App Making Noise in Africa
hearScreen develops a low-cost Hearing Solution
Hearing loss is a global epidemic with a significant impact on individuals, communities and, increasingly, at a societal level. The latest Global Burden of Disease Study estimated that 1.23 billion people had some form of hearing impairment (20 decibels or more) in 2013. Increasingly non-fatal conditions, such as hearing loss, are transitioning to become dominant contributors to the burden of disease.
The impact of hearing loss prevalence on the global burden of disease is further exacerbated by the inaccessibility of hearing health services for the majority of the world’s population. In regions such as sub-Saharan Africa, for example, many countries have more than 1 million people per single hearing health provider. Early access to ear and hearing health care is key to ensure optimal outcomes. In fact, up to 50 percent of hearing losses could be prevented through primary and secondary preventative measures. Those with permanent hearing losses that have early access to appropriate care can have excellent outcomes that minimize the impact of the disability and negate the associated psychosocial difficulties.
There has been growing interest in employing mHealth in the provision of ear and hearing health care, especially in underserved world regions. One of these developments is a smartphone application, which was developed at the University of Pretoria in South Africa, called hearScreen (where the author serves as CEO). Whilst there are many end-user apps available in app stores that provide some form of hearing test, none of them allows for actual calibration of headphones according to international and national standards (e.g. the International Organization for Standardization, American National Standards Institute).
(Operation screens at hearScreen, left to right: the homescreen, the signal presentation and results page.)
hearScreen was developed particularly for the developing world as a low-cost screening solution that incorporates the necessary quality control features to ensure laypersons with limited training can use it. In South Africa, more than 7,000 children and adults have already received a hearScreen test. A collaborative project with a local NGO and a early childhood development funder, Innovation Edge, will see 10,000 preschool children being tested as part of a community-based screening programme in a poor township outside of Pretoria, South Africa.
hearScreen features accurate headphone calibration according to required standards, using a low-cost smartphone. The application automates screening protocols and interpretation for adults and children according to best practice guidelines with a simple user-friendly interface and onscreen instructions that allow screening to be facilitated by persons with minimal training.
The smartphone microphone is employed for intelligent, real-time noise monitoring to evaluate if test outcomes are influenced by environmental noise. All patient details and results are captured intuitively on the smartphone and uploaded to a cloud-based server for remote data management and surveillance. Geotagged results link patients with the closest hearing health care providers and through a cloud-based server. These features make the validated hearScreen application uniquely suited to community-based hearing health provision through the use of minimally trained persons.
hearScreen will initially offer a complete solution that includes a smartphone, headphones, carry case and 100 free screening credits for a one-time price of around $400 ($4 per screening). Screening credits can be purchased in pre-paid bundles starting at $1 for a credit that will provide the screener a clinically valid screening test, an sms and pdf report and linkage to their closest hearing health providers. The hearScreen app will be made available on the Android and iOS app stores in the second quarter of 2016, allowing customers to use their own smartphones in conjunction with a hearScreen-calibrated earphone to conduct screening tests. The hearScreen solution is set to launch a crowdfunding campaign in March to help raise funds for commercialisation and to attract international interest.
- Health Care