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ABSTRACT: Objective
To assess the feasibility and acceptability of training community health workers (CHWs) in ear and hearing care, and their ability to identify patients with ear and hearing disorders.Design
Cluster randomised controlled trial (RCT).Setting
Health centres in Thyolo district, Malawi.Participants
Ten health centres participated, 5 intervention (29 CHWs) and 5 control (28 CHWs).Intervention
Intervention CHWs received 3 days of training in primary ear and hearing care, while among control CHWs, training was delayed for 6 months. Both groups were given a pretest that assessed knowledge about ear and hearing care, only the intervention group was given the posttest on the third day of training. The intervention group was given 1?month to identify patients with ear and hearing disorders in their communities, and these people were screened for hearing disorders by ear, nose and throat clinical specialists.Outcome measures
Primary outcome measure was improvement in knowledge of ear and hearing care among CHWs after the training. Secondary outcome measures were number of patients with ear or hearing disorders identified by CHWs and number recorded at health centres during routine activities, and the perceived feasibility and acceptability of the intervention.Results
The average overall correct answers increased from 55% to 68% (95% CI 65 to 71) in the intervention group (p<0.001). A total of 1739 patients with potential ear and hearing disorders were identified by CHWs and 860 patients attended the screening camps, of whom 400 had hearing loss (73 patients determined through bilateral fail on otoacoustic emissions, 327 patients through audiometry). Where cause could be determined, the most common cause of ear and hearing disorders was chronic suppurative otitis media followed by impacted wax. The intervention was perceived as feasible and acceptable to implement.Conclusions
Training was effective in improving the knowledge of CHW in ear and hearing care in Malawi and allowing them to identify patients with ear and hearing disorders. This intervention could be scaled up to other CHWs in low-income and middle-income countries.Trial registration number
Pan African Clinical Trial Registry (201705002285194); Results.
SUBMITTER: Mulwafu W
PROVIDER: S-EPMC5652500 | biostudies-literature | 2017 Oct
REPOSITORIES: biostudies-literature
Mulwafu Wakisa W Kuper Hannah H Viste Asgaut A Goplen Frederik K FK
BMJ open 20171011 10
<h4>Objective</h4>To assess the feasibility and acceptability of training community health workers (CHWs) in ear and hearing care, and their ability to identify patients with ear and hearing disorders.<h4>Design</h4>Cluster randomised controlled trial (RCT).<h4>Setting</h4>Health centres in Thyolo district, Malawi.<h4>Participants</h4>Ten health centres participated, 5 intervention (29 CHWs) and 5 control (28 CHWs).<h4>Intervention</h4>Intervention CHWs received 3 days of training in primary ear ...[more]