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Alothman N, Elbeltagy R, Mulla R. Universal newborn hearing screening program in Saudi Arabia: Current insight. J Otol 2024; 19:35-39. [PMID: 38313764 PMCID: PMC10837551 DOI: 10.1016/j.joto.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/25/2023] [Accepted: 01/01/2024] [Indexed: 02/06/2024] Open
Abstract
Newborn hearing screening (NHS) programs are essential to identify hearing loss early in life and to improve outcomes in children. In Saudi Arabia, the national NHS program has been operational since 2016; however, few studies have evaluated its status, and none have covered all provinces across the country. This cross-sectional retrospective study provides an overview of the program's status across all provinces, focusing on screening coverage rates, referral/fail rates, and follow-up procedures. In 2021, 199,034 newborns were screened, with a coverage rate of 92.6% and an overall referral/fail rate of 1.87%. These performance measures provide a foundation for future progress and improvements. This study highlights the importance of ongoing efforts to enhance the program's effectiveness and sustainability.
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Affiliation(s)
- Noura Alothman
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Reem Elbeltagy
- Audiovestibular Medicine, Ear-Nose-Throat Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Reem Mulla
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
- Department of Hearing, Speech and Language Sciences, Gallaudet University, Washington, DC, USA
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Universal newborn hearing screening with automated auditory brainstem response (AABR) in Hungary: 5-year experience in diagnostics and influence on the early intervention. Eur Arch Otorhinolaryngol 2022; 279:5647-5654. [PMID: 35767058 PMCID: PMC9244110 DOI: 10.1007/s00405-022-07441-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/09/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE In 2015 a new regulation and guidelines for the universal newborn hearing screening by AABR measurement have been implemented in Hungary. The aim of our study was to analyse (1) the past 5 years of data from our diagnostic centre about the incidence and types of congenital hearing losses, and (2) the first experiences with the National Newborn Hearing Screening Registry, started in 2019, and (3) the influence of the screening on the pediatric cochlear implant program. METHODS 1269 children referred to our diagnostic centre between 2017 and 2021 were investigated. A third AABR measurement and full audiological evaluation were performed. Furthermore, one-year period data of the screening registry, and the number of implanted children at or under the age of 3 were analysed using the national databases. RESULTS Altogether 276 newborns (22% of the referred cases after the two-stage screening) had hearing loss, 134 (49%) out of them was conductive origin, almost twice frequent in male as in female. Permanent sensorineural hearing impairment was found in 142 (51%), 58 (40%) of them had bilateral, severe to profound hearing loss, occurring more frequently in male as in female. The national digital registration of the screening data within 12 months concerned 68%. The number of early cochlear implantation in one year increased from 1 to 23 children in the past 15 years. CONCLUSION A third AABR after the two-stage screening increased the efficiency and filtered the 78% false-positive cases. The audiological diagnostics verified and typed the hearing losses ensuring the early intervention.
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The Development of a Paediatric Phoneme Discrimination Test for Arabic Phonemic Contrasts. Audiol Res 2021; 11:150-166. [PMID: 33917153 PMCID: PMC8167783 DOI: 10.3390/audiolres11020014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/12/2021] [Accepted: 03/30/2021] [Indexed: 11/16/2022] Open
Abstract
Objective: The aim of this project was to develop the Arabic CAPT (A-CAPT), a Standard Arabic version of the CHEAR auditory perception test (CAPT) that assesses consonant perception ability in children. Method: This closed-set test was evaluated with normal-hearing children aged 5 to 11 years. Development and validation of the speech materials were accomplished in two experimental phases. Twenty-six children participated in phase I, where the test materials were piloted to ensure that the selected words were age appropriate and that the form of Arabic used was familiar to the children. Sixteen children participated in phase II where test-retest reliability, age effects, and critical differences were measured. A computerized implementation was used to present stimuli and collect responses. Children selected one of four response options displayed on a screen for each trial. Results: Two lists of 32 words were developed with two levels of difficulty, easy and hard. Assessment of test-retest reliability for the final version of the lists showed a strong agreement. A within-subject ANOVA showed no significant difference between test and retest sessions. Performance improved with increasing age. Critical difference values were similar to the British English version of the CAPT. Conclusions: The A-CAPT is an appropriate speech perception test for assessing Arabic-speaking children as young as 5 years old. This test can reliably assess consonant perception ability and monitor changes over time or after an intervention.
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Schickinger-Fischer B. [Early detection of unilateral connatal hearing loss via newborn hearing screening and the implementation of the SAV-concept 2017 in lower Austria and Burgenland]. Wien Med Wochenschr 2021; 172:14-19. [PMID: 33738629 DOI: 10.1007/s10354-021-00835-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 02/23/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Recent studies showed the benefit or even need of hearing aids or cochlear implants in children with unilateral hearing loss to improve localization abilities and speech intelligibility. Therefore, the Audiology working group of the Austrian ENT society adopted the SAV-concept in 2017 (Screening Abklärung Versorgung von konnatalen Hörstörungen - Konzeptpapier 2017 AG Audiologie) to establish methods for testing, the mode of testing both ears, the desired schedule for the screening process and the subsequent therapy. METHODS The screening data were collected via questionnaires sent to all maternity and neonatal wards in different districts by responsible persons of the Austrian ENT society. Data on the implementation of the SAV concept were evaluated retrospectively based on the responses for the regions of Lower Austria and Burgenland. RESULTS The feedback, the implementation and responsibility for the screening program in respect of method and schedule differs throughout the federal states of Austria as well as in hospitals of state health organizations. CONCLUSION Austria in comparison to other European countries is missing a central documentation and tracking system via a governmental screening coordination office as the data are not generally transferred to a common birth register. Therefore, different timetables and organization for the universal new born hearing screening in the federal states as well as in state organizations were found causing a delayed diagnosis and treatment of children with unilateral hearing loss.
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Alanazi AA. Referral and Lost to System Rates of Two Newborn Hearing Screening Programs in Saudi Arabia. Int J Neonatal Screen 2020; 6:50. [PMID: 33123632 PMCID: PMC7570083 DOI: 10.3390/ijns6030050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/19/2020] [Indexed: 11/17/2022] Open
Abstract
Congenital hearing loss has been commonly reported as a significant health problem. Lost to system (LTS) is a major challenge facing newborn hearing screening (NHS) programs. This retrospective cross-sectional descriptive study aimed to determine the referral and LTS rates after the two-stage NHS based on transient evoked otoacoustic emissions (TEOAEs) in two main hospitals in Riyadh, Saudi Arabia (SA). NHS was performed on newborns before hospital discharge. Newborns were only rescreened if NHS initially revealed a fail/refer outcome in one or both ears. Those who failed the first and second screenings or had risk factors were referred for auditory brainstem response (ABR) testing to confirm or exclude hearing loss. In total, 20,171 newborns (40,342 ears; 52% males; 48% females) were screened, of whom 19,498 (96.66%) passed the initial screening, while 673 (3.34%) failed. Of the 673 newborns, 235 (34.92%) were LTS, and 438 (65.08%) were rescreened, of whom 269 (61.42%) failed and were referred for a comprehensive audiological assessment to confirm the existence of hearing loss. The referral rate after the initial two-stage screening was equal to 1.33%. The lack of awareness of the importance of NHS among parents seems to be the major cause behind the LTS rate. The stakeholders have to work efficiently to reduce the LTS rate.
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Affiliation(s)
- Ahmad A Alanazi
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia; ; Tel.: +966-112499999 (ext. 95117)
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Kolethekkat AA, Al Abri R, Hlaiwah O, Al Harasi Z, Al Omrani A, Sulaiman AA, Al Bahlani H, Al Jaradi M, Mathew J. Limitations and drawbacks of the hospital-based universal neonatal hearing screening program: First report from the Arabian Peninsula and insights. Int J Pediatr Otorhinolaryngol 2020; 132:109926. [PMID: 32036167 DOI: 10.1016/j.ijporl.2020.109926] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 02/02/2020] [Accepted: 02/02/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To assess the efficacy of the current universal neonatal hearing screening program in a tertiary medical institution in Oman, identify its limitations and drawbacks, and explore their causative factors. METHODS A retrospective review was carried out to analyse the hearing screening of 12,743 live babies born between January 2016 and December 2018. Screen coverage, drop outs, follow up rate, and age at completion of screening, diagnosis, and intervention were analysed. The results were compared with the Joint Committee on Infant Hearing (JCIH) performance quality indices. Prospective questionnaire-based telephonic interviews were then conducted with the parents or caregivers of neonates with hearing loss. Finally, the causes of loss to follow up or delays in hearing screenings, diagnosis, and/or early intervention were studied. RESULTS The true prevalence of hearing loss was 4.0 in 1000. The coverage of first-stage screening was 90% whereas the compliance with the second stage was 88.04%. 22.8% of the patients eventually obtained final diagnostic confirmation. The overall compliance with amplification was 30.2%. The completion ages of primary screening and final confirmation were 7.98 and 17.3 weeks respectively. The importance of hearing screening is well received by parents, but problems related to communication, delays in the appointment system, and inefficient follow up tracking were identified as the main limitations and drawbacks of the program. CONCLUSION The coverage of the neonatal hearing screening program had not yet reached the required goal of 95%. The performance indicators also fell below the international benchmark. There is a need to address the identified causative factors. Effective communication and well-maintained tracking systems need to be implemented.
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Affiliation(s)
| | | | - Omar Hlaiwah
- ENT Division, Department of Surgery, SQU Hospital, Oman
| | | | | | | | | | | | - John Mathew
- ENT Division, Department of Surgery, SQU Hospital, Oman
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Butcher E, Dezateux C, Cortina-Borja M, Knowles RL. Prevalence of permanent childhood hearing loss detected at the universal newborn hearing screen: Systematic review and meta-analysis. PLoS One 2019; 14:e0219600. [PMID: 31295316 PMCID: PMC6622528 DOI: 10.1371/journal.pone.0219600] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 06/27/2019] [Indexed: 11/19/2022] Open
Abstract
CONTEXT Permanent childhood hearing loss (PCHL) can affect speech, language, and wider outcomes. Adverse effects are mitigated through universal newborn hearing screening (UNHS) and early intervention. OBJECTIVE We undertook a systematic review and meta-analysis to estimate prevalence of UNHS-detected PCHL (bilateral loss ≥26 dB HL) and its variation by admission to neonatal intensive care unit (NICU). A secondary objective was to report UNHS programme performance (PROSPERO: CRD42016051267). DATA SOURCES Multiple electronic databases were interrogated in January 2017, with further reports identified from article citations and unpublished literature (November 2017). STUDY SELECTION UNHS reports from very highly-developed (VHD) countries with relevant prevalence and performance data; no language or date restrictions. DATA EXTRACTION Three reviewers independently extracted data and assessed quality. RESULTS We identified 41 eligible reports from 32 study populations (1799863 screened infants) in 6195 non-duplicate references. Pooled UNHS-detected PCHL prevalence was 1.1 per 1000 screened children (95% confidence interval [CI]: 0.9, 1.3; I2 = 89.2%). This was 6.9 times (95% CI: 3.8, 12.5) higher among those admitted to NICU. Smaller studies were significantly associated with higher prevalences (Egger's test: p = 0.02). Sensitivity and specificity ranged from 89-100% and 92-100% respectively, positive predictive values from 2-84%, with all negative predictive values 100%. LIMITATIONS Results are generalisable to VHD countries only. Estimates and inferences were limited by available data. CONCLUSIONS In VHD countries, 1 per 1000 screened newborns require referral to clinical services for PCHL. Prevalence is higher in those admitted to NICU. Improved reporting would support further examination of screen performance and child demographics.
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Affiliation(s)
- Emma Butcher
- Life Course Epidemiology and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Carol Dezateux
- Life Course Epidemiology and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Mario Cortina-Borja
- Clinical Epidemiology, Nutrition and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Rachel L. Knowles
- Life Course Epidemiology and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Public Health England, London, United Kingdom
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Alyami H, Soer M, Swanepoel A, Pottas L. Deaf or hard of hearing children in Saudi Arabia: Status of early intervention services. Int J Pediatr Otorhinolaryngol 2016; 86:142-9. [PMID: 27260597 DOI: 10.1016/j.ijporl.2016.04.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 04/07/2016] [Accepted: 04/08/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This study aims to determine the status of early intervention services provided to children who are deaf or hard of hearing and their parents/caregivers from birth to five years of age at two main state hospitals in Riyadh, Saudi Arabia, based on their parents' perceptions. METHOD A descriptive quantitative research design was used to determine the status of early intervention services for deaf or hard of hearing children in Saudi Arabia based on their parents' perceptions. Semistructured interviews based on a questionnaire were conducted with 60 research participants from two main state hospitals where early detection and intervention services are provided. A purposive sampling technique was employed. Descriptive and inferential statistical analyses were performed on the data collected. RESULTS The participants' children were diagnosed at a substantially late age, resulting in delayed ages for initial hearing aid fitting and enrolment in early intervention services. A significant relationship was found between the residential area of the participants and timely access to intervention services. The results indicated that participants residing in Riyadh were fitted with hearing aids and enrolled into EI services earlier than those living outside of Riyadh. The delivery of information also emerged as a weakness in the EI system for the majority of participants. CONCLUSION The findings of the study suggested that limited services of detection and intervention for deaf or hard of hearing children and residential area of participants are likely to be barriers to early access to intervention services. It is proposed that the benefits of UNHS accompanied by appropriate early intervention services should be made available in all regions throughout Saudi Arabia.
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Affiliation(s)
- Huda Alyami
- Communication Pathology, University of Pretoria, Pretoria 0027, South Africa.
| | - Maggi Soer
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria 0002, South Africa
| | - Andre Swanepoel
- Department of Statistics, University of Pretoria, Pretoria 0002, South Africa
| | - Lidia Pottas
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria 0002, South Africa
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Borders VP, Vess J, Dumas BP, Edlund BJ. Improving Follow-Up for Failed Newborn Hearing Screening in Emirati Infants. Worldviews Evid Based Nurs 2016; 13:250-2. [DOI: 10.1111/wvn.12142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Virginia P. Borders
- College of Nursing; Medical University of South Carolina, St. Simons Island; GA USA
| | - Joy Vess
- College of Nursing; Medical University of South Carolina; Charleston SC USA
| | - Bonnie P. Dumas
- College of Nursing; Medical University of South Carolina; Charleston SC USA
| | - Barbara J. Edlund
- College of Nursing; Medical University of South Carolina; Charleston SC USA
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Mincarone P, Leo CG, Sabina S, Costantini D, Cozzolino F, Wong JB, Latini G. Evaluating reporting and process quality of publications on UNHS: a systematic review of programmes. BMC Pediatr 2015. [PMID: 26198353 PMCID: PMC4511235 DOI: 10.1186/s12887-015-0404-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Congenital hearing loss is one of the most frequent birth defects, and Early Detection and Intervention has been found to improve language outcomes. The American Academy of Pediatrics (AAP) and the Joint Committee on Infant Hearing (JCIH) established quality of care process indicators and benchmarks for Universal Newborn Hearing Screening (UNHS). We have aggregated some of these indicators/benchmarks according to the three pillars of universality, timely detection and overreferral. When dealing with inter-comparison, relying on complete and standardised literature data becomes crucial. The purpose of this paper is to verify whether literature data on UNHS programmes have included sufficient information to allow inter-programme comparisons according to the indicators considered. Methods We performed a systematic search identifying UNHS studies and assessing the quality of programmes. Results The identified 12 studies demonstrated heterogeneity in criteria for referring to further examinations during the screening phase and in identifying high-risk neonates, protocols, tests, staff, and testing environments. Our systematic review also highlighted substantial variability in reported performance data. In order to optimise the reporting of screening protocols and process performance, we propose a checklist. Another result is the difficulty in guaranteeing full respect for the criteria of universality, timely detection and overreferral. Conclusions Standardisation in reporting UNHS experiences may also have a positive impact on inter-program comparisons, hence favouring the emergence of recognised best practices. Electronic supplementary material The online version of this article (doi:10.1186/s12887-015-0404-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pierpaolo Mincarone
- Institute for Research on Population and Social Policies, National Research Council, Rome, 00185, Italy.
| | - Carlo Giacomo Leo
- Institute of Clinical Physiology, National Research Council, Lecce, 73100, Italy. .,Division of Clinical Decision Making, Department of Medicine, Tufts Medical Center, Boston, MA, 02111, USA.
| | - Saverio Sabina
- Institute of Clinical Physiology, National Research Council, Lecce, 73100, Italy.
| | - Daniele Costantini
- Newborn Hearing Screening Service, Azienda USL7 Siena, Siena, 53100, Italy.
| | | | - John B Wong
- Division of Clinical Decision Making, Department of Medicine, Tufts Medical Center, Boston, MA, 02111, USA. .,School of Medicine, Tufts University, Boston, MA, 02111, USA.
| | - Giuseppe Latini
- Institute of Clinical Physiology, National Research Council, Lecce, 73100, Italy. .,Division of Neonatology, "Perrino" Hospital, ASL Brindisi, Brindisi, 72100, Italy.
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Guimarães VDC, Barbosa MA. Prevalence of auditory changes in newborns in a teaching hospital. Int Arch Otorhinolaryngol 2012; 16:179-85. [PMID: 25991933 PMCID: PMC4399599 DOI: 10.7162/s1809-97772012000200005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 08/14/2011] [Indexed: 11/29/2022] Open
Abstract
Introduction: The precocious diagnosis and the intervention in the deafness are of basic importance in the infantile development. The loss auditory and more prevalent than other joined riots to the birth. Objective: Esteem the prevalence of auditory alterations in just-born in a hospital school. Method: Prospective transversal study that evaluated 226 just-been born, been born in a public hospital, between May of 2008 the May of 2009. Results: Of the 226 screened, 46 (20.4%) had presented absence of emissions, having been directed for the second emission. Of the 26 (56.5%) children who had appeared in the retest, 8 (30.8%) had remained with absence and had been directed to the Otolaryngologist. Five (55.5%) had appeared and had been examined by the doctor. Of these, 3 (75.0%) had presented normal otoscopy, being directed for evaluation of the Evoked Potential Auditory of Brainstem (PEATE). Of the total of studied children, 198 (87.6%) had had presence of emissions in one of the tests and, 2 (0.9%) with deafness diagnosis. Conclusion: The prevalence of auditory alterations in the studied population was of 0,9%. The study it offers given excellent epidemiologists and it presents the first report on the subject, supplying resulted preliminary future implantation and development of a program of neonatal auditory selection.
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Affiliation(s)
- Valeriana de Castro Guimarães
- Epidemiologist. Doctor in Sciences of the Health. Responsible for the Service of Audiology of the Clinic of Otolaryngology HC/UFG
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Hanna KF, Maia RA. Triagem auditiva neonatal: incidência de deficiência auditiva neonatal sob a perspectiva da nova legislação paulista. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2010. [DOI: 10.1590/s1519-38292010000200013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVOS: identificar a incidência de recém-nascidos com deficiência auditiva, em maternidade particular da cidade de São Paulo. MÉTODOS: estudo de coorte transversal, realizado no período de 2004 a 2008, em maternidade localizada na zona sul da cidade de São Paulo, com 20.615 recém-nascidos de ambos os sexos, sem indicadores de risco para deficiência auditiva e submetidos à triagem auditiva neonatal. O teste foi realizado por intermédio das Emissões Otoacústicas Evocadas Transientes (EOAET). Os pacientes que falharam nas EOAET nas duas fases foram encaminhados para a realização do Potencial Evocado Auditivo do Tronco Encefálico (PEATE) para a confirmação da deficiência auditiva neonatal. Empregou-se o Teste Exato de Fischer e o nível de significância adotado foi de 0,05 oup<0,05. RESULTADOS: a incidência de deficiência auditiva neonatal encontrada neste estudo foi de 1,2/1000. CONCLUSÃO: a legislação estadual permite que a triagem auditiva neonatal (TAN) seja mais efetiva na detecção precoce da deficiência auditiva neonatal. A TAN evita prejuízos tanto no desenvolvimento oral quanto da linguagem no contexto social, profissional e educacional.
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Tann J, Wilson WJ, Bradley AP, Wanless G. Progress Towards Universal Neonatal Hearing Screening: A World Review. ACTA ACUST UNITED AC 2009. [DOI: 10.1375/audi.31.1.3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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The Need for Standardization of Methods for Worldwide Infant Hearing Screening: A Systematic Review. Laryngoscope 2008; 118:1830-6. [DOI: 10.1097/mlg.0b013e31817d755e] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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[Analysis of specificity and sensitivity of Polish "Universal Newborn Hearing Screening Program"]. Otolaryngol Pol 2008; 62:88-95. [PMID: 18637428 DOI: 10.1016/s0030-6657(08)70215-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Polish National Universal Hearing Screening Program (PNPUHS) has got three-level structure. Audiology Outpatient Clinic in The Childrens' Memorial Health Institute in Warsaw is a center of the second and the third level. Newborns are referred to us from neonatal units, the first level in the program. We found that referred children, both with unilateral as well as bilateral referral rating in TEOAE, show a high proportion of false positive results. AIM To analyze a diagnostic process of healthy neonates referred to our Audiology Outpatient Clinic with referral rating in one and both ears measured by TEOAE in 2005 and 2006. Assessed parameters include: attendance of patients to further diagnostics tests, with respect to their results, specificity and sensitivity of methods: TEOAE, DPOAE, analysis of final diagnoses of hearing loss. PATIENTS 1764 infants without risk factors of hearing loss, aged from one to six months referred with referral rating in one or both ears in TEOAE. METHODS Diagnostics methods include: otoscopy, DPOAE, AI, BOA. Incorrect results are indication for ABR examination, if not conclusive ASSR. Collected data were statistically analyzed by chi-squared test and Czupurow and V-Cramer coefficient. RESULTS 998 (56,5%) of 1764 examined children passed DPOAE. Only 512 (66,8%) of remaining 766 neonates carried on further investigations. Diagnosis of hearing loss was made in 449 patients (25%), including 320 (71%) with bilateral and 129 (29%) with unilateral involvement. Sensorineural hearing loss was detected in 274 children (61%), conductive in 161 (35,8%), and mixed in 14 patients (3,1%). Global PNUHSP specificity are 95,45% and sensitivity results are 95,08% respectively. Although in our Audiology Outpatient Clinic, sensitivity rate of TEOAE and DPOAE is 94,5%, and 94,4% respectively, the specificity rate of TEOAE appeared to be 36,9% and of DPOAE 79,7%. CONCLUSIONS Universal newborn hearing screening program permit early diagnosis and intervention in neonates and infants before 6th month of age. High rate of specificity and sensitivity characterizes the Polish Program. Low rate of specificity detected in our outpatient clinic indicates the necessity to effect and cost analysis in neonatal units. Comparison of two groups with bilateral and unilateral referral rating in screening shows that higher number of patients follow diagnostic process from the group with bilateral incorrect results, more diagnoses of hearing loss was established in this group as well.
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Olusanya BO, Wirz SL, Luxon LM. Hospital-based universal newborn hearing screening for early detection of permanent congenital hearing loss in Lagos, Nigeria. Int J Pediatr Otorhinolaryngol 2008; 72:991-1001. [PMID: 18433883 DOI: 10.1016/j.ijporl.2008.03.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2007] [Revised: 03/05/2008] [Accepted: 03/06/2008] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the feasibility and effectiveness of hospital-based universal newborn hearing screening programme for the early detection of permanent congenital or early-onset hearing loss (PCEHL) in Lagos, Nigeria. METHODS A cross-sectional pilot study based on a two-stage universal newborn hearing screening by non-specialist health workers using transient evoked otoacoustic emissions (TEOAE) and automated auditory brainstem-response (AABR) in an inner-city maternity hospital over a consecutive period of 40 weeks. The main outcome measures were the practicality of screening by non-specialist staff with minimal training, functionality of screening instruments in an inner-city environment, screening coverage, referral rate, return rate for diagnosis, yield of PCEHL and average age of PCEHL confirmation. RESULTS Universal hearing screening of newborns by non-specialist staff without prior audiological experience is feasible in an inner-city environment in Lagos after a training period of two-weeks. Notwithstanding excessive ambient noise within and outside the wards, it was possible to identify a test site for TEOAE screening within the hospital. The screening coverage was 98.7% (1330/1347) of all eligible newborns and the mean age of screening was 2.6 days. Forty-four babies out of the 1274 who completed the two-stage screening were referred yielding a referral rate of 3.5%. Only 16% (7/44) of babies scheduled for diagnostic evaluation returned and all were confirmed with hearing loss resulting in an incidence of 5.5 (7/1274) per 1000 live births or a programme yield of 5.3 (7/1330) per 1000. Six infants had bilateral hearing loss and the degree was severe (> or =70 dB nHL) in three infants, moderate (40 dB nHL) in one infant and mild (<40 dB nHL) in two infants. The age at diagnosis ranged from 46 days to 360 days and only two infants were diagnosed within 90 days. CONCLUSIONS Hospital-based universal hearing screening of newborns before discharge is feasible in Nigeria. Non-specialist staff are valuable in achieving a satisfactory referral rate with a two-stage screening protocol. However, a more efficient tracking and follow-up system is needed to improve the return rate for diagnosis and age of confirmation of hearing loss.
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Affiliation(s)
- B O Olusanya
- Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, University College London, London, UK.
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Pereira PKS, Martins ADS, Vieira MR, Azevedo MFD. [Newborn hearing screening program: association between hearing loss and risk factors]. ACTA ACUST UNITED AC 2008; 19:267-78. [PMID: 17934602 DOI: 10.1590/s0104-56872007000300005] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2006] [Accepted: 07/18/2007] [Indexed: 11/22/2022]
Abstract
BACKGROUND Hearing loss in newborns. AIM To verify the prevalence of auditory alterations in newborns of Hospital São Paulo (hospital), observing if there are any correlations with the following variables: birth weight, gestational age, relation weight/gestational age and risk factors for hearing loss. METHOD A retrospective analysis of the hospital records of 1696 newborns; 648 records of preterm infants and 1048 records of infants born at term. All of the infants had been submitted to an auditory evaluation consisting of: Transient Otoacoustic Emissions, investigation of the cochleal-palpebral reflexes and acoustic imittance tests, identifying the type and level of hearing loss. RESULTS Sensorineural hearing loss was identified in .82% of the infants who were born at term and in 3.1% of the preterm infants -- with a statistically significant difference. Conductive hearing loss was the most frequent type of hearing loss in both groups, occurring in 14.6% of the term infants and in 16.3% of the preterm infants. Alteration of the central auditory system was considered as a possible diagnosis for 5.8% of the preterm infants and for 3.3% of the term infants. For the group of infants who were born at term, a significant correlation was observed between failure in the hearing screening test and the presence of risk factors such as family history and presence of a syndrome -- the child who presented a syndrome had 37 times more chances of failing in the hearing screening test and seven times more chances of failing in the right ear when there was a family history for hearing loss. The lower the gestational age (< 30 weeks) and birth weight (< 1500 g), the higher the chances of failing in the hearing screening test (3 times more). CONCLUSION Hearing loss had a higher occurrence in preterm infants who remained in the ICU. Gestational age and birth weight were important variables related to the possibility of failure in the hearing screening test. A correlation was observed between the presence of a syndrome and sensorineural hearing loss in infants who were born at term.
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Zhang VW, McPherson B, Shi BX, Tang JLF, Wong BYK. Neonatal hearing screening: a combined click evoked and tone burst otoacoustic emission approach. Int J Pediatr Otorhinolaryngol 2008; 72:351-60. [PMID: 18178260 DOI: 10.1016/j.ijporl.2007.11.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2007] [Revised: 11/20/2007] [Accepted: 11/22/2007] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study evaluated an alternative transient evoked otoacoustic emissions method for screening hearing in newborn babies that may reduce the referral rate of initial screening. METHODS A total of 1,033 neonates (2,066 ears) from two hospitals were recruited. Subjects had their hearing screened in both ears using a combined approach-both click evoked OAEs (CEOAEs) and 1kHz tone burst evoked OAEs (TBOAEs). RESULTS 1kHz TBOAEs were more robust than CEOAEs in terms of emission response level and signal-to-noise ratio (SNR) at both 1 and 1.5kHz frequency bands. The prevalence rate for CEOAE and TBOAE responses in these two frequency bands was significantly different. The combined protocol significantly reduced the referral rate-by almost 2 percentage points for first time screening. CONCLUSIONS The implementation of a combined 1kHz TBOAE/CEOAE screening protocol is a feasible and effective way to reduce referral rates, and hence false positive rates, in neonatal hearing screening programs.
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Affiliation(s)
- Vicky W Zhang
- Centre for Communication Disorders, The University of Hong Kong, Hong Kong SAR, China.
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Olusanya BO, Swanepoel DW, Chapchap MJ, Castillo S, Habib H, Mukari SZ, Martinez NV, Lin HC, McPherson B. Progress towards early detection services for infants with hearing loss in developing countries. BMC Health Serv Res 2007; 7:14. [PMID: 17266763 PMCID: PMC1802737 DOI: 10.1186/1472-6963-7-14] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2006] [Accepted: 01/31/2007] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Early detection of infants with permanent hearing loss through infant hearing screening is recognised and routinely offered as a vital component of early childhood care in developed countries. This article investigates the initiatives and progress towards early detection of infants with hearing loss in developing countries against the backdrop of the dearth of epidemiological data from this region. METHODS A cross-sectional, descriptive study based on responses to a structured questionnaire eliciting information on the nature and scope of early hearing detection services; strategies for financing services; parental and professional attitudes towards screening; and the performance of screening programmes. Responses were complemented with relevant data from the internet and PubMed/Medline. RESULTS Pilot projects using objective screening tests are on-going in a growing number of countries. Screening services are provided at public/private hospitals and/or community health centres and at no charge only in a few countries. Attitudes amongst parents and health care workers are typically positive towards such programmes. Screening efficiency, as measured by referral rate at discharge, was generally found to be lower than desired but several programmes achieved other international benchmarks. Coverage is generally above 90% but poor follow-up rates remain a challenge in some countries. The mean age of diagnosis is usually less than six months, even for community-based programmes. CONCLUSION Lack of adequate resources by many governments may limit rapid nationwide introduction of services for early hearing detection and intervention, but may not deter such services altogether. Parents may be required to pay for services in some settings in line with the existing practice where healthcare services are predominantly financed by out-of-pocket spending rather than public funding. However, governments and their international development partners need to complement current voluntary initiatives through systematic scaling-up of public awareness and requisite manpower development towards sustainable service capacities at all levels of healthcare delivery.
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Affiliation(s)
- Bolajoko O Olusanya
- Institute of Child Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - De Wet Swanepoel
- Department of Communication Pathology, University of Pretoria, Pretoria, South Africa
| | | | - Salvador Castillo
- Audiology and Phoniatrics Department, México Children's Hospital, 'Federico Gómez" Dr. Márquez 162, Colonia Doctores, 06726 México City, Mexico
| | - Hamed Habib
- Pediatric Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Siti Z Mukari
- Department of Audiology & Speech Sciences, Faculty of Allied Health Sciences Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | | | - Hung-Ching Lin
- Department of Otolaryngology, Hearing and Speech Centre, Mackay Memorial Hospital, Taipei, Taiwan
| | - Bradley McPherson
- Division of Speech and Hearing Sciences, Faculty of Education, University of Hong Kong, Hong Kong, China
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Martines F, Porrello M, Ferrara M, Martines M, Martines E. Newborn hearing screening project using transient evoked otoacoustic emissions: Western Sicily experience. Int J Pediatr Otorhinolaryngol 2007; 71:107-12. [PMID: 17095100 DOI: 10.1016/j.ijporl.2006.09.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2006] [Revised: 09/27/2006] [Accepted: 09/30/2006] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To study the incidence of congenital sensorineural hearing loss in all newborns introducing a screen test with a protocol no expensive, with a good "screen sensitivity" that could let an earlier identification of hearing impairment beginning early intervention by 2 months of age and increasing the probability of having language development within the normal range of development. METHODS The study was conducted in Sciacca hospital from the beginning of 2003 to our days and was carried out with transient evoked otoacoustic emission using the criteria for PASS or RETEST and considering eventual prenatal and perinatal risk factors. All the newborns were divided into four groups each one with its personal secondary step program. RESULTS In the years 2003-2004 the number of the newborns in Sciacca hospital was: 538 for 2003, 653 for 2004 with a total of 1191; all these infants were divided in three groups: resident in Sciacca, resident in the Sciacca borderlands and resident out of the district of Sciacca. The coverage (percentage of the target population who undergo the screen) was of 90% in the 2003 (483 newborns) and of 90% in the 2004 (585 newborns) with two cases of congenital sensorineural hearing loss identified. The incidence of sensorineural hearing loss, in the District of Sciacca, was estimated to be 2.07/1000 in 2003 and 1.70/1000 in 2004. CONCLUSIONS The higher incidence of sensorineural hearing loss in our study is due to a high prevalence of consanguineous marriage in Sicily that was shown to be linked with hearing impairment. The "sensitivity value" was 95% at the first step but became 99% after the second step with a few number of false positive (0.74%). All the infants with a diagnosis of sensorineural hearing loss began a rehabilitation program before the age of 5 months and they have a good speech development and speech intelligibility.
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Affiliation(s)
- F Martines
- Università degli Studi di Palermo, Dipartimento di Biotecnologie Mediche e Medicina Legale, Sezione di Audiologia, Italy.
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