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Auteur Kelli L. Hicks |
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Environmental Factors for Hearing Loss and Middle Ear Disease in Alaska Native Children and Adolescents / Kelli L. Hicks in Ear and hearing, Vol. 44, n°1 (Janvier-Février 2023)
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Titre : Environmental Factors for Hearing Loss and Middle Ear Disease in Alaska Native Children and Adolescents : A Cross-Sectional Analysis from a Cluster Randomized Trial Type de document : Article Auteurs : Kelli L. Hicks ; Samantha K. Robler ; Alyssa Platt ; Sarah N. Morton ; Joseph R. Egger ; Suzan D. Emmett Année de publication : 2023 Article en page(s) : p.2-9 Note générale : DOI: 10.1097/AUD.0000000000001265 Langues : Anglais (eng) Descripteurs : HE Vinci
Condition de vie ; Eau courante ; Enfant déficient auditif ; Oreille moyenne
Autres descripteurs
Facteur environnemental ; Infection de l'oreilleRésumé : Objectives: Infection-related childhood hearing loss is one of the few preventable chronic health conditions that can affect a child's lifelong trajectory. This study sought to quantify relationships between infection-mediated hearing loss and middle ear disease and environmental factors, such as exposure to wood smoke, cigarette smoke, household crowding, and lack of access to plumbed (running) water, in a northwest region of rural Alaska.
Design: This study is a cross-sectional analysis to estimate environmental factors of infection-related hearing loss in children aged 3 to 21 years. School hearing screenings were performed as part of two cluster randomized trials in rural Alaska over two academic years (2017-2018 and 2018-2019). The first available screening for each child was used for this analysis. Sociodemographic questionnaires were completed by parents/guardians upon entry into the study. Multivariable regression was performed to estimate prevalence differences and prevalence ratios (PR). A priori knowledge about the prevalence of middle ear disease and the difficulty inherent in obtaining objective hearing loss data in younger children led to analysis of children by age (3 to 6 years versus 7 years and older) and a separate multiple imputation sensitivity analysis for pure-tone average (PTA)-based infection-related hearing loss measures.
Results: A total of 1634 children participated. Hearing loss was present in 11.1% of children sampled based on otoacoustic emission as the primary indicator of hearing loss and was not associated with exposure to cigarette smoke (PR = 1.07; 95% confidence interval [CI], 0.48 to 2.38), use of a wood-burning stove (PR = 0.85; 95% CI, 0.55 to 1.32), number of persons living in the household (PR = 1.06; 95% CI, 0.97 to 1.16), or lack of access to running water (PR = 1.38; 95% CI, 0.80 to 2.39). Using PTA as a secondary indicator of hearing loss also showed no association with environmental factors. Middle ear disease was present in 17.4% of children. There was a higher prevalence of middle ear disease in homes without running water versus those with access to running water (PR = 1.53; 95% CI, 1.03 to 2.27). There was little evidence to support any cumulative effects of environmental factors. Heterogeneity of effect models by age found sample prevalence of hearing loss higher for children aged 3 to 6 years (12.2%; 95% CI, 9.3 to 15.7) compared to children 7 years and older (10.6%; 95% CI, 8.9 to 2.6), as well as for sample prevalence of middle ear disease (22.7%; 95% CI, 18.9 to 26.9 and 15.3%; 95% CI, 13.3 to 17.5, respectively).
Conclusions: Lack of access to running water in the home was associated with increased prevalence of middle ear disease in this rural, Alaska Native population, particularly among younger children (aged 3 to 6 years). There was little evidence in this study that cigarette smoke, wood-burning stoves, and greater numbers of persons in the household were associated with infection-mediated hearing loss or middle ear disease. Future research with larger sample sizes and more sensitive measures of environmental exposure is necessary to further evaluate these relationships. Children who live in homes without access to running water may benefit from earlier and more frequent hearing health visits.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://ovidsp.ovid.com/ovidweb.cgi?T=J [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=301586
in Ear and hearing > Vol. 44, n°1 (Janvier-Février 2023) . - p.2-9[article]Prevalence of Childhood Hearing Loss in Rural Alaska / Suzan D. Emmett in Ear and hearing, Vol. 44, n°5 (September- October 2023)
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Titre : Prevalence of Childhood Hearing Loss in Rural Alaska Type de document : Article Auteurs : Suzan D. Emmett ; Meade Inglis-Jenson ; Nae-Yuh Wang ; Alain Labrique ; Joseph J. Gallo ; Alyssa Platt ; Cole D. Jenson ; Philip Hofstetter ; Kelli L. Hicks ; Alexandra Ross ; Joseph R. Egger ; Samantha K. Robler Année de publication : 2023 Article en page(s) : p. 1240-1250 Note générale : DOI: 10.1097/AUD.0000000000001368 Langues : Anglais (eng) Descripteurs : HE Vinci
Audiologie pédiatrique ; Déficience auditive ; Disparités en matière de santé, minorités et populations vulnérables ; Prévalence ; Santé auditive ; Services de santé communautairesRésumé : Objectives: Childhood hearing loss has well-known lifelong consequences. Certain rural populations are at higher risk for infection-related hearing loss. For Alaska Native children, historical data on hearing loss prevalence suggest a higher burden of infection-related hearing loss, but updated prevalence data are urgently needed in this high-risk population.
Design: Hearing data were collected as part of two school-based cluster-randomized trials in 15 communities in rural northwest Alaska over two academic years (2017-2019). All enrolled children from preschool to 12th grade were eligible. Pure-tone thresholds were obtained using standard audiometry and conditioned play when indicated. The analysis included the first available audiometric assessment for each child (n = 1634 participants, 3 to 21 years), except for the high-frequency analysis, which was limited to year 2 when higher frequencies were collected. Multiple imputation was used to quantify the prevalence of hearing loss in younger children, where missing data were more frequent due to the need for behavioral responses. Hearing loss in either ear was evaluated using both the former World Health Organization (WHO) definition (pure-tone average [PTA] > 25 dB) and the new WHO definition (PTA >= 20 dB), which was published after the study. Analyses with the new definition were limited to children 7 years and older due to incomplete data obtained on younger children at lower thresholds.
Results: The overall prevalence of hearing loss (PTA > 25 dB; 0.5, 1, 2, 4 kHz) was 10.5% (95% confidence interval [CI], 8.9 to 12.1). Hearing loss was predominately mild (PTA >25 to 40 dB; 8.9%, 95% CI, 7.4 to 10.5). The prevalence of unilateral hearing loss was 7.7% (95% CI, 6.3 to 9.0). Conductive hearing loss (air-bone gap of >= 10 dB) was the most common hearing loss type (9.1%, 95% CI, 7.6 to 10.7). Stratified by age, hearing loss (PTA >25 dB) was more common in children 3 to 6 years (14.9%, 95% CI, 11.4 to 18.5) compared to children 7 years and older (8.7%, 95% CI, 7.1 to 10.4). In children 7 years and older, the new WHO definition increased the prevalence of hearing loss to 23.4% (95% CI, 21.0 to 25.8) compared to the former definition (8.7%, 95% CI, 7.1 to 10.4). Middle ear disease prevalence was 17.6% (95% CI, 15.7 to 19.4) and was higher in younger children (23.6%, 95% CI, 19.7 to 27.6) compared to older children (15.2%, 95% CI, 13.2 to 17.3). High-frequency hearing loss (4, 6, 8kHz) was present in 20.5% (95% CI, 18.4 to 22.7 [PTA >25 dB]) of all children and 22.8% (95% CI, 20.3 to 25.3 [PTA >25 dB]) and 29.7% (95% CI, 27.0 to 32.4 [PTA >= 20 dB]) of children 7 years and older (limited to year 2).
Conclusions: This analysis represents the first prevalence study on childhood hearing loss in Alaska in over 60 years and is the largest cohort with hearing data ever collected in rural Alaska. Our results highlight that hearing loss continues to be common in rural Alaska Native children, with middle ear disease more prevalent in younger children and high-frequency hearing loss more prevalent with increasing age. Prevention efforts may benefit from managing hearing loss type by age. Lastly, continued research is needed on the impact of the new WHO definition of hearing loss on field studies.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://ovidsp.ovid.com/ovidweb.cgi?T=J [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=310211
in Ear and hearing > Vol. 44, n°5 (September- October 2023) . - p. 1240-1250[article]Telemedicine Referral to Improve Access to Specialty Care for Preschool Children in Rural Alaska / Samantha Kleindienst Robler in Ear and hearing, Vol. 44, n°6 (November December 2023)
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Titre : Telemedicine Referral to Improve Access to Specialty Care for Preschool Children in Rural Alaska : A Cluster-Randomized Controlled Trial Type de document : Article Auteurs : Samantha Kleindienst Robler ; Alyssa Platt ; Joseph J. Gallo ; Alain Labrique ; Elisabeth L. Turner ; Philip Hofstetter ; Meade Inglis-Jenson ; Cole D. Jenson ; Kelli L. Hicks ; Nae-Yuh Wang ; Suzan D. Emmett Année de publication : 2023 Article en page(s) : p. 1311-1321 Note générale : DOI: 10.1097/AUD.0000000000001372 Langues : Anglais (eng) Descripteurs : HE Vinci
Accessibilité des services de santé ; Dépistage auditif de l'enfant ; Perte d'audition ; Santé en zone rurale ; Télé-audiologieRésumé : Objectives: Preschool programs provide essential preventive services, such as hearing screening, but in rural regions, limited access to specialists and loss to follow-up compound rural health disparities. We conducted a parallel-arm cluster-randomized controlled trial to evaluate telemedicine specialty referral for preschool hearing screening. The goal of this trial was to improve timely identification and treatment of early childhood infection-related hearing loss, a preventable condition with lifelong implications. We hypothesized that telemedicine specialty referral would improve time to follow-up and the number of children receiving follow-up compared with the standard primary care referral.
Design: We conducted a cluster-randomized controlled trial in K-12 schools in 15 communities over two academic years. Community randomization occurred within four strata using location and school size. In the second academic year (2018-2019), an ancillary trial was performed in the 14 communities that had preschools to compare telemedicine specialty referral (intervention) to standard primary care referral (comparison) for preschool hearing screening. Randomization of communities from the main trial was used for this ancillary trial. All children enrolled in preschool were eligible. Masking was not possible because of timing in the second year of the main trial, but referral assignment was not openly disclosed. Study team members and school staff were masked throughout data collection, and statisticians were blinded to allocation during analysis. Preschool screening occurred once, and children who were referred for possible hearing loss or ear disease were monitored for follow-up for 9 months from the screening date. The primary outcome was time to ear/hearing-related follow-up from the date of screening. The secondary outcome was any ear/hearing follow-up from screening to 9 months. Analyses were conducted using an intention-to-treat approach.
Results: A total of 153 children were screened between September 2018 and March 2019. Of the 14 communities, 8 were assigned to the telemedicine specialty referral pathway (90 children), and 6 to the standard primary care referral pathway (63 children). Seventy-one children (46.4%) were referred for follow-up: 39 (43.3%) in the telemedicine specialty referral communities and 32 (50.8%) in the standard primary care referral communities. Of children referred, 30 (76.9%) children in telemedicine specialty referral communities and 16 (50.0%) children in standard primary care referral communities received follow-up within 9 months (Risk Ratio = 1.57; 95% confidence interval [CI], 1.22 to 2.01). Among children who received follow-up, median time to follow-up was 28 days (interquartile range [IQR]: 15 to 71) in telemedicine specialty referral communities compared with 85 days (IQR: 26 to 129) in standard primary care referral communities. Mean time to follow-up for all referred children was 4.5 (event time ratio = 4.5; 95% CI, 1.8 to 11.4; p = 0.045) times faster in telemedicine specialty referral communities compared with standard primary care referral communities in the 9-month follow-up time frame.
Conclusions: Telemedicine specialty referral significantly improved follow-up and reduced time to follow-up after preschool hearing screening in rural Alaska. Telemedicine referrals could extend to other preventive school-based services to improve access to specialty care for rural preschool children.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://ovidsp.ovid.com/ovidweb.cgi?T=J [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=312200
in Ear and hearing > Vol. 44, n°6 (November December 2023) . - p. 1311-1321[article]