Decentralised detection and monitoring of hearing loss can be supported by new mHealth technologies using automated testing, which can be facilitated by minimally trained persons. These technologies may prove particularly useful in an infectious disease (ID) clinic setting where patients are at high risk for hearing loss. The current study aimed to evaluate the clinical utility of mobile and automated audiometry hearing health technology in an ID clinic setting. The current study was exploratory as it aimed to determine whether smartphone automated audiometry and South African English Digits-In-Noise (SA Eng DIN) smartphone applications could be utilised in an infectious disease clinic setting to monitor an HIV-related hearing loss in a feasible and time efficient way. Smartphone automated audiometry (hearTest™) and speech-in-noise testing (SA English Digits-In-Noise (DIN) test) were compared with manual audiometry at 2, 4, and 8 kHz. Smartphone automated audiometry and the DIN test were repeated to determine the test re-test reliability. Two hundred subjects (73% female and 27% male) were enrolled. Fifty participants were re-tested with the smartphone applications. Participants’ ages ranged from 18 to 55 years with a mean age of 44.4 (8.7 SD). Threshold comparisons were made between smartphone audiometry testing and manual audiometry. Smartphone automated audiometry, manual audiometry, and test re-test measures were compared to determine the statistical significance of any differences observed using the Wilcoxon signed-ranked test. Spearman rank correlation test was used to determine the relationship between the smartphone applications and manual audiometry, as well as for test re-test measurements. For all participants, 88.2% of thresholds corresponded within 10 dB or less between smartphone audiometry and manual audiometry. There was a significant difference (p>0.05) between smartphone and manual audiometry for the right ear at 4 and 8 kHz and the left ear at 2 and 4 kHz respectively. No significant difference was noted (p>0.05) between test and re-test measures of smartphone technology except at 4kHz in the right ear in smartphone automated audiometry. The absolute average difference between the initial and re-test of DIN testing was 1.2 dB (1.5 SD). No significant difference was noted in the test re-test measures of the DIN test (p < vii 0.05). A correlation coefficient of 0.56 was present in the DIN test re-test measures when the Spearman rank correlation test was administered. Smartphone audiometry with calibrated headphones provides reliable results and can be used as a baseline and monitoring tool at ID clinics. / Dissertation (MA)--University of Pretoria, 2017. / Speech-Language Pathology and Audiology / MA / Unrestricted

HIV/AIDS is severely affecting the armed forces in South Africa. Combating HIV/AIDS demands a high level of commitment from the Ministry of Defence and all the Divisions and Services at all levels in the Department of Defence. Prevention practice for HIV/ AIDS is a challenged because the nature and full extent of the impact on the forces, and in particular on serodiscordant couples, are not known. This research study explored the experiences of serodiscordant couples regarding the impact of serodiscordancy on their marriages. The Infectious Disease Clinic engages serodiscordant couples as active participants in dealing with their HIV status. The researcher explored the impact of HIV serodiscordancy on married couples attending the Infectious Disease Clinic at 1 Military Hospital with the intended outcome of informing intervention and prevention strategies and programmes for serodiscordant couples. The study utilised a qualitative research approach and the research design was an instrumental case study. The population for the study was all the married serodiscordant couples in the Infectious Disease Clinic at 1 Military Hospital. The sample consisted of 20 serodiscordant couples attending the Infectious Disease Clinic for at least the past two years. The data was collected through semi-structured interviews. The study concluded that empowerment programmes on HIV/AIDS should include knowledge of, as well as coping skills and guidance for couples dealing with serodiscordancy, including disclosure and discrimination; marital and parenting roles; health management, building of trust; facilitating open and positive communication; and financial management. Based on the conclusions of the study, the main recommendation is that prevention strategies and empowerment programmes for serodiscordant couples should be based on a holistic, well-integrated intervention plan which contextualises strategies and programmes for prevention, treatment, counselling, empowerment and continuous support of the employee, their spouse and their family, including home visits, as required by the serodiscordant couple. Furthermore, it should clearly conceptualise the role of each team member at both the Infectious Disease Clinic and the relevant units of the SANDF, in particular the role of the social worker. / Dissertation (MSW)--University of Pretoria, 2010. / Social Work and Criminology / unrestricted