Introduction Globally, more than 50 million children have hearing or vision loss. Most of these sensory losses are identified late due to a lack of systematic screening, making treatment and rehabilitation less effective. Mobile health (mHealth), which is the use of smartphones or wireless devices in health care, can improve access to screening services. mHealth technologies allow lay health workers (LHWs) to provide hearing and vision screening in communities. Purpose The aim of the study was to evaluate a hearing and vision school screening program facilitated by LHWs using smartphone applications in a low-income community in South Africa. Method Three LHWs were trained to provide dual sensory screening using smartphone-based applications. The hearScreen app with calibrated headphones was used to conduct screening audiometry, and the Peek Acuity app was used for visual acuity screening. Schools were selected from low-income communities (Gauteng, South Africa), and children aged between 4 and 9 years received hearing and vision screening. Screening outcomes, associated variables, and program costs were evaluated. Results A total of 4,888 and 4,933 participants received hearing and vision screening, respectively. Overall, 1.6% of participants failed the hearing screening, and 3.6% failed visual acuity screening. Logistic regression showed that female participants were more likely to pass hearing screening (OR = 1.61, 95% CI [1.11, 2.54]), while older children were less likely to pass visual acuity screening (OR = 0.87, 95% CI [0.79, 0.96]). A third (32.5%) of referred cases followed up for air-conduction threshold audiometry, and one in four (25.1%) followed up for diagnostic vision testing. A high proportion of these cases were confirmed to have hearing (73.1%, 19/26) or vision loss (57.8%, 26/45). Conclusions mHealth technologies can enable LHWs to identify school-age children with hearing and/or vision loss in low-income communities. This approach allows for low-cost, scalable models for early detection of sensory losses that can affect academic performance.

中文翻译：

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使用移动健康技术在低收入社区的学校进行基于社区的听力和视力筛查。

简介 在全球范围内，有超过 5000 万儿童患有听力或视力丧失。由于缺乏系统的筛查，大多数这些感觉丧失被发现较晚，从而降低了治疗和康复的效果。移动健康 (mHealth)，即在医疗保健中使用智能手机或无线设备，可以改善获得筛查服务的机会。移动医疗技术允许非专业卫生工作者 (LHW) 在社区提供听力和视力筛查。目的 本研究的目的是评估南非低收入社区中由 LHW 使用智能手机应用程序推动的听力和视力学校筛查计划。方法 三名 LHW 接受了培训，以使用基于智能手机的应用程序提供双重感官筛选。带有校准耳机的 heartScreen 应用程序用于进行筛查测听，Peek Acuity 应用程序用于视力筛查。学校选自低收入社区（南非豪登省），4 至 9 岁的儿童接受听力和视力筛查。对筛查结果、相关变量和项目成本进行了评估。结果 共有 4,888 名和 4,933 名参与者分别接受了听力和视力筛查。总体而言，1.6% 的参与者未能通过听力筛查，3.6% 的参与者未能通过视力筛查。Logistic 回归显示，女性参与者更有可能通过听力筛查（OR = 1.61, 95% CI [1.11, 2.54]），而年龄较大的儿童不太可能通过视力筛查（OR = 0.87, 95% CI [0.79, 0.96]）。三分之一 (32.5%) 的转诊病例跟进了空气传导阈值测听，四分之一 (25. 1%) 跟进诊断性视力测试。这些病例中有很大一部分被证实有听力 (73.1%, 19/26) 或视力丧失 (57.8%, 26/45)。结论 mHealth 技术可以使 LHW 能够识别低收入社区中听力和/或视力丧失的学龄儿童。这种方法允许使用低成本、可扩展的模型来及早检测可能影响学业成绩的感官损失。