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Purpose: The aim of this study was to describe extended high-frequency (EHF) pure-tone audiometry monitoring of ototoxicity in a longitudinal treatment program for drug-resistant tuberculosis (DRTB). Method: This was a retrospective record review of longitudinal conventional (0.25-8 kHz) and EHF (9-16 kHz) audiometry for ototoxicity monitoring of DRTB patients undergoing treatment at community-based clinics between 2013 and 2017. Data from 69 patients with an average age of 37.9 years (SD = 11.2, range: 16.0-63.8 years) were included. Patients were assessed by primary health care audiologists (87%) or community health workers (13%) using portable audiological equipment. The average length of time between initial and exit assessments was 84.6 days (SD = 74.2, range: 2-335 days). Results: EHF ototoxicity of a mild or greater degree of hearing loss (> 25 dB HL in one or both ears across frequencies) was evident in 85.5% of patients' posttreatment, compared with 47.8% of patients across conventional frequencies. EHF audiometry demonstrated an ototoxic shift (American Speech-Language-Hearing Association criteria) in 56.5% of cases compared with 31.9% when only conventional audiometry was considered. Mean hearing deterioration for patients was significant across EHFs (9-16 kHz) bilaterally (p < .05). Absent EHF thresholds at the initial assessment, owing to maximum output limits, was a limitation that occurred most frequently at 16 kHz (17.4%, 24/138). Conclusions: EHF audiometry is most sensitive for the early detection of ototoxicity and should be included in monitoring programs. Clinical ototoxicity monitoring protocols should consider shortened assessment approaches that target frequencies most sensitive to ototoxicity, including EHFs. Supplemental Material: https://doi.org/10.23641/asha.21651242 [ABSTRACT FROM AUTHOR]

Purpose: The study investigated whether the auditory brainstem response (ABR) at a baseline and at higher repetition rates can detect if neurodegeneration has occurred in adults living with HIV who present with normal behavioral puretone thresholds. Method: An exploratory research design was used. Forty adults with HIV (80 ears, 57.5% female; Mage = 26.3 years, SD = 3.68) and 20 adults without HIV participated. Phase 1 compared ABR absolute and interwave latencies at a baseline rate. Phase 2 examined the effect of HIV status and category of immunodeficiency on ABR absolute Wave V latency and Wave V latency shift at increased stimulus rates. Analysis included a two-way analysis of variance of the interaction between stimulus rate and HIV status and between CD4+ category and rate, and multiple regression analysis. Results: In adults living with HIV, the baseline ABR yielded prolonged Wave III and V absolute latencies and interpeak prolongations in 22.5%. Interaural Wave V latency differences were present in 15% of participants. An additional 15% of ears presented with abnormal Wave V at increased rates. No significant interaction between HIV status and rate in either ear or between CD4+ category and rate was found in either ear (p > .05). Although rate and gender contributed significantly to the prediction of Wave V latency of the rate study (left and right, p < .001), HIV status did not (left and right, p > .05). Conclusions: Although the interaction of HIV status and CD4+ with rate was not significant, more ears were identified with abnormal results at increased stimulus rates than with the baseline ABR alone. The ABR at increased rates may therefore be a valuable addition for the identification of individuals living with HIV with auditory neural deficiencies. [ABSTRACT FROM AUTHOR]

Background: P300 event-related potentials can be used to measure auditory processing speed, working memory, and attention. Purpose: The purpose of the study was to compare P300 event-related potentials in normal-hearing adults with those of adults with Type II diabetes mellitus. Research Design: A two-group (with diabetes and controls) comparative study (age- and sex-matched) with a nonprobability sampling method was used. Study Sample: Sixty-four adult participants (32 with diabetes, 32 without diabetes) between the ages of 23 and 60 years participated. Data Collection and Analysis: Pure-tone audiometry was performed to ensure participants had pure-tone averages of ≤ 25 dB HL. Folstein Mini-Mental State Examinations were conducted, which ensured absence of cognitive impairment. Blood glucose levels were measured immediately prior to P300 testing, after which amplitude and latency results were captured. Descriptive analysis was used to calculate mean, standard deviation, median, and 25th and 75th percentiles. To study differences between adults with and without diabetes as well as the effect of glucose, linear mixedmodel regression analyses were performed when left and right ears were combined, and simple linear regression analyses were performed when left and right ears were analyzed separately. Results: For P300 latency results, a significant statistical difference (p < .001) was observed between participants with and without diabetes (352.46 ms, SD = 36.36; 314.09 ms, SD = 32.08), respectively. A significant statistical difference (p < .001) in amplitude was observed between participants with and without diabetes, respectively (12.10 μV, SD = 3.70; 15.08 μV, SD = 2.82). Glucose was a key moderator of only amplitude after adjusting for diabetes status. Glucose had no effect on amplitude and latency for adults without Type II diabetes mellitus (DM). Conclusions: Type II DM decreases amplitude and increases latency; in addition, adults with Type II DM, attention, and working memory, as denoted by P300 amplitude, may deteriorate with increased glucose levels on the day of testing. [ABSTRACT FROM AUTHOR]

Background: Hearing loss is one of the most common developmental disorders identifiable at birth with its prevalence increasing throughout school years. However, early detection programs are mostly unavailable in low- and middle-income countries (LMICs) where more than 80% of children with hearing loss reside. Objective: This study investigated the feasibility of a smartphone-based hearing screening program for preschool children operated by community healthcare workers (CHWs) in community-based early childhood development (ECD) centers. Method: Five CHWs were trained to map ECD centers and conduct smartphone-based hearing screenings within a poor community in South Africa over a 12-month period. The hearScreenTM smartphone application employed automated test protocols operating on low-cost smartphones. A cloud-based data management and referral function allowed for remote monitoring for surveillance and follow up. Results: 6424 children (3-6 years) were screened for hearing loss with an overall referral rate of 24.9%. Only 39.4% of these children attended their follow-up appointment at a local clinic, of whom 40.5% referred on their second screening. Logistic regression analysis indicated that age, gender and environmental noise levels (1 kHz) had a significant effect on referral rates (p < 0.05). The quality index reflecting test operator test quality increased during the first few months of testing. Conclusion: Smartphone-based hearing screening can be used by CHWs to detect unidentified children affected by hearing loss within ECD centers. Active noise monitoring, quality indices of test operators and cloud-based data management and referral features of the hearScreenTM application allows for the asynchronous management of hearing screenings and follow-ups. [ABSTRACT FROM AUTHOR]

Abstract Objective This study aimed to determine and describe hearing loss among preschool children in a South African community representative of typical low- and middle income countries (LMIC). Method Children between the ages of 3–6 years received a hearing screening at their early childhood development (ECD) center. If a child failed the hearing screening, he/she was seen for a follow-up rescreen and diagnostic assessment if necessary at their ECD center or closest referral clinic. Diagnostic testing consisted of otoscopy, tympanommetry and pure-tone diagnostic audiometry. Results A total of 6424 children were screened at ECD centers with a referral rate of 24.9%. Follow-up assessments were conducted on 45.3% (725) of these children. Diagnostic testing revealed that 9.3% of children presented with impacted cerumen and 18.7% presented with a hearing loss (56.5% binaural). Binary logistic regression revealed no gender or age effects (p > 0.05). Conductive hearing loss (65.2%) was the most common type of hearing loss found in children. Conclusions Most preschool children who failed the hearing screening and received a diagnostic assessment were in need of intervention services for conductive hearing losses, followed by sensorineural and mixed losses. [ABSTRACT FROM AUTHOR]