B4School Tympanometry Screening Is Not Equitable
Authors List
Oliver, T., Leversha, A., Garland, R., Te Whatu Ora, Wellington, New Zealand
Searchfield, A., Exeter, D., Manuel, A., Purdy, SC., University of Auckland, New Zealand
Jo, E., Health New Zealand and the University of Auckland, Wellington, New Zealand
Introduction
Otitis media with effusion (OME) is a common childhood illness in Aotearoa. Though often brief, if it is prolonged it can affect early childhood and school learning. The B4School check is a screening programme for four-year-olds that includes a pure tone audiometry screen with supplemental tympanometry for children who do not pass the pure tone screen. Children with flat tympanograms and associated hearing loss are referred. It is recommended that families seek review in primary care, on the assumption that their child likely has OME.
Aims
To investigate the numbers of children who are missed for screening, as well as those children with flat tympanography, to determine if there is inequity within the programme as well as in subsequent access to appropriate management.
Methods
Retrospective cohort study of children eligible for B4School check between January 2018 and December 2022. This study interrogated data from the B4School programme, analysing all children screened nationwide. Their data were linked to individual level demographic data held within the Ministry of Health, including ethnicity, deprivation statistics and enrolment status in and access to primary healthcare. Children were also identified within Ministry of Health databases who did not appear in the B4School database and hence were missed for screening.
Results
Māori, Pacific, and children living in more deprived areas were significantly less likely to have hearing screening. Furthermore, when screened these children had higher rates of OME and were less likely to be referred onwards. They also have significantly poorer access to primary healthcare to enable appropriate follow-up and management.
Conclusion
Recommendations can be made to assist in the redevelopment of a more equitable national screening programme, including OME management.
Oliver, T., Leversha, A., Garland, R., Te Whatu Ora, Wellington, New Zealand
Searchfield, A., Exeter, D., Manuel, A., Purdy, SC., University of Auckland, New Zealand
Jo, E., Health New Zealand and the University of Auckland, Wellington, New Zealand
Introduction
Otitis media with effusion (OME) is a common childhood illness in Aotearoa. Though often brief, if it is prolonged it can affect early childhood and school learning. The B4School check is a screening programme for four-year-olds that includes a pure tone audiometry screen with supplemental tympanometry for children who do not pass the pure tone screen. Children with flat tympanograms and associated hearing loss are referred. It is recommended that families seek review in primary care, on the assumption that their child likely has OME.
Aims
To investigate the numbers of children who are missed for screening, as well as those children with flat tympanography, to determine if there is inequity within the programme as well as in subsequent access to appropriate management.
Methods
Retrospective cohort study of children eligible for B4School check between January 2018 and December 2022. This study interrogated data from the B4School programme, analysing all children screened nationwide. Their data were linked to individual level demographic data held within the Ministry of Health, including ethnicity, deprivation statistics and enrolment status in and access to primary healthcare. Children were also identified within Ministry of Health databases who did not appear in the B4School database and hence were missed for screening.
Results
Māori, Pacific, and children living in more deprived areas were significantly less likely to have hearing screening. Furthermore, when screened these children had higher rates of OME and were less likely to be referred onwards. They also have significantly poorer access to primary healthcare to enable appropriate follow-up and management.
Conclusion
Recommendations can be made to assist in the redevelopment of a more equitable national screening programme, including OME management.
