title: Paediatric diagnostic audiology testing in South Africa.
abstract: BACKGROUND
  With the increased emphasis on the importance of early identification of paediatric hearing loss within developing countries such as South Africa and Nigeria there has been a recognition of the ethical obligation to ensure access to timely diagnostic and intervention services for children identified with hearing loss; regardless of their geographic or socioeconomic status. There are limited studies on diagnosis of paediatric hearing loss in a developing world context.
  
  
  OBJECTIVE
  The objective of this study was to determine processes used for diagnosis of paediatric hearing loss in South Africa, across the private and public healthcare sectors, and to profile the age of testing for each component of the diagnostic test battery.
  
  
  METHODS
  Diagnostic audiology testing data of 230 children enrolled in an early intervention programme was analysed to profile the reporting of diagnostic audiology testing as well as diagnostic audiology procedures employed. Results were analysed according to province as well as healthcare sector to compare diagnostic services across regions as well as healthcare sectors.
  
  
  RESULTS
  The differences in audiology practice and tests employed with paediatric clients across the regions of Gauteng, Kwazulu Natal and Western Cape indicates that services across regions and across the public and private sector are not equitable. Each region is equally unlikely to complete a full, comprehensive diagnostic evaluation on paediatric clients. The age of testing highlights the increased age of diagnosis of hearing loss.
  
  
  CONCLUSIONS
  Paediatric diagnostic audiology is a section of Early Hearing Detection and Intervention services that requires attention in terms of the appropriateness of procedures as well as equity of services. Further studies on diagnostic practice and resources in South Africa will provide information on factors that are preventing adherence to international best practice guidelines for paediatric diagnostic audiology.
authors: Centre for Deaf Studies, University of the Witwatersrand, South Africa. Electronic address: selvarani.moodley@wits.ac.za.
authors: Selvarani
authors: S
authors: Moodley
mesh_terms: D001298:Audiology / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D042241:Early Diagnosis; D018479:Early Intervention, Educational; D005260:Female; D006309:Hearing; D034381:Hearing Loss / Q000175:diagnosis* / Q000453:epidemiology; D006320:Hearing Tests / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D010372:Pediatrics; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology
keywords: Diagnosis; Hearing loss; Paediatric audiology