Deepashree Joshi B, Vidya Ramkumar, Lekha S Nair, Hannah Kuper
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引用次数: 5
摘要
背景:高收入国家(HICs)发起的早期听力检测和干预(EHDI)措施在低收入和中等收入国家(L&MICs)进行了尝试。然而，关于EHDI模型的信息、对策略和结果的具体适应情况尚不清楚。目的:本系统综述的目的是确定已发表的科学文献中用于亚洲低收入和中等收入国家的各种EHDI模型，并描述其疗效和效度。方法:如果研究项目来自亚洲低收入和中等收入国家，针对6岁以下儿童实施，并在2010年至2021年间发表，则该研究符合条件。使用Google Scholar、PubMed、Web of Science、Scopus、EBSCOHost和ebscoc - cinahl检索文章。从每篇选定的文章中提取数据，并评估偏倚风险。使用系统评价和元分析优选报告项目流程图对搜索结果进行总结。主要结局采用叙事综合，次要结局采用森林图。结果:总共纳入了82项研究，这些研究分为两类:新生儿和婴儿筛查计划和年龄较大的儿童筛查计划。在新生儿和婴儿筛查方案中，主要采用两阶段客观耳声发射(畸变产物/瞬态诱发)或自动听觉脑干反应筛查，然后进行详细的听觉脑干反应来确认听力损失。听力学家是最常见的筛查人员。年龄较大的儿童的筛查主要由耳鼻喉科医生、学校教师和护士完成。他们进行了单阶段纯音听力筛查，然后进行了详细的检查。结论:使用的筛选工具和方案与HICs相似。但是，每个国家都没有遵循统一的议定书。由于有关成本效益等影响结果的信息有限，EHDI项目的长期可行性尚不清楚。普洛斯彼罗注册号:CRD42021240341。
Early hearing detection and intervention (EHDI) programmes for infants and young children in low-income and middle-income countries in Asia: a systematic review.
Background: Early hearing detection and intervention (EHDI) measures initiated in high-income countries (HICs) were attempted in low-income and middle-income countries (L&MICs). However, information regarding the models of EHDI, context-specific adaptations made to strategies and outcomes are not known.
Aims: The aims of this systematic review were to identify the various models of EHDI used in Asian L&MICs in the published scientific literature and to describe their efficacy and validity.
Methods: The studies were eligible if the programme was from Asian L&MICs, implemented for children below 6 years of age and published between 2010 and 2021. Google Scholar, PubMed, Web of Science, Scopus, EBSCOHost and EBSCO-CINAHL were used to find articles. Data were extracted from each selected article, and the risk of bias was assessed. The search results were summarised using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram. For primary outcomes, narrative synthesis was used, and forest plots were generated for secondary outcomes.
Results: In all, 82 studies were included, and these studies were divided into two categories: newborn and infant screening programmes and screening programmes for older children. Predominantly, a two-stage objective otoacoustic emission (Distortion Product/Transient Evoked) or automated auditory brainstem response screening, followed by a detailed auditory brainstem response to confirm the hearing loss, was used in newborn and infant screening programmes. Audiologists were the most frequent screening personnel. Screening of older children was mostly done by otolaryngologists, school instructors and nurses. They performed a single-stage pure tone audiometry screening followed by a detailed examination.
Conclusion: The screening tools and protocols used were similar to those used in HICs. However, no uniform protocols were followed within each country. Long-term viability of EHDI programmes was not known as there was limited information on impact outcomes such as cost-benefit.
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