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Ravi R, Gunjawate DR, Yerraguntla K, Bellur R. Universal Newborn Hearing Screening: An Indian Experience of Conceptualizing and Testing a Comprehensive Model. Indian J Otolaryngol Head Neck Surg 2022; 74:170-177. [PMID: 36032924 PMCID: PMC9411350 DOI: 10.1007/s12070-020-01937-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 06/23/2020] [Indexed: 12/01/2022] Open
Abstract
There have been isolated attempts to implement newborn hearing screening at various setups across India. However, none of these attempts has followed a holistic model comprising of multiple components. Therefore, a need was felt to design and implement a comprehensive universal newborn hearing-screening model to, improve follow-up, and provide practically implementable solutions for developing economies. The model was conceptualized after a detailed preliminary planning level. Separate protocols for newborns from well-baby nursery and neonatal intensive care unit were implemented. Measures were implemented to improve follow-up. Knowledge, attitude, and practices survey followed by a sensitization program was carried out to highlight the importance of newborn hearing screening among the healthcare providers. A knowledge and attitude survey was also carried out among mothers. The estimated prevalence rate was 8.78 per 1000. Measures enabled an improved follow-up rate that lead to a reduced age of identification to 6 months. The surveys among mothers and healthcare providers helped to identify the lacunae in knowledge levels, which need to be filled in order to improve their attitudes. Thus, this was a successful model for universal newborn hearing screening comprising of two-stage screening, separate protocols, steps to improve follow-up, improving awareness among parents, sensitization programs, and surveys among mothers as well as healthcare providers.
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Affiliation(s)
- Rohit Ravi
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka 575001 India
| | - Dhanshree R. Gunjawate
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka 575001 India
| | - Krishna Yerraguntla
- Department of Speech and Hearing, Manipal College of Health Professionals, Manipal Academy of Higher Education, Manipal, Karnataka India
| | - Rajashekhar Bellur
- Department of Speech and Hearing, Manipal College of Health Professionals, Manipal Academy of Higher Education, Manipal, Karnataka India
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Performance and characteristics of the Newborn Hearing Screening Program in Campania region (Italy) between 2013 and 2019. Eur Arch Otorhinolaryngol 2021; 279:1221-1231. [PMID: 33768315 PMCID: PMC8897375 DOI: 10.1007/s00405-021-06748-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/11/2021] [Indexed: 11/06/2022]
Abstract
Purpose Universal newborn hearing screening (UNHS) in the first month of life is crucial for facilitating both early hearing detection and intervention (EHDI) of significant permanent hearing impairment (PHI). In Campania region, UNHS has been introduced in 2003 by the Regional Council Resolution and started on January 2007. The aim of this paper is to update a previous article describing the performance of the program since its implementation in the period between 2013 and 2019. Methods A longitudinal retrospective study was carried at the Regional Reference Center III on 350,178 babies born in the analysis period. The paper reports the main results of overall coverage, referral rate, lost-to-follow-up rate,yield for PHI and shall determine various risk factor associations with hearing impairment Results In Campania region, 318,878 newborns were enrolled at I level, with a coverage rate of 91.06%, 301,818 (86.18%) Well Infant Nurseries (WIN) and 17,060 (5.35%) Neonatal Intensive Care Unit (NICU) babies. PHI was identified in 413 children, 288 (69.73%) bilaterally and 125 (30.26%) unilaterally. The overall cumulative incidence rate of PHI was 1.29 per 1000 live-born infants (95% CI 1.17–1.42) with a quite steady tendency during the whole study period. Conclusions This study confirms the feasibility and effectiveness of UNHS in Campania region also in a setting with major socioeconomic and health organization restrictions.The program meets quality benchmarks to evaluate the progress of UNHS. Nowadays, it is possible to achieve an early diagnosis of all types of HL avoiding the consequences of hearing deprivation.
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Turchetta R, Conti G, Marsella P, Orlando MP, Picciotti PM, Frezza S, Russo FY, Scorpecci A, Cammeresi MG, Giannantonio S, Greco A, Ralli M. Universal newborn hearing screening in the Lazio region, Italy. Ital J Pediatr 2018; 44:104. [PMID: 30143030 PMCID: PMC6108150 DOI: 10.1186/s13052-018-0534-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 08/06/2018] [Indexed: 11/10/2022] Open
Abstract
Background The introduction of Universal Newborn Hearing Screening (UNHS) programs has drastically contributed to the early diagnosis of hearing loss in children, allowing prompt intervention with significant results on speech and language development in affected children. UNHS in the Lazio region has been initially deliberated in 2012; however, the program has been performed on a universal basis only from 2015. The aim of this retrospective study is to present and discuss the preliminary results of the UNHS program in the Lazio region for the year 2016, highlighting the strengths and weaknesses of the program. Methods Data from screening facilities in the Lazio region for year 2016 were retrospectively analyzed. Data for Level I centers were supplied by the Lazio regional offices; data for Level II and III centers were provided by units that participated to the study. Results During 2016, a total of 44,805 babies were born in the Lazio region. First stage screening was performed on 41,821 children in 37 different birth centers, with a coverage rate of 93.3%. Of these, 38.977 (93.2%) obtained a “pass” response; children with a “refer” result in at least one ear were 2844 (6.8%). Data from Level II facilities are incomplete due to missing reporting, one of the key issues in Lazio UNHS. Third stage evaluation was performed on 365 children in the three level III centers of the region, allowing identification of 70 children with unilateral (40%) or bilateral (60%) hearing loss, with a prevalence of 1.6/1000. Conclusions The analysis of 2016 UNHS in the Lazio region allowed identification of several strengths and weaknesses of the initial phase of the program. The strengths include a correct spread and monitoring of UNHS among Level I facilities, with an adequate coverage rate, and the proper execution of audiological monitoring and diagnosis among Level III facilities. Weakness, instead, mainly consisted in lack of an efficient and automated central process for collecting, monitoring and reporting of data and information.
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Affiliation(s)
- Rosaria Turchetta
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Guido Conti
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology, Catholic University of Sacred Heart, Rome, Italy
| | - Pasquale Marsella
- Department of Surgery, Audiology and Otosurgery Unit, Bambino Gesù Pediatric Hospital, Rome, Italy
| | | | - Pasqualina Maria Picciotti
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology, Catholic University of Sacred Heart, Rome, Italy
| | - Simonetta Frezza
- Department of Pediatrics, Division of Neonatology, Catholic University of Sacred Heart, Rome, Italy
| | | | - Alessandro Scorpecci
- Department of Surgery, Audiology and Otosurgery Unit, Bambino Gesù Pediatric Hospital, Rome, Italy
| | | | - Sara Giannantonio
- Department of Surgery, Audiology and Otosurgery Unit, Bambino Gesù Pediatric Hospital, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy.
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Follow-up in newborn hearing screening - A systematic review. Int J Pediatr Otorhinolaryngol 2016; 90:29-36. [PMID: 27729148 DOI: 10.1016/j.ijporl.2016.08.016] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 08/24/2016] [Accepted: 08/24/2016] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The quality and efficiency of newborn hearing screening programs (NHS) rely heavily on appropriate follow-up. The Joint Committee on Infant Hearing recommends a follow-up rate of more than 95% of infants who fail the initial hearing screening. However, a 70% benchmark is considered to be more feasible. This high loss to follow-up (LTF) rate acts as a threat to the overall success of NHS programs. The objective of the study was to identify and examine the reported rates of LTF, attributed reasons for LTF and strategies undertaken to reduce LTF. METHODS Using a systematic search, articles published between 2005 to December 2015 were identified from PubMed/Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Educational Resources Information Center (ERIC), Scopus, Ovid, ProQuest, and Cochrane Library. To be included in the review, the study should be exploring the loss to follow-up or drop-out rate in newborn hearing screening programs and be published in an indexed peer-reviewed journal in the English language. The main outcome measures were overall rate of LTF, factors leading to LTF and measures adopted to overcome LTF. RESULTS 53 articles were short-listed for data extraction. Out of these, 27 were single-centre studies, 19 were multi-centre, 3 compared multiple databases, and 4 used survey-based methods. Overall LTF rates of 20% in single-centre and 21% in multiple-centre studies were observed. Educational disparity and lack of adequate knowledge among parents were associated with LTF. The most commonly used strategy to overcome LTF suggested by studies was the use of an adequate data management system. CONCLUSION This review is a novel attempt to explore the LTF among NHS studies, reasons for LTF and strategies to reduce LTF. This review can act as a basis for planning and execution of effective NHS programs.
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Vos B, Senterre C, Lagasse R, Tognola G, Levêque A. Organisation of newborn hearing screening programmes in the European Union: widely implemented, differently performed. Eur J Public Health 2016; 26:505-10. [DOI: 10.1093/eurpub/ckw020] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Schade G. Early detection of hearing loss. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2010; 7:Doc05. [PMID: 22073092 PMCID: PMC3199831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The universal newborn hearing screening (UNHS) is currently spreading in Germany, as well, even though there can be no talk of a comprehensive establishment. The introduction of UNHS in several federal states such as Hamburg, Hessen, and Schleswig-Holstein can be ascribed to the personal commitment of individual pediatric audiologists. Apart from the procurement of the screening equipment and the training of the staff responsible for the examination of the newborns, the tracking, i.e. the follow-up on children with conspicuous test results, is of utmost importance. This involves significant administration effort and work and is subject to data protection laws that can differ substantially between the various federal states. Among audiologists, there is consensus that within the first three months of a child's life, a hearing loss must be diagnosed and that between the age of 3 and 6 months, the supply of a hearing aid must have been initiated. For this purpose, screening steps 1 (usually a TEOAE measurement) and 2 (AABR testing) need to be conducted in the maternity hospital. The follow-up of step 1 then comprises the repetition of the TEOAE- and AABR measurement for conspicuous children by a specialized physician. The follow-up of step 2 comprises the confirmatory diagnostics in a pediatric audiological center. This always implies BERA diagnostics during spontaneous sleep or under sedation. The subsequent early supply of a hearing aid should generally be conducted by a (pediatric) acoustician specialized on children.
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Affiliation(s)
- Götz Schade
- Univ. HNO-Klinik Bonn, Deutschland,*To whom correspondence should be addressed: Götz Schade, Univ. HNO-Klinik Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Deutschland, Tel.: +49(0)228 28715563, E-mail:
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Mezzano P, Serra G, Calevo MG. Cost analysis of an Italian neonatal hearing screening programme. J Matern Fetal Neonatal Med 2009; 22:806-11. [DOI: 10.3109/14767050902994465] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Current world literature. Curr Opin Otolaryngol Head Neck Surg 2008; 16:569-72. [PMID: 19005328 DOI: 10.1097/moo.0b013e32831cf1a7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Calevo MG, Mezzano P, Zullino E, Padovani P, Serra G. Ligurian experience on neonatal hearing screening: clinical and epidemiological aspects. Acta Paediatr 2007; 96:1592-9. [PMID: 17937684 DOI: 10.1111/j.1651-2227.2007.00475.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM Early identification and rehabilitation of newborns with congenital hearing impairment (HI) by Universal Neonatal Hearing Screening (UNHS). METHODS The neonatal population was divided into two groups: babies with No Audiological Risk (NAR), and babies With Audiological Risk (WAR). NAR neonates underwent OAE testing, and in case of a doubtful (Refer) result, ABR testing was carried out. All WAR newborns underwent ABR testing within the third month of life. RESULTS Between February 1, 2002 and December 31, 2004, UNHS was carried out on 32 502 newborns at the 13 regional birth centres, representing 98.7% of the whole regional neonatal population. The prevalence of HI in the population we tested was estimated at about 1 per thousand, while Bilateral Hearing Impairment (BHI) was estimated at 0.65 per thousand. A 3.7% prevalence of HI and a 2.8% prevalence of BHI was observed among the WAR population. Median age at the end of the diagnostic procedures was 6.7 months in the WAR population and 6.9 months in the NAR population. CONCLUSIONS Our project is based on two levels of testing, which resulted in a 0.28% false-positive rate with 100% sensitivity and 99% specificity. Our screening is the first Italian experience that has been extended to a whole region and the results prove that regional neonatal hearing screening is feasible.
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Affiliation(s)
- M G Calevo
- Epidemiology and Biostatistics Service, Scientific Directorate, G. Gaslini Institute, Largo G. Gaslini 5, 16147 Genoa, Italy.
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