# mHealth OAE: Towards Universal Newborn Hearing Screening in Kenya (mTUNE)

> **NIH NIH R21** · UNIVERSITY OF WASHINGTON · 2024 · $163,253

## Abstract

ABSTRACT
Hearing loss is among the leading causes of disability worldwide, with the highest burden in resource limited
settings (RLS). Children are disproportionately affected, given the detriment to a child’s neurocognitive and social
development, yet the impacts can be mitigated if detected and treated early. Nearly 60% of hearing loss in
children is due to preventable factors, and identification is the first step in addressing hearing loss. High income
countries have implemented universal newborn hearing screening (UNHS) programs with a goal of diagnosing
hearing loss and starting early intervention in the first few months of life. Few comparable programs exist in low
and middle income countries, given such barriers as limited access to trained personnel and high cost of hearing
screening equipment.
We propose to optimize a low-cost smartphone otoacoustic emissions (OAE) device for hearing screening and
study the implementation in an RLS. The smartphone OAE is comparable to conventional hearing screening
equipment in US trials and now must be evaluated where it can have the greatest impact. The aims of the R21
are to optimize the OAE device in various clinical settings and patient ages in Kenya. We will evaluate potential
impact of noisy clinical environments, assess consistency of screening, and compare usability in frontline and
lay health facility workers, with a deliverable of a low-cost, user-friendly OAE that is a feasible tool in a low-
resource clinical setting. Work will begin to integrate hearing screening results from the smartphone OAE directly
with electronic medical records systems in Kenya. The R33 will further establish implementation outcomes and
validity of the smartphone OAE device in a UNHS program, and will provide an in-depth evaluation of the
implementation strategy and task-shifting in the Kenyan context. In parallel, the R33 will deploy the smartphone
OAE in a longitudinal study of suspected (HIV exposure) and known (otitis media with effusion) risk factors for
hearing loss. The longitudinal study will leverage an additional innovative lay-person friendly smartphone tool
that can be used to monitor for middle ear fluid, an important companion for hearing screening in children that
typically relies on expensive, skill intensive equipment. The research team includes medical providers, public
health researchers, computer scientists and the Technical Working Group for Ear and Hearing Care in Kenya’s
Ministry of Health, a collaboration that will support program sustainability when the project is complete. The
project establishes a foundation for smartphone OAE in UNHS programs, high-risk infant surveillance, ototoxicity
monitoring, and future research to understand and improve ear and hearing care in RLS. The outcomes of this
work align with the goals of the WHO World Report on Hearing, which strives for all people, including those with
hearing loss, to have access to high-quality services without experiencing financial har...

## Key facts

- **NIH application ID:** 10929468
- **Project number:** 5R21DC021643-02
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** SARAH F. BENKI-NUGENT
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $163,253
- **Award type:** 5
- **Project period:** 2023-09-15 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10929468

## Citation

> US National Institutes of Health, RePORTER application 10929468, mHealth OAE: Towards Universal Newborn Hearing Screening in Kenya (mTUNE) (5R21DC021643-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10929468. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*