Tablet-based Hearing Screening in Children Aged 5 to 17 in Rural Dominican Republic
Dylan A Levy1, David R Hill1, Frank J Bia1,2
1Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven.
Objective:
The principal aim of this study was to examine the feasibility of hearing screening using tablet audiometry among a cohort of school-aged children in rural Dominican Republic. The authors hypothesized that the tablet audiometer would serve as an expeditious means for hearing loss screening in various remote locations.
Study Design:
Cross-sectional.
Setting:
Twenty-three remote locations in and around the city of La Romana, Dominican Republic. The quietest location available in each site was used for testing.
Patients:
Inclusion criteria comprised children aged 5 to 17 currently residing in the testing location. Children aged <5 years or >18 years were excluded.
Intervention:
Screening.
Main Outcome Measures:
For each subject, air conduction thresholds were obtained bilaterally at 500, 1000, 2000, and 4000 Hz; testing duration was also measured. Hearing loss was suspected if any threshold measured ≥30 dB.
Results:
In this cohort of 423 subjects, 44 (10.4%) failed the screening protocol. The mean thresholds for 500, 1000, 2000, and 4000 Hz frequencies were 26.05, 22.73, 17.57, and 17.15 dB, respectively. Of the 658 thresholds obtained at ≥30 dB, the majority were at 500 or 1000 Hz. The mean testing duration was 494 seconds.
Conclusions:
These results suggest that children living in remote communities can be screened quickly for hearing loss using a tablet audiometer. However, significant background noise during testing negatively impacted the low-frequency measurements, thus compromising test reliability. Despite extending the reach of existing audiological services, the value of tablet audiometry is not entirely clear in rural environments with uncontrollable background noise.
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