Programa Saúde na Escola: testes de triagem para identificação da perda auditiva

Abstract

It is essential to use instruments with adequate diagnostic accuracy to identify hearing loss in schoolchildren. Knowing and managing information in hearing health that covers school environment, individual and school information, helps the elaboration of individual and collective actions in the scope of Health and Education, as the Brazilian Health in School Program (PSE) aims. The objective of this thesis is to study protocols for identifying hearing loss in elementary school students I and II, developed from five studies. Two studies of diagnostic accuracy will be described, a systematic review, an experience report and an ecological study. 1) Study of diagnostic accuracy, comparing conventional hearing screening methods to the reference standard - audiometric, tympanometric screening and otoacoustic emissions with transient stimulus (TOAE); 2) Accuracy study comparing different TOAE failure criteria compared to the reference standard; 3) Systematic review of computerized methods of hearing screening; 4) Report on actions to promote hearing health in the school environment; 5) Ecological study on School Hearing Screening (TAE) within the scope of SUS. The results of the thesis include 1) TOAE as a protocol with better measures of accuracy for school hearing screening; 2) TEOAE with signal / noise ratio equal to or greater than 3dB in three of the five non-consecutive frequency bands with better accuracy; 3) Among the six instruments identified, three had sensitivity and specificity greater than 70% - teleaudiometer based on a P.E.T.I.T. tablet, HearScreen ™ application, computer-based audiometer; 4) The five proposed activities had good results, with engagement observed by the entire school community and changes in habits by the students; 5) There is no tendency for a significant increase in the rates of school hearing screening in Brazil, which are distributed unevenly in the national territory. With the completion of individual studies and their joint analysis, it is observed that different instruments can be used to identify hearing loss in schoolchildren as long as they are valid, but this action should not be isolated, and local realities and the network must be considered hearing health, since there is low coverage of TAE under SUS. In this way, results had shown limits on hearing health actions to school age and also contribute to subsidize PSE actions in the scope of hearing health, considering the intersectoral needs and health and education.