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Primary ear care in low-income settings : hearing loss characteristics and cerumen management efficacy

Dissertation (MA)--University of Pretoria, 2024.

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Other Authors: Swanepoel, De Wet
Format: Thesis
Language:en_US
Published: University of Pretoria 2024
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access_status_str Open Access
author2 Swanepoel, De Wet
author_browse Swanepoel, De Wet
author_facet Swanepoel, De Wet
collection Thesis
dc_rights_str_mv © 2023 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria.
description Dissertation (MA)--University of Pretoria, 2024.
format Thesis
id oai:repository.up.ac.za:2263/99230
institution University of Pretoria (South Africa)
language en_US
last_indexed 2026-06-10T12:40:23.989Z
license_str Other — see source repository
provenance_str_mv Harvested via OAI-PMH from UPSpace — University of Pretoria Institutional Repository
publishDate 2024
publishDateRange 2024
publishDateSort 2024
publisher University of Pretoria
publisherStr University of Pretoria
record_format dspace
source_str UPSpace — University of Pretoria Institutional Repository
spelling oai:repository.up.ac.za:2263/99230 Primary ear care in low-income settings : hearing loss characteristics and cerumen management efficacy Swanepoel, De Wet sellomarvenmms@gmail.com Reddy, Tarryn Marisca Frisby, Caitlin Manganye, Sello Marven UCTD Sustainable Development Goals (SDGs) Hearing loss Low-income community Elderly population Task-shifting Cerumen impaction Cerumen management Community-based care Dissertation (MA)--University of Pretoria, 2024. Hearing loss is estimated to affect 1.5 billion people globally, with higher rates in low- and middle-income countries (LMICs). Older adults frequently experience hearing and ear-related issues, such as age-related hearing loss and cerumen impaction. Access to ear and hearing services in LMICs, including sub-Saharan Africa, is challenged by limited resources, a scarcity of hearing care professionals, and underdeveloped economic infrastructures. Mobile technologies and task-shifting strategies are potential solutions to mitigate these challenges. This study implemented a community-based approach, utilising task-shifting to CHWs, to improve hearing care in these regions. This study aimed to describe the prevalence and characteristics of hearing loss in a self-referred adult cohort in low-income South African communities and to evaluate the effectiveness of a community-based cerumen management protocol implemented in a community-based setting. This study employed a cross-sectional, predominantly quantitative design. A total of 227 participants, aged between 43 and 102 years, were recruited through self-referral from two community centres located in low-income communities (Khayelitsha and Mbekweni) in the Western Cape, South Africa. All participants underwent a hearing evaluation, and those identified with cerumen impaction received cerumen management. Of the 448 ears evaluated, 57.9% had normal video otoscopy results, 29.1% had cerumen impaction, and 1.3% had other abnormalities. A high prevalence (97.8%) of confirmed hearing loss was observed, with mild hearing loss being the most common (45.8%). Sensorineural hearing loss was the predominant type (55.3%), followed by conductive hearing loss due to cerumen impaction (28.4%) and other conductive/mixed hearing loss (1.3%). Our cerumen management program successfully improved some participants’ hearing thresholds and restored outer ear canal integrity. After cerumen removal, 50.9% of participants with cerumen impaction had normal video otoscopy results, with mean hearing improvements of 16.2 dB (±17.9 SD) in the left ears and 15.8 dB (±17.2 SD) in the right ears. However, the overall improvement in hearing thresholds was limited in significance. The rising rates of hearing loss in LMICs, particularly among older adults, underscore the importance of incorporating hearing care into primary healthcare (PHC) settings. Our community-based cerumen management plan effectively restored outer ear canal integrity and improved hearing thresholds for some individuals. Integrating community resources and task-shifting strategies holds significant potential in addressing ear-related issues through a cost-effective service model in resource-constrained settings. Speech-Language Pathology and Audiology MA Audiology Unrestricted Faculty of Humanities SDG-03: Good heatlh and well-being 2024-11-21T13:06:21Z 2024-11-21T13:06:21Z 2025-04 2024-09 Dissertation * April 2025 (A2025) http://hdl.handle.net/2263/99230 https://doi.org/10.25403/UPresearchdata.26970355 en_US © 2023 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. application/pdf University of Pretoria
spellingShingle UCTD
Sustainable Development Goals (SDGs)
Hearing loss
Low-income community
Elderly population
Task-shifting
Cerumen impaction
Cerumen management
Community-based care
Primary ear care in low-income settings : hearing loss characteristics and cerumen management efficacy
title Primary ear care in low-income settings : hearing loss characteristics and cerumen management efficacy
title_full Primary ear care in low-income settings : hearing loss characteristics and cerumen management efficacy
title_fullStr Primary ear care in low-income settings : hearing loss characteristics and cerumen management efficacy
title_full_unstemmed Primary ear care in low-income settings : hearing loss characteristics and cerumen management efficacy
title_short Primary ear care in low-income settings : hearing loss characteristics and cerumen management efficacy
title_sort primary ear care in low income settings hearing loss characteristics and cerumen management efficacy
topic UCTD
Sustainable Development Goals (SDGs)
Hearing loss
Low-income community
Elderly population
Task-shifting
Cerumen impaction
Cerumen management
Community-based care
url http://hdl.handle.net/2263/99230
https://doi.org/10.25403/UPresearchdata.26970355