Coronavirus disease (COVID-19) pandemic is the latest threat to global health that causes severe acute respiratory syndrome (SARS). Tele-practice has inadvertently sprung to the forefront to become a common practice amongst healthcare providers during COVID-19. Limited evidence exists on the use of tele-practice in assessing middle ear function in adults living with HIV during the COVID-19 pandemic. The aims of this study were to investigate the use of tele-practice for assessment of middle ear function in adults with HIV during the COVID-19 pandemic. A quantitative observational, cross-sectional design was adopted. A total of 134 adults diagnosed with HIV were purposively selected from the HIV clinic. An audiology researcher, in the role of site-facilitator, captured video otoscopic images of the tympanic membrane using a video otoscopy for all participants through asynchronous tele-practice. All captured images were sent to two independent otorhinolaryngologists for diagnosis. Findings of this study indicated that tele-practice can be used to assess middle ear function in adults living with HIV during COVID-19 pandemic. When asynchronous tele-practice was used, there was a moderate diagnostic agreement (k = 0.58) between the two otorhinolaryngologists on abnormality versus normality, but poor agreement (k = 0.15) on the nature of abnormality (e.g. OME vs CSOM). Current findings highlight the urgent need for a widespread use of tele-practice during the continued clinical follow up and management of adults living with HIV, and the implementation of tele-practice, particularly in low- and middle-income countries (LMICs) where capacity versus demand challenges related to ear and hearing care continue to exists.

Background: Simulation plays an important role as an alternative method for training of students, particularly in health education. As a result of coronavirus disease 2019 (COVID-19) restrictions of face-to-face interactions, traditional teaching methods have been disrupted, increasing the need for alternative methods to supplement modes of student clinical training in healthcare programmes.Objectives: The scoping review aimed to determine what has been documented about simulation as a mode of clinical training in healthcare professions (HCPs) in order to guide speech-language pathology and audiology (SLPA) professions during the COVID-19 pandemic and beyond.Method: A scoping review was conducted. Electronic bibliographic databases including Science Direct, PubMed, Scopus MEDLINE, ProQuest, Google Scholar and WorldCat were searched to identify peer reviewed publications, published in English, between January 2011 and December 2021, and related to the use of simulation in HCPs clinical training programmes.Results: A total of 32 articles met the inclusion criteria for this scoping review. Three themes emerged when reviewing the studies: (1) face-to-face simulations as a mode of clinical training, (2) virtual reality simulation and telesimulation as modes of clinical training and (3) simulation as a complementary mode of clinical training. Evidence suggests that whilst simulations are cost-effective, accessible and efficacious as clinical training modes, they need to be combined with other modes of training such as the traditional clinical training to yield better learning outcomes.Conclusions: Current findings highlight the role and value of simulation as a clinical training mode during COVID-19 and beyond. However, there are aspects that need to be considered to ensure that this mode of clinical training is effective, with endorsement and regulations by the SLPA Professional Board of the Health Professions Council of South Africa (HPCSA). Simulations need to be complemented with traditional clinical training methods. In the context of SLPA, particularly in low- and middle-income countries (LMICs), simulation can be used to better prepare students for their clinical placement where clinical training platforms are limited and where simulation combined with teletraining or telesupervision can be utilised to increase access to training.

Introduction: Middle ear pathologies have been linked with HIV. The onset and development of these pathologies in individuals with HIV have not been categorized; and clarity has not been gained regarding whether their presentation is any different in this population when compared to HIV negative control group. Purpose: The aim of this study was to explore and document published evidence reflecting trends in middle ear pathologies in adults living with HIV. Methods: A systematic review of literature from January 1982 to December 2018 was conducted using Medline, CINAHL, PubMed, and Psych Info. Studies that reported the occurrence rate of middle ear pathologies in adults with HIV and published in English were included. Results: Twelve articles met the inclusion criteria. Evidence suggests that the reported occurrence rates of middle ear pathologies ranges from 2.5% to 58% in this population. The variability in assessment measures as well as the different cut-off criteria used in studies seem to have an influence in the findings, with pure tone audiometry identifying more middle ear pathologies in the current review than tympanometry with 226 Hz probe tone and clinical examination. Otitis media, conductive hearing loss, and type B tympanogram were common findings reported in this study. No evidence of an association between the use of antiretroviral therapy (ART) and the rates of middle ear pathologies was found. Conclusion: Although there are very few studies that have reported on middle ear pathologies in adults living with HIV, the available studies have sufficiently established a link between HIV and middle ear disease in this population, and have revealed that the rate of occurrence is influenced by a number of factors. Key amongst these is the type of assessment measure used. Careful analysis of middle ear pathologies in this population through well controlled research designs that include different assessment measures. The use of case-control and longitudinal designs to determine differences between groups and to establish the time of onset and development of middle ear pathologies is required.

Background: Literature suggests that there is a correlation between video otoscopy and standard tympanometry findings. However, there is limited evidence on whether these two measures are comparable in the identification of middle ear pathologies in adults living with human immunodeficiency virus (HIV). Objective: This study aimed to determine the correlation between video otoscopy and standard tympanometry with 226 Hz probe tone in the identification of middle ear pathologies in adults living with HIV in Limpopo, South Africa. Method: A prospective, non-experimental, comparative design was employed on HIV-positive adults aged 18 years and older. All participants underwent basic audiological assessment including case history interviews, video otoscopy, tympanometry with a 226 Hz probe tone and pure tone audiometry. Two ear, nose and throat (ENT) specialists independently analysed video otoscopic images and provided their reports to the researcher, and these were compared to the tympanometry results. The IBM SPSS v.24 was used for data analysis, including the use of Cohen’s kappa to determine the agreement between the two procedures. Pearson’s correlation coefficient was used to determine the strength of the correlation between tympanometry and video otoscopy. Results: A total of 87 adults (N = 161 ears) took part in the study. Middle ear pathology was observed in 8% (n = 13) of the sample when tympanometry was used, and this increased to 10.6% (n = 17) when video otoscopy was utilised. Kappa statistics found a good agreement (k = 0.7) between the diagnoses made by two ENTs. However, there was poor agreement (k = 0.2) between the diagnoses by video otoscopy and tympanometry. Pearson’s correlation coefficient indicated weak correlation between video otoscopy and tympanometry (r = 0.195). Conclusion: Findings from this study suggest that video otoscopy may be more accurate in the identification of middle ear pathologies in adults living with HIV when compared to tympanometry. These findings have training implications in the use of video otoscopy to ensure accuracy and reliability. Clinical implications of current findings include the use of both video otoscopy and tympanometry in a complementary manner for more sensitive identification of middle ear pathologies in this population. Lastly, tele-audiologic implications of the use of video otoscopy to increase access in resource-constrained contexts are raised.

The South African Journal of Communication Disorders (SAJCD) publishes reports and papers concerned with research, and critically evaluative theoretical, philosophical and conceptual issues dealing with aspects of human communication and its disorders, dysphagia, service provision, training and policy.

The South African Journal of Communication Disorders (SAJCD) publishes reports and papers concerned with research, and critically evaluative theoretical, philosophical and conceptual issues dealing with aspects of human communication and its disorders, dysphagia, service provision, training and policy.