Development of an artificial intelligence based occupational noise induced hearing loss early warning system for mine workers.

Introduction: Occupational Noise Induced Hearing Loss (ONIHL) is one of the most prevalent conditions among mine workers globally. This reality is due to mine workers being exposed to noise produced by heavy machinery, rock drilling, blasting, and so on. This condition can be compounded by the fact that mine workers often work in confined workspaces for extended periods of time, where little to no attenuation of noise occurs. The objective of this research work is to present a preliminary study of the development of a hearing loss, early monitoring system for mine workers. Methodology: The system consists of a smart watch and smart hearing muff equipped with sound sensors which collect noise intensity levels and the frequency of exposure. The collected information is transferred to a database where machine learning algorithms namely the logistic regression, support vector machines, decision tree and Random Forest Classifier are used to classify and cluster it into levels of priority. Feedback is then sent from the database to a mine worker smart watch based on priority level. In cases where the priority level is extreme, indicating high levels of noise, the smart watch vibrates to alert the miner. The developed system was tested in a mock mine environment consisting of a 67 metres tunnel located in the basement of a building whose roof top represents the "surface" of a mine. The mock-mine shape, size of the tunnel, steel-support infrastructure, and ventilation system are analogous to deep hard-rock mine. The wireless channel propagation of the mock-mine is statistically characterized in 2.4-2.5 GHz frequency band. Actual underground mine material was used to build the mock mine to ensure it mimics a real mine as close as possible. The system was tested by 50 participants both male and female ranging from ages of 18 to 60 years. Results and discussion: Preliminary results of the system show decision tree had the highest accuracy compared to the other algorithms used. It has an average testing accuracy of 91.25% and average training accuracy of 99.79%. The system also showed a good response level in terms of detection of noise input levels of exposure, transmission of the information to the data base and communication of recommendations to the miner. The developed system is still undergoing further refinements and testing prior to being tested in an actual mine.

An Analysis of Risk Factors for Hearing Function in Adults Living with Human Immunodeficiency Virus in Gauteng, South Africa.

The aim of this study was to explore risk factors for hearing loss or affecting hearing function in adults living with HIV. A quantitative cross-sectional design was employed. A non-probability purposive sampling method was used to select and recruit 132 participants aged 18 years and above from an HIV clinic within the Academic Hospital in Gauteng Province, South Africa. Participants' hearing were tested using, video otoscopy, tympanometry, pure tones, and speech audiometry. Of the 22.73% prevalence of hearing loss in the sample, the multiple logistic regression, controlling for other variables, indicated that age (AOR) = 1.049; 95%CI: 1.0005 to 1.0978) (p-value = 0.048) and extended use of antiretroviral therapy (AOR) = 1.0073; 95%CI: 0.9312 to 1.0896)) (p-value = 0.856) were strongly associated with the development of hearing loss. Although the odds of male participants to have hearing loss was 2.3572 (95%CI: 0.9394 to 5.915) compared to females, this association was marginal (p-value = 0.068). Current findings provide evidence for the risk factors for hearing loss in adults living with HIV. Given that an extended use of ART and a higher number of CD4 are strongly associated with hearing loss, these findings raise important implications for a focused monitoring for this population in order to identify early signs of hearing loss and implement timeous intervention to reduce the potential impact of hearing loss.

Erratum: Conducting clinical research in the era of the COVID-19 pandemic: Challenges and lessons for Speech-Language Pathology and Audiology research.

No abstract available.

Middle ear pathologies in children living with HIV: A scoping review.

BACKGROUND:  Middle ear pathologies are associated with and persist in individuals living with human immunodeficiency virus (HIV). Yet, limited research exists on middle ear pathologies in children living with human immunodeficiency viruses. OBJECTIVE:  To systematically review evidence of middle ear pathologies in children living with HIV, how it is described, measures used to describe it and other relevant information. METHODS:  This study was a scoping review. The data were collected from different electronic databases including PubMed, Scopus, Science Direct, ProQuest, and Web of Science. The electronic database search was conducted for articles published between January 2010 and December 2020. Keywords used for searching relevant articles included 'middle ear pathology', 'middle ear disorder', 'children', 'HIV', 'otitis media (OM)', 'hearing loss (HL)', 'hearing impairment', 'paediatric', 'minors', 'infants' and 'HIV/AIDS'. Only articles that were published in English and reported on the middle ear function and pathologies of children living with HIV were considered. RESULTS:  A total of 350 articles were extracted through databases, but only six studies were eligible and included for further analysis. Studies reviewed suggested that middle ear pathologies in children living with HIV exist and are common. Recurrent OM, type B tympanogram, chronic OM and HL with conductive element were common. Tympanometry with a 226 Hz probe tone and air bone gap were used commonly to establish the presence of middle ear pathology. CONCLUSION:  The findings of this study highlighted that despite the dearth of evidence in this area, available evidence indicates that children living with HIV are at increased risk of middle ear pathology. However, studies in this review have mostly used middle ear measures with poor sensitivity and specificity. Therefore, the prevalence and nature of middle ear pathologies in studies reviewed may have been underreported. Further research using sensitive measures such as wideband acoustic immittance is required. Despite the paucity of evidence, the current findings raise important clinical implications for the assessment and management of middle ear pathologies in children living with HIV.Contribution: This study makes a significant contribution to the literature regarding middle ear pathologies and HIV, particularly in children.

Simulations as a mode of clinical training in healthcare professions: A scoping review to guide planning in speech-language pathology and audiology during the COVID-19 pandemic and beyond.

BACKGROUND:  Simulation plays an important role as an alternative method for training of students, particularly in health education. As a result of coronavirus disease 2019 (COVID-19) restrictions of face-to-face interactions, traditional teaching methods have been disrupted, increasing the need for alternative methods to supplement modes of student clinical training in healthcare programmes. OBJECTIVES:  The scoping review aimed to determine what has been documented about simulation as a mode of clinical training in healthcare professions (HCPs) in order to guide speech-language pathology and audiology (SLPA) professions during the COVID-19 pandemic and beyond. METHOD:  A scoping review was conducted. Electronic bibliographic databases including Science Direct, PubMed, Scopus MEDLINE, ProQuest, Google Scholar and WorldCat were searched to identify peer reviewed publications, published in English, between January 2011 and December 2021, and related to the use of simulation in HCPs clinical training programmes. RESULTS:  A total of 32 articles met the inclusion criteria for this scoping review. Three themes emerged when reviewing the studies: (1) face-to-face simulations as a mode of clinical training, (2) virtual reality simulation and telesimulation as modes of clinical training and (3) simulation as a complementary mode of clinical training. Evidence suggests that whilst simulations are cost-effective, accessible and efficacious as clinical training modes, they need to be combined with other modes of training such as the traditional clinical training to yield better learning outcomes. CONCLUSIONS:  Current findings highlight the role and value of simulation as a clinical training mode during COVID-19 and beyond. However, there are aspects that need to be considered to ensure that this mode of clinical training is effective, with endorsement and regulations by the SLPA Professional Board of the Health Professions Council of South Africa (HPCSA). Simulations need to be complemented with traditional clinical training methods. In the context of SLPA, particularly in low- and middle-income countries (LMICs), simulation can be used to better prepare students for their clinical placement where clinical training platforms are limited and where simulation combined with teletraining or telesupervision can be utilised to increase access to training.

Conducting clinical research in the era of the COVID-19 pandemic: Challenges and lessons for Speech-Language Pathology and Audiology research.

BACKGROUND: The novel coronavirus disease 2019 (COVID-19) presented new and unanticipated challenges to the academic training and performance of clinical research at undergraduate and postgraduate levels of training. This highlighted the need for reimagining research designs and methods to ensure continued generation of knowledge - a core function of a research-intensive university. Whilst adhering to government regulations geared towards protecting both the research participants and researchers, innovative research methods are required. OBJECTIVE: The purpose of this scoping review is to explore published evidence on innovative clinical research methods and processes employed during COVID-19 and to document challenges encountered and lessons that the fields of Speech-Language Pathology and Audiology can learn. METHODS: Electronic bibliographic databases including Science Direct, PubMed, Scopus, MEDLINE, ProQuest were searched to identify peer-reviewed publications, published in English, between 2019 and 2021, related to innovative clinical research methods and processes applied where in-person contact is regulated. RESULTS: Significant challenges with conducting research in the COVID-19 era were identified, with important lessons learned and numerous opportunities that have relevance for this pandemic era and beyond. These findings are presented under 10 themes that emerged that highlight important considerations for research methods and processes during a pandemic and beyond. The findings of this study also raise implications for telehealth from which low- and middle-income countries (LMICs), where resource challenges exist, can benefit. CONCLUSION: Challenges and opportunities identified in this review have relevance for the field of Speech-Language Pathology and Audiology as far as current and future (beyond COVID-19) clinical research planning is concerned.

Middle ear status - structure, function and pathology: A scoping review on middle ear status of COVID-19 positive patients.

BACKGROUND:  The coronavirus disease 2019 (COVID-19) pandemic is the latest public health emergency that has presented challenges globally. Limited evidence exists on the association between COVID-19 and middle ear pathologies, regardless of the respiratory nature of some of the core symptoms. OBJECTIVE:  This scoping review aimed at exploring evidence on the effects of COVID-19 on middle ear functioning as part of symptom mapping and preventive planning for ear and hearing care. METHOD:  Electronic bibliographic databases, including Medline, ProQuest, PubMed, Science Direct, ERIC and Scopus, were searched to identify peer reviewed publications, published in English, between December 2019 and January 2022, related to the effects of COVID-19 on middle ear functioning. The keywords used as MeSH terms included 'middle ear pathology', 'middle ear disorder', 'otitis media', 'hearing loss', 'hearing impairment', 'audiology' and 'COVID-19' or 'coronavirus'. RESULTS:  From eight studies that met the inclusion criteria, the findings revealed that middle ear pathologies occur in this population, with the occurrence ranging from 1.15% to 75%. Tympanic membrane structural changes, otitis media and conductive hearing loss (CHL) were commonly reported. The current findings must be interpreted with caution given that most of the studies reviewed had extremely small sample sizes or were case studies or series, thus limiting generalisability. CONCLUSION:  The findings highlight the value of strategic research planning to collate data during pandemics, ensuring that future studies use appropriate and well-designed methodologies. Trends and patterns of middle ear pathologies in this population must also be established to determine the need for periodic monitoring.

The Use of Tele Practice in Assessment of Middle Ear Function in Adults Living with HIV During the COVID-19 Pandemic.

Coronavirus disease (COVID-19) pandemic is the latest threat to global health that causes severe acute respiratory syndrome (SARS). Tele-practice has inadvertently sprung to the forefront to become a common practice amongst healthcare providers during COVID-19. Limited evidence exists on the use of tele-practice in assessing middle ear function in adults living with HIV during the COVID-19 pandemic. The aims of this study were to investigate the use of tele-practice for assessment of middle ear function in adults with HIV during the COVID-19 pandemic. A quantitative observational, cross-sectional design was adopted. A total of 134 adults diagnosed with HIV were purposively selected from the HIV clinic. An audiology researcher, in the role of site-facilitator, captured video otoscopic images of the tympanic membrane using a video otoscopy for all participants through asynchronous tele-practice. All captured images were sent to two independent otorhinolaryngologists for diagnosis. Findings of this study indicated that tele-practice can be used to assess middle ear function in adults living with HIV during COVID-19 pandemic. When asynchronous tele-practice was used, there was a moderate diagnostic agreement (k = 0.58) between the two otorhinolaryngologists on abnormality versus normality, but poor agreement (k = 0.15) on the nature of abnormality (e.g. OME vs CSOM). Current findings highlight the urgent need for a widespread use of tele-practice during the continued clinical follow up and management of adults living with HIV, and the implementation of tele-practice, particularly in low- and middle-income countries (LMICs) where capacity versus demand challenges related to ear and hearing care continue to exists.

Investigation of the Interaction between Hearing Function and Comorbidities in Adults Living with Human Immunodeficiency Virus.

Adults living with the human immunodeficiency virus (HIV) have a high prevalence of co-existing comorbidities. While research indicates that adults living with HIV are at risk of developing hearing impairment, limited research exists on the interaction between hearing function and comorbidities in this population. The objective of this study was to determine and compare the hearing function of a group of adults living with HIV and comorbidities and those without comorbidities. A sample of 132 adults living with HIV underwent a basic audiological test battery to assess their hearing function. Participants with comorbidities were 1.23 times more likely to develop hearing loss, with crude odds of 1.236 (95%CI 0.5467 to 2.795), while those with three comorbidities were 2.52 times more likely to develop hearing loss. Participants with hypertension were 93% more likely to develop hearing loss when compared to nonhypertensive participants (OR = 1.928; 95%CI: 0.7856 to 4.7345). There was only a marginal association between hypercholesterolemia and sensorineural hearing loss (SNHL), with no association between other comorbidities and the type of hearing loss. The current findings raise a need for prioritizing patients with comorbidities in audiological assessment and monitoring in resource-constrained contexts, where capacity versus demand challenges might prevent the provision of audiological services to all adults living with HIV. These findings also highlight the importance of preventive care in this population with regard to the burden of the disease, as it may lead to worse ear and hearing outcomes for affected individuals.

The sensitivity and specificity of wideband absorbance measure in identifying pathologic middle ears in adults living with HIV.

BACKGROUND: Limited research exists on the sensitivity and specificity of wideband acoustic immittance (WAI) in adults living with human immunodeficiency virus (HIV). This study forms part of the bigger study titled 'wideband acoustic immittance in adults living with HIV'. OBJECTIVES: To determine the sensitivity and specificity of the wideband absorbance measure at tympanic peak pressure (TPP), as a screening tool for detecting middle ear pathologies in adults living with HIV. METHOD: A prospective nonexperimental study comprising 99 adults living with HIV was performed. All participants underwent a basic audiological test battery which included case history, video otoscopy, tympanometry, wideband absorbance at TPP and pure tone audiometry. Middle ear pathologies were established by two otorhinolaryngologists using asynchronous video otoscopic images analysis. The outcomes of the otorhinolaryngologists served as the gold standard against which the wideband absorbance at TPP and tympanometry were measured. The receiver operating characteristics (ROC) curve was calculated. RESULTS: ROC revealed the sensitivity of wideband absorbance at TPP to be higher in low to mid frequencies, but significantly lower in frequencies above 971.53 Hz. The sensitivity of tympanometry was lower. However, there was no difference between the specificity of wideband absorbance at TPP and tympanometry, indicating that when there are no pathologies, tympanometry is equally accurate. CONCLUSION: The current findings reveal that wideband absorbance at TPP can distinguish middle ear pathologies better than the tympanometry. Incorporating wideband absorbance at TPP in clinical practice may improve early identification and intervention of middle ear pathologies.

Undergraduate audiology students' perceived competence and confidence in conducting otoscopic examination following video otoscopic training.

BACKGROUND: Emerging research indicates that video otoscopy can be used as a teaching tool to enhance students' ability to identify outer and middle ear pathologies. However, there is little research on the perceptions of audiology students regarding their competence and confidence following video otoscopic training, and how they view the use of video otoscopy as a teaching tool. Therefore, this study aimed to determine undergraduate (UG) audiology students' perceived competence and confidence in conducting otoscopy following training by video otoscopic examination. METHODS: A survey methodology with a cross sectional design was employed. An electronic questionnaire was distributed to all third and fourth year (senior) (N = 79) UG audiology students using Survey Monkey. Ethical approval and permission from relevant stakeholders were obtained. Data were analysed using both descriptive and inferential statistics. RESULTS: 60 % of the students felt competent in performing otoscopy, while 63.3 % felt less competent in interpreting otoscopic examination findings. 43.3 % felt they can confidently and competently identify outer ear pathologies. There was no association between the number of video otoscopic examinations performed and perceived competence or/and confidence. There was also no statistically significant relationship between year of study (e.g., third year versus fourth year) and perceived competence or/and confident (p = 0.7131). Almost all (97 %) students felt that video otoscopic training should continue to be part of the clinical training as it helped them enhance their skills in performing otoscopy. CONCLUSIONS: Current findings highlight the need to improve students' practical training, incorporating pathologic ears into the curriculum. These findings also highlight the importance of supplementing practical training methodologies with changing technological advancements, particularly where tele-audiology opportunities may exist.

Acoustic immittance measures and middle ear assessment: Current practice by South African audiologists.

BACKGROUND: Limited research exists regarding South African audiologists' practice with acoustic immittance. This study was part of a bigger study titled 'Wideband acoustic immittance in adults living with human immunodeficiency virus'. OBJECTIVES: The purpose of the study was to explore current practice of South African audiologists regarding acoustic immittance measures, and to explore their perceived knowledge and views on acoustic immittance advancements. METHOD: A quantitative survey with a cross sectional design was employed. An electronic questionnaire was distributed to participants via professional associations of audiologists. Data was analysed through descriptive and inferential statistics. RESULTS: Most audiologists worked in private practice and conducted tympanometry with 226Hz probe tone and ipsilateral acoustic reflexes. There was no association between clinical setting, levels of qualification, and the use of tympanometry. None of the participants included multifrequency and multicomponent tympanometry (MFT) and/or wideband acoustic immittance (WAI) in their test battery. Most of the participants were not familiar with MFT and WAI. Familiarity with MFT and WAI were only associated with the level of qualification. Limited training and lack of equipment were major barriers to conducting some of the acoustic immittance measures. Most participants believed that they would include MFT and/or WAI in their test battery if they had access to the equipment. CONCLUSION: Current findings raise training and clinical implications for the South African audiologists, including training institutions. These findings provide motivation for strategic resource allocation, planning and distribution of audiology clinics in the country if positive preventive audiology outcomes are to be achieved.

Factors influencing speech language pathologists' and audiologists' decision to pursue postgraduate studies in South Africa.

BACKGROUND: Factors that influence various professionals to pursue postgraduate studies have been investigated. However, there is a dearth of evidence of factors that influence South African speech language pathologists (SLPs) and audiologists (As) to pursue their postgraduate studies. OBJECTIVE: Therefore, this study aimed to determine factors that influence the decision of South African SLPs and As to pursue postgraduate studies and potential barriers to this pursuit. METHOD: A quantitative survey research methodology with a cross-sectional research design was adopted, where a 21-item web-based survey was used to survey 127 speech therapists, As and speech therapists and As from across the country. All participants were qualified and registered with the Health Professionals Council of South Africa (HPCSA). Ethical clearance and permission from relevant stakeholders were obtained. Data were analysed descriptively. RESULTS: The findings suggested that over half of the participants pursued their postgraduate studies to fulfil a personal goal and improve their knowledge, whilst others did it to develop expertise and for job opportunities. Participants highlighted that a lack of time and funding, heavy workloads and bad experiences during their undergraduate studies were the main barriers to pursuing postgraduate studies. Whilst community service was not a barrier per se, participants felt that it delayed them from beginning their postgraduate studies immediately. CONCLUSION: The findings of this study highlighted the urgent need for institutions of higher learning, government and other stakeholders to provide the necessary support for SLPs and As in South Africa to pursue postgraduate studies.

Middle ear pathologies in adults within the mining industry: A systematic review.

BACKGROUND: Literature suggests that risk factors for middle ear pathologies, such as traumatic injuries and human immunodeficiency virus (HIV), exist in mines. However, studies on hearing health in mines seem to focus primarily on occupational noise-induced hearing loss and ignore middle ear pathologies. As a result, there is little documented evidence on the trends of middle ear pathologies in mine workers. OBJECTIVES: The aim of this study was to explore and document published evidence reflecting trends in middle ear pathologies in mine workers. METHOD: A systematic literature review of studies that reported middle ear pathologies in mine workers was conducted. Medline, CINAHL, PubMed, PsychInfo and Google Scholar databases were searched for studies in English published between January 1994 and December 2018 and reporting on trends in middle ear pathologies in mine workers. RESULTS: Two research studies met the selection criteria and were included for analysis. One research study used tympanometry with 226 Hz probe tone, while another study used interviews to determine the presence of middle ear pathologies. While these studies indicate that middle ear pathologies exist in individuals working in mines, the evidence is limited. CONCLUSION: While current data indicate that individuals working in mines may present with middle ear pathologies of varying severities, the evidence is too small to provide a clear trend of middle ear pathologies in individuals working in mines. Therefore, the current limited data suggest a need for further studies to examine middle ear pathologies in individuals working in mines.

Middle ear Pathologies in Adults Living with Human Immunodeficiency Virus: A Systematic Review.

INTRODUCTION: Middle ear pathologies have been linked with HIV. The onset and development of these pathologies in individuals with HIV have not been categorized; and clarity has not been gained regarding whether their presentation is any different in this population when compared to HIV negative control group. PURPOSE: The aim of this study was to explore and document published evidence reflecting trends in middle ear pathologies in adults living with HIV. METHODS: A systematic review of literature from January 1982 to December 2018 was conducted using Medline, CINAHL, PubMed, and Psych Info. Studies that reported the occurrence rate of middle ear pathologies in adults with HIV and published in English were included. RESULTS: Twelve articles met the inclusion criteria. Evidence suggests that the reported occurrence rates of middle ear pathologies ranges from 2.5% to 58% in this population. The variability in assessment measures as well as the different cut-off criteria used in studies seem to have an influence in the findings, with pure tone audiometry identifying more middle ear pathologies in the current review than tympanometry with 226 Hz probe tone and clinical examination. Otitis media, conductive hearing loss, and type B tympanogram were common findings reported in this study. No evidence of an association between the use of antiretroviral therapy (ART) and the rates of middle ear pathologies was found. CONCLUSION: Although there are very few studies that have reported on middle ear pathologies in adults living with HIV, the available studies have sufficiently established a link between HIV and middle ear disease in this population, and have revealed that the rate of occurrence is influenced by a number of factors. Key amongst these is the type of assessment measure used. Careful analysis of middle ear pathologies in this population through well controlled research designs that include different assessment measures. The use of case-control and longitudinal designs to determine differences between groups and to establish the time of onset and development of middle ear pathologies is required.

A comparison between video otoscopy and standard tympanometry findings in adults living with human immunodeficiency virus (HIV) in South Africa.

BACKGROUND: Literature suggests that there is a correlation between video otoscopy and standard tympanometry findings. However, there is limited evidence on whether these two measures are comparable in the identification of middle ear pathologies in adults living with human immunodeficiency virus (HIV). Objective: This study aimed to determine the correlation between video otoscopy and standard tympanometry with 226 Hz probe tone in the identification of middle ear pathologies in adults living with HIV in Limpopo, South Africa. Method: A prospective, non-experimental, comparative design was employed on HIV-positive adults aged 18 years and older. All participants underwent basic audiological assessment including case history interviews, video otoscopy, tympanometry with a 226 Hz probe tone and pure tone audiometry. Two ear, nose and throat (ENT) specialists independently analysed video otoscopic images and provided their reports to the researcher, and these were compared to the tympanometry results. The IBM SPSS v.24 was used for data analysis, including the use of Cohen's kappa to determine the agreement between the two procedures. Pearson's correlation coefficient was used to determine the strength of the correlation between tympanometry and video otoscopy. Results: A total of 87 adults (N = 161 ears) took part in the study. Middle ear pathology was observed in 8% (n = 13) of the sample when tympanometry was used, and this increased to 10.6% (n = 17) when video otoscopy was utilised. Kappa statistics found a good agreement (k = 0.7) between the diagnoses made by two ENTs. However, there was poor agreement (k = 0.2) between the diagnoses by video otoscopy and tympanometry. Pearson's correlation coefficient indicated weak correlation between video otoscopy and tympanometry (r = 0.195). Conclusion: Findings from this study suggest that video otoscopy may be more accurate in the identification of middle ear pathologies in adults living with HIV when compared to tympanometry. These findings have training implications in the use of video otoscopy to ensure accuracy and reliability. Clinical implications of current findings include the use of both video otoscopy and tympanometry in a complementary manner for more sensitive identification of middle ear pathologies in this population. Lastly, tele-audiologic implications of the use of video otoscopy to increase access in resource-constrained contexts are raised.

Public awareness of audiology, hearing and hearing health in the Limpopo Province, South Africa.

BACKGROUND: The burden of hearing loss is on the increase, especially in low-income countries such as South Africa. The need for urgent action to prevent ear and hearing problems is a priority, especially as in many cases permanent hearing loss is preventable. In South Africa, as in other developing countries, there is a limited number of hearing health professionals and audiological resources. The lack of hearing health services may impact the general public's awareness of hearing and hearing health. Limited information is available on the South African public's knowledge of audiologists and the services they provide, especially in underserved rural communities. AIM: The aim of this study was to describe individuals' awareness of the audiology profession, hearing and hearing loss, and hearing health in a rural area of the Limpopo Province. METHOD: A cross-sectional survey design was employed for the purpose of this study. Using a random sampling strategy, 297 households in four rural villages were selected and a selfdeveloped questionnaire was administered to one individual (18 years and older) per household. The questionnaire consisted of 23 questions targeting awareness of the audiology profession, as well as knowledge of hearing, hearing loss and hearing health. RESULTS: Only 14% of participants were aware of the audiology profession, indicating that individuals living in rural communities are not aware of the role of audiologists and the services they provide. Doctors and nurses were identified by participants as the individuals who assist them with hearing-related problems. Although most participants (87%) acknowledged that it is very important to undergo a hearing test, only 5% have previously visited an audiologist. Most participants were aware that ear infections and excessive noise exposure can cause hearing loss. The majority also believed that ears must be kept clean at all times and used cotton buds to maintain ear hygiene. CONCLUSION: There is a general lack of public awareness of audiologists and the services they offer. This study highlighted the need for the National Department of Health in collaboration with professional associations and hearing health professionals to develop and implement effective strategies to increase the South African public's awareness of the profession and the services they provide. South African universities can also play a significant role in teaching students to develop context-relevant strategies to increase awareness of the profession.

The prevalence of hearing impairment within the Cape Town Metropolitan area.

BACKGROUND: There is a lack of data on the prevalence of hearing impairment in South Africa. Current data is unreliable as it is based on national census information which tends to underestimate the prevalence of hearing impairment. AIM: The aim of this study was to estimate the prevalence of hearing impairment in the Cape Town Metropolitan area and to determine factors associated with hearing impairment. METHOD: A cross-sectional household survey involving 2494 partcipants from 718 households was conducted between the months of February and October 2013. Random cluster sampling was used to select four health sub-districts from eight health sub-districts in the Cape Town Metropolitan area using a method of probability proportional to size (PPS). The survey was conducted according to the World Health Organization (WHO) Ear and Hearing Disorders Survey Protocol and the classifcation of hearing impairment matched the WHO's criteria for the grading of hearing impairment. RESULTS: The overall prevalence of hearing impairment in the population of this study was 12.35% (95%CI: 11.06% - 13.64%) and prevalence of disabling hearing impairment was 4.57% (95% CI: 3.75% - 5.39%) amongst individuals ≥ 4 years old. The following factors were found to be associated with hearing impairment; male gender, age, hypertension, a history of head and neck trauma and a family history of hearing impairment. CONCLUSION: Based on the data from communities surveyed during this study, hearing impairment is more prevalent than previously estimated based on national population census information. Interventions for the prevention of hearing impairment in these communities should focus on individuals with associated risk factors.