Browsing by Author "Ibekwe, Titus"
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Publication The Global Otolaryngology-Head and Neck Surgery Workforce(2023) Petrucci, Beatriz; Okerosi, Samuel; Patterson, Rolvix; Hobday, Sara; Salano, Valerie; Waterworth, Christopher; Brody, Robert; Sprow, Holly; Alkire, Blake; Fagan, Johannes; Ovnat Tamir, Sharon; Der, Carolina; Bhutta, Mahmood; Maina, Ivy; Pang, Jonathan; Daudu, Davina; Mukuzi, Allan; Srinivasan, Tarika; Pietrobon, Carolina; Hao, Sheng-Po; Nakku, Doreen; Seguya, Amina; Din, Taseer; Djoutsop Mbougo, Olga; Mokoh, Lilian; Jashek-Ahmed, Farizeh; Law, Tyler; Holt, Elizabeth; Haider, Ali; Zemene, Yilkal; Ibekwe, Titus; Raphiou, Oumar; Alvarado, Jaqueline; Mulwafu, Wakisa; Fenton, John; Agius, Adrian; Doležal, Pavel; Amani, Édouard; Mojica, Karen; Silva, RicardoImportance: A core component of delivering care of head and neck diseases is an adequate workforce. The World Health Organization report, Multi-Country Assessment of National Capacity to Provide Hearing Care, captured primary workforce estimates from 68 member states in 2012, noting that response rates were a limitation and that updated more comprehensive data are needed. Objective: To establish comprehensive workforce metrics for global otolaryngology-head and neck surgery (OHNS) with updated data from more countries/territories. Design, setting, and participants: A cross-sectional electronic survey characterizing the OHNS workforce was disseminated from February 10 to June 22, 2022, to professional society leaders, medical licensing boards, public health officials, and practicing OHNS clinicians. Main outcome: The OHNS workforce per capita, stratified by income and region. Results: Responses were collected from 121 of 195 countries/territories (62%). Survey responses specifically reported on OHNS workforce from 114 countries/territories representing 84% of the world's population. The global OHNS clinician density was 2.19 (range, 0-61.7) OHNS clinicians per 100 000 population. The OHNS clinician density varied by World Bank income group with higher-income countries associated with a higher density of clinicians. Regionally, Europe had the highest clinician density (5.70 clinicians per 100 000 population) whereas Africa (0.18 clinicians per 100 000 population) and Southeast Asia (1.12 clinicians per 100 000 population) had the lowest. The OHNS clinicians deliver most of the surgical management of ear diseases and hearing care, rhinologic and sinus diseases, laryngeal disorders, and upper aerodigestive mucosal cancer globally. Conclusion and relevance: This cross-sectional survey study provides a comprehensive assessment of the global OHNS workforce. These results can guide focused investment in training and policy development to address disparities in the availability of OHNS clinicians.Publication Validation of the Decision model of the Burden of Hearing loss Across the Lifespan (DeciBHAL) in Chile, India, and Nigeria(2022) Borre, Ethan; Ayer, Austin; Der, Carolina; Ibekwe, Titus; Emmett, Susan; Dixit, Siddharth; Shahid, Minahil; Olusanya, Bolajoko; Garg, Suneela; Johri, Mohini; Saunders, James; Tucci, Debara; Wilson, Blake; Ogbuoji, Osondu; Sanders, GillianBackground: There is no published decision model for informing hearing health care resource allocation across the lifespan in low- and middle-income countries. We sought to validate the Decision model of the Burden of Hearing loss Across the Lifespan International (DeciBHAL-I) in Chile, India, and Nigeria. Methods: DeciBHAL-I simulates bilateral sensorineural hearing loss (SNHL) and conductive hearing loss (CHL) acquisition, SNHL progression, and hearing loss treatment. To inform model inputs, we identified setting-specific estimates including SNHL prevalence from the Global Burden of Disease (GBD) studies, acute otitis media (AOM) incidence and prevalence of otitis-media related CHL from a systematic review, and setting-specific pediatric and adult hearing aid use prevalence. We considered a coefficient of variance root mean square error (CV-RMSE) of ≤15% to indicate good model fit. Findings: The model-estimated prevalence of bilateral SNHL closely matched GBD estimates, (CV-RMSEs: 3.2-7.4%). Age-specific AOM incidences from DeciBHAL-I also achieved good fit (CV-RMSEs=5.0-7.5%). Model-projected chronic suppurative otitis media prevalence (1.5% in Chile, 4.9% in India, and 3.4% in Nigeria) was consistent with setting-specific estimates, and the incidence of otitis media-related CHL was calibrated to attain adequate model fit. DeciBHAL-projected adult hearing aid use in Chile (3.2-19.7% ages 65-85 years) was within the 95% confidence intervals of published estimates. Adult hearing aid prevalence from the model in India was 1.4-2.3%, and 1.1-1.3% in Nigeria, consistent with literature-based and expert estimates. Interpretation: DeciBHAL-I reasonably simulates hearing loss natural history, detection, and treatment in Chile, India, and Nigeria. Future cost-effectiveness analyses might use DeciBHAL-I to inform global hearing health policy.