (05) 501-508
- Elangovan S. 2005; Telehearing and the internet. Semin Hear 26: 19-25
- Ferrari DV, Bernardez-Braga GRA. 2009; Remote probe microphone measurement to verify hearing aid performance. J Telemed Telecare 15: 122-124
- Givens GD, Blanarovich A, Murphy T, Simmons S, Blach D, Elangovan S. 2003; Internet-based tele-audiometry system for the assessment of hearing: a pilot study. Telemed J E Health 9 (04) 375-378
- Joint Committee on Infant Hearing, 2007 Joint Committee on Infant Hearing (JCIH) 2007; Year 2007 position statement: principles and guidelines for early hearing detection and intervention programs. Pediatrics 120: 899-921 http://www.asha.org/policy/PS2007-00281.htm
- Katz J, Medwetsky L, Burkard R, Hood L. 2009. Handbook of Clinical Audiology. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 912-913
- Krumm M. 2010; Emerging applications in tele audiology. Starkey Audiol Ser 2 (02) 1-4
- Krumm M, Huffman T, Dick K, Klich R. 2008; Telemedicine for audiology screening of infants. J Telemed Telecare 14 (02) 102-104
- Krumm M, Ribera J, Klich R. 2007; Providing basic hearing tests using remote computing technology. J Telemed Telecare 13: 406-410
- Moeller MP, Tomblin JB, Yoshinaga-Itano C, Connor CM, Jerger S. 2007; Current state of knowledge: language and literacy of children with hearing impairment. Ear Hear 28: 740-753
- Penteado SP, Ramos SDL, Battistella LR, Marone SAM, Bentos RF. 2012; Remote hearing aid fitting: tele-audiology in the context of Brazilian public policy. Int Arch Otorhinolaryngol 16 (03) 371-381
- Ramos A, Rodriguez C, Martinez-Beneyto P, Perez D, Gault A, Falcon JC, Boyle P. 2009; Use of telemedicine in the remote programming of cochlear implants. Acta Otolaryngol 129: 533-540
- Ribera JE. 2005; Inter-judge reliability and validation of tele-health applications of the Hearing In Noise Test. Semin Hear 26: 13-18
- Ribera JE. 2011 Tele-audiology in the United States: past, present, and future. In: Kldiashvili E, ed. Grid Technologies for e-Health: Applications for Telemedicine Services and Delivery
- Hershey, PA: Medical Information Science Reference (an imprint of IGI Global), 205–214
- Schmiedge J. 1997 Distortion product oto-acoustic emissions testing using telemedicine technology [Masters’ Thesis]. Minot State University, Minot, ND, 1–92
- Swanepoel DW, Koekemoer D, Clark J. 2010; Intercontinental hearing assessment—a study in tele-audiology. J Telemed Telecare 16: 248-252
- Yoshinaga-Itano C. 2004; Levels of evidence: universal newborn hearing screening and early hearing detection and intervention systems (EHDI). J Commun Disord 37: 451-465
- Yoshinaga-Itano C, Sedey A, Coulter D, Mehl A. 1998; Language of early and later identified children with hearing loss. Pediatrics 102: 1161-1171
- Yu JKY, Ng IHY, Kam ACS, Wong KTC, Wong ECM, Tong MCF, Yu HC, Yu KM. 2010; The universal neonatal hearing screening program in Hong Kong: the outcome of a combined otoacoustic emissions and automated auditory brainstem response screening protocol. Hong Kong J Paediatr 15: 2-11