Abstract
Background: In Minority World countries, up to 5 in every 1000 newborns are congenitally affected by hearing impairment. Due to the physiologically irretrievable loss of maturation in untreated hearing impairment in early childhood, language development fails to take place, and serious consequences occur. Thus, the participative and educational opportunities of the affected child are minimized. An interdisciplinary approach, including special needs education, otorhinolaryngology, speech–language therapy (SLT), and information technology (IT), is necessary to face the challenges of delayed social, cognitive, and emotional development by implementing diagnosis and treatment of infant sensorineural hearing loss in Tanzania. This interdisciplinary project aims to implement an early diagnostic approach in sub-Saharan Africa (SSA) to detect and treat infant hearing impairment. Methodology: A multi-centered cross-method project to improve educational and participation opportunities of children with severe sensorineural hearing loss is described. As a first step, universal newborn hearing screening (UNHS) was implemented and monitored in a clinical context in Tanzania. Telemedical applications will be adopted with the provision of hearing aids and cochlear implants (CI). Additional training of speech–language therapists (SLTs), audiologists, and other field-related professionals in hearing impairment will take place in a digital, transnational way. Results: UNHS was successfully implemented at Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania, which provided the first audiological and UNHS training of trainers and screeners. The obtained data were evaluated concerning prevalence, risk factors, and comorbidities of newborn hearing impairment. As the next step, more screenings will be conducted and informational material will be developed. The focus will be on materials for the support and education of hearing-impaired young children because they can benefit most from early diagnosis as well as further treatment, for example, technical devices such as hearing aids or CI. Discussion: This multi-centered study enables the first epidemiological assessment of childhood sensorineural hearing impairment in Tanzania. Alongside pedagogical and medical-therapeutic measures, this study increases the future educational and participation chances of hearing-impaired children in Tanzania.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Notes
- 1.
For a basic background to ear, nose, throat medicine (ENT), see Maqbool and Maqbool (2007).
- 2.
For further information and a medical perspective on cochlear implantation, see Lesinski-Schiedat et al. (2023).
- 3.
This project is funded by the Lower Saxony Ministry of Social Affairs, Health and Equal Opportunities.
- 4.
For information and examples of informational material for community empowerment, see Wu et al. (2023).
References
Abraham, Z., Massawe, E., Ntunaguzi, D., Kahinga, A., & Mawala, S. (2019). Prevalence of noise-induced hearing loss among textile industry workers in Dar es Salaam, Tanzania. Annals of Global Health, 85, 1–6. https://doi.org/10.5334/aogh.2352
American Speech-Language-Hearing Association (ASHA). (n.d.). Telepractice. https://www.asha.org/Practice-Portal/Professional-Issues/Telepractice/. Accessed19 Dec 2021.
Bastos, I., Mallya, J., Ingvarsson, L., Reimer, Å., & Andréasson, L. (1995). Middle ear disease and hearing impairment in northern Tanzania. A prevalence study of school children in the Moshi and Monduli districts. International Journal of Pediatric Otorhinolaryngology, 32, 1–12. https://doi.org/10.1016/0165-5876(94)01904-C
Ching, T. Y. C. (2013). Optimizing listening potential through acoustic amplification. In E. M. Fitzpatrick & S. P. Doucet (Eds.), Pediatric audiologic rehabilitation: From infancy to adolescence (pp. 29–43). Thieme.
Deutsches Hörzentrum (DHZ). (n.d.). Remote care. https://www.dhz.clinic/en/hearing-aids/ci/remote-care. Accessed 19 Dec 2021
Division Sustainable Development Goals. (2020). Sustainable development goals. https://sustainabledevelopment.un.org/sdgs. Accessed 26 May 2022.
Dobie, R. A., & van Hemel, S. (2004). Hearing loss: Determining eligibility for social security benefits. National Academies Press.
Estabrooks, W., MacIver-Lux, K., Rhoades, E. A., & Lim, S. R. (2016). Auditory-verbal therapy: An overview. In W. Estabrooks, K. MacIver-Lux, & E. A. Rhoades (Eds.), Auditory-verbal therapy: For young children with hearing loss and their families and the practitioners who guide them (pp. 1–22). Plural.
Fitzpatrick, E. M., & Doucet, S. P. (2013). Listening and spoken language at school age. In E. M. Fitzpatrick & S. P. Doucet (Eds.), Pediatric audiologic rehabilitation: From infancy to adolescence (pp. 142–115). Thieme.
Freeland, A., Jones, J., & Mohammed, N. K. (2010). Sensorineural deafness in Tanzanian children - Is ototoxicity a significant cause? A pilot study. International Journal of Pediatric Otorhinolaryngology, 74, 516–519. https://doi.org/10.1016/j.ijporl.2010.02.010
Geers, A. E., Mitchell, C. M., Warner-Czyz, A., Wang, N.-Y., & Eisenberg, L. S. (2017). Early sign language exposure and cochlear implantation benefits. Pediatrics, 140(1), 1–9. https://doi.org/10.1542/peds.2016-3489
Graydon, K., Waterworth, C., Miller, H., & Gunasekera, H. (2019). Global burden of hearing impairment and ear disease. The Journal of Laryngology and Otology, 133, 18–25. https://doi.org/10.1017/S0022215118001275
Hoth, S., & Baljić, I. (2017). Current audiological diagnostics. GMS current topics in Otorhinolaryngology, Head and Neck Surgery, 16, 1–41. https://doi.org/10.3205/cto000148
James, S. L., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., et al. (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392, 1789–1858. https://doi.org/10.1016/S0140-6736(18)32279-7
Kisanga, S. E. (2019). Barriers to learning faced by students who are deaf and hard of hearing in higher education institutions in Tanzania. Papers in Education and Development, 37(2), 205–229.
Kovačević, J., Slavnić, S., & Maćesić-Petrović, D. (2010). Treatment and speech-language development at the children with hearing impairments. Procedia – Social and Behavioral Sciences, 5, 163–169. https://doi.org/10.1016/j.sbspro.2010.07.066
Lenarz, T. (2018). Cochlear implant – state of the art. GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery, 5. https://doi.org/10.3205/cto000143.
Lesinski-Schiedat, A., Richard, E., Mkumbo, R., Mohamed, R. A., & Illg, A. (2023). The organization of cochlear implant programs in Tanzania: Assessment of needs and challenges. In U. Lüdtke, E. Kija, & M. K. Karia (Eds.), Handbook of Speech-Language Therapy in sub-Saharan Africa (pp. 543–551). Springer.
Lieu, J. E. C., Tye-Murray, N., & Fu, Q. (2012). Longitudinal study of children with unilateral hearing loss. The Laryngoscope, 122, 2088–2095. https://doi.org/10.1002/lary.23454
Lüdtke, U. (2012). Relational emotions in semiotic and linguistic development: Towards an intersubjective theory of language learning and language therapy. In A. Foolen, U. M. Lüdtke, T. P. Racine, & J. Zlatev (Eds.), Moving ourselves, moving others: Motion and emotion in consciousness, intersubjectivity and language (pp. 305–346). John Benjamins.
Maqbool, M., & Maqbool, S. (2007). Textbook of ear, nose and throat diseases (11th ed.). Jaypee Brothers.
McCreery, R. W., & Walker, E. A. (2016). Hearing aids and auditory-verbal therapy. In W. Estabrooks, K. MacIver-Lux, & E. A. Rhoades (Eds.), Auditory-verbal therapy: For young children with hearing loss and their families and the practitioners who guide them (pp. 127–160). Plural.
Minja, B. M., & Machemba, A. (1996). Prevalence of otitis media, hearing impairment and cerumen impaction among school children in rural and urban Dar es Salaam, Tanzania. International Journal of Pediatric Otorhinolaryngology, 37, 29–34. https://doi.org/10.1016/0165-5876(96)01363-8
Mndeme, F. G., & Mkoma, S. L. (2012). Assessment of work zone noise levels at a cement factory in Tanga, Tanzania. Ethiopian Journal of Environmental Studies and Management, 5, 225–231. https://doi.org/10.4314/ejesm.v5i3.2
Morton, C. C., & Nance, W. E. (2006). Newborn hearing screening - A silent revolution. The New England Journal of Medicine, 354, 2151–2164. https://doi.org/10.1056/NEJMra050700
Musiba, Z. (2015). The prevalence of noise-induced hearing loss among Tanzanian miners. Occupational Medicine, 65, 386–390. https://doi.org/10.1093/occmed/kqv046
Nyarubeli, I. P., Tungu, A. M., Moen, B. E., & Bråtveit, M. (2019). Prevalence of noise-induced hearing loss among Tanzanian iron and steel workers: A cross-sectional study. International Journal of Environmental Research and Public Health, 16, 1–13. https://doi.org/10.3390/ijerph16081367
Olusanya, B. O. (2004). Classification of childhood hearing impairment: Implications for rehabilitation in developing countries. Disability and Rehabilitation, 26, 1221–1228. https://doi.org/10.1080/09638280410001724852
Rhoades, E. A., & MacIver-Lux, K. (2016). Parent coaching strategies in auditory-verbal therapy. In W. Estabrooks, K. MacIver- Lux, & E. A. Rhoades (Eds.), Auditory-verbal therapy: For young children with hearing loss and their families and the practitioners who guide them (pp. 327–340). Plural.
Rhoades, E. A., Maclver-Lux, K., & Lim, S. R. (2016). Inclusion at school and auditory-verbal therapy. In W. Estabrooks, K. MacIver-Lux, & E. A. Rhoades (Eds.), Auditory-verbal therapy: For young children with hearing loss and their families and the practitioners who guide them (pp. 493–506). Plural.
Ross, D. S., Visser, S. N., Holstrum, W. J., Qin, T., & Kenneson, A. (2010). Highly variable population-based prevalence rates of unilateral hearing loss after the application of common case definitions. Ear and Hearing, 31, 126–133. https://doi.org/10.1097/AUD.0b013e3181bb69db
Schütte, U., Polzin, C., Vuliva, A., & Lüdtke, U. (2023). Clinical competence of SLTs in culturally and linguistically diverse contexts: A qualitative study of intercultural work experiences abroad. In U. Lüdtke, E. Kija, & M. K. Karia (Eds.), Handbook of Speech-Language Therapy in sub-Saharan Africa (pp. 75–96). Springer.
Schwab, S., Wimberger, T., & Mamas, C. (2019). Fostering social participation in inclusive classrooms of students who are deaf. International Journal of Disability, Development and Education, 66, 325–342. https://doi.org/10.1080/1034912X.2018.1562158
Smith, R. J. H., Bale, J. F., & White, K. R. (2005). Sensorineural hearing loss in children. The Lancet, 365, 879–890. https://doi.org/10.1016/S0140-6736(05)71047-3
Solvang, I. E., Naalsund, K., Tønder, S., Hansen, G. S., Hagan, T. B., Mnyanyi, C., et al. (2020). Prevalence of hearing impairment among primary school children in the Kilimanjaro region within Tanzania. International Journal of Pediatric Otorhinolaryngology, 130, 109797. https://doi.org/10.1016/j.ijporl.2019.109797
Turunen-Taheri, S., Carlsson, P.-I., Johnson, A.-C., & Hellström, S. (2019). Severe-to-profound hearing impairment: Demographic data, gender differences and benefits of audiological rehabilitation. Disability and Rehabilitation, 41, 2766–2774. https://doi.org/10.1080/09638288.2018.1477208
United Nations (UN). (2006). Convention on the rights of persons with disabilities (CRPD). United Nations. https://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities.html. Accessed 20 Apr 2022.
United Republic of Tanzania. (2009). National strategy on inclusive education 2009–2017. http://www.africanchildforum.org/clr/policy%20per%20country/2018%20Update/Tanzania/tanzania_education_2009-2017_en.pdf. Accessed 12 Feb 2022.
United Republic of Tanzania. (2017). National Strategy for inclusive education 2018–2021. Dar es Salaam. http://planipolis.iiep.unesco.org/sites/planipolis/files/ressources/national_strategy_for_inclusive_education_version_for_signing.pdf. Accessed 12 Feb 2022..
Wang, N.-M., Liu, C.-J., Liu, S.-Y., Huang, K.-Y., & Kuo, Y.-C. (2011). Predicted factors related to auditory performance of school-aged children with cochlear implants. Cochlear Implants International, 12(Suppl 1), S92–S95. https://doi.org/10.1179/146701011X13001035752615
Watkin, P. M., & Baldwin, M. (2011). Identifying deafness in early childhood: Requirements after the newborn hearing screen. Archives of Disease in Childhood, 96, 62–66. https://doi.org/10.1136/adc.2010.185819
Wolfe, J., & Neumann, S. (2016). Implantable hearing technologies and auditory-verbal therapy. In W. Estabrooks, K. MacIver-Lux, & A. Rhoades (Eds.), Auditory-verbal therapy: For young children with hearing loss and their families and the practitioners who guide them (pp. 161–200). Plural.
World Health Organization (WHO). (2017). Global costs of unaddressed hearing loss and cost-effectiveness of interventions. World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/254659/9789241512046-eng.pdf;jsessionid=D414F251F78D06A07F64B34D3CFED97C?sequence=1. Accessed 30 Mar 2022..
World Health Organization (WHO). (2021). Deafness and hearing loss. https://www.who.int/news-room/factsheets/detail/deafness-and-hearing-loss. Accessed 12 Feb 2022.
Wu, J., Polzin, C., Vuliva, A., Mdemu, E. M., Beta, K., & Lüdtke, U. (2023). A network of knowledge: Participatory development of culturally sensitive information, education and communication materials for the prevention of communication disability in rural Tanzania. In U. Lüdtke, E. Kija, & M. K. Karia (Eds.), Handbook of Speech-Language Therapy in sub-Saharan Africa (pp. 283–312). Springer.
Acknowledgments
Our warmest thanks go to all the mothers and their children who participated in this pilot study. Further, we would gratefully like to thank the Ministry of Social Welfare, Health and Equal Opportunities, Lower Saxony, Germany, for funding, and the KIND Hörstiftung and Zeisberg GmbH, without whom this project could not have been realized in this fruitful way. Further, the authors thank Catherine Haab for developing the app.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Lüdtke, U.M. et al. (2023). Hear Africa! Improving Language Development, Education, and Participation of Children with Severe Sensorineural Hearing Loss in Tanzania. In: Lüdtke, U.M., Kija, E., Karia, M.K. (eds) Handbook of Speech-Language Therapy in Sub-Saharan Africa. Springer, Cham. https://doi.org/10.1007/978-3-031-04504-2_16
Download citation
DOI: https://doi.org/10.1007/978-3-031-04504-2_16
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-04503-5
Online ISBN: 978-3-031-04504-2
eBook Packages: Behavioral Science and PsychologyBehavioral Science and Psychology (R0)