Universal newborn hearing screening in South Africa: a single-centre study.
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ABSTRACT:
SUBMITTER: Gina A
PROVIDER: S-EPMC7978244 | biostudies-literature | 2021
REPOSITORIES: biostudies-literature
Publications
Universal newborn hearing screening in South Africa: a single-centre study.
Gina Ayanda A Bednarczuk Nadja F NF Jayawardena Asitha A Rea Peter P Arshad Qadeer Q Saman Yougan Y
BMJ paediatrics open 20210318 1
Hearing screening for newborn babies is an established protocol in many high-income countries. Implementing such screening has yielded significant socioeconomic advantages at both an individual and societal level. This has yet to permeate low/middle-income countries (LMIC). Here, we illustrate how newborn hearing screening needs to be contextually adapted for effective utilisation and implementation in an LMIC. Specifically, this advocates the use of auditory brainstem testing as the first-line ...[more]
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Project description:The universal newborn hearing screening (UNHS) component of the multi-center EUSCREEN project is being piloted in Albania since January 1st 2018. The aim of this study was to explore mothers' perceptions about various elements of UNHS in Albania. A cross-sectional study was carried out in the three sites of UNHS in Albania, namely in Tirana, Kukës and Pogradec during May-June 2019. During this period 512 consecutively approached mothers giving birth to included maternity hospitals were interviewed face-to-face about different aspects of UNHS. Basic socio-demographic and socioeconomic information was also collected. Mean age of participating mothers was 28.6 years ± 5.5 years. The overwhelming majority (93%) of mothers knew what their baby was being tested for, 33% were aware that hearing screening was offered in maternity hospital, 94% were very satisfied/satisfied with UNHS and about 62% were very stressed/stressed waiting for screening results, with significant sociodemographic and socioeconomic differences. The main information source about UNHS was screening staff in the maternity hospitals where mothers gave birth, reported in 67% of cases. All mothers (100%) agreed on the importance of early detection of newborn hearing problems, all mothers were willing to be informed early if their newborn baby had a hearing problem and all mothers were willing to contribute financially for testing the hearing of their newborn baby. These findings should guide information and education campaigns about UNHS in Albania. The public willingness to financially support neonatal hearing testing should be considered as an opportunity to achieve universal newborn hearing screening in the country.
| S-EPMC7444524 | biostudies-literature
Project description:ObjectiveTo conduct a scoping review on etiologic investigation of prelingual hearing loss among children <2 years of age in the era of universal newborn hearing screening (UNHS).Data sourcesPubMed, Embase, PsycInfo, CINAHL, and Cochrane Library databases.Review methodsWe searched for articles published from January 1, 1998, to February 19, 2020. We reviewed studies that (1) included children identified with either congenital or delayed-onset hearing loss before 2 years of age among cohorts who had undergone UNHS and (2) investigated ≥1 etiologies of hearing loss. We defined hearing loss as congenital when confirmed after UNHS failure and as delayed onset when diagnosed after ≥1 assessments with normal hearing.ResultsAmong 2069 unique citations, 115 studies met criteria for full-text assessment, and 20 met our inclusion criteria. Six studies tested children diagnosed with hearing loss for genetic etiology, 9 for congenital cytomegalovirus (CMV) infection, and 5 for both. Among 1787 children with congenital hearing loss and etiologic investigation, 933 (52.2%) were tested for genetic mutations and 1021 (57.1%) for congenital CMV infection. The proportion of congenital hearing loss cases attributable to genetic etiology ranged between 7.7% and 83.3% and to congenital CMV infection between 0.0% and 32.0%.ConclusionData are lacking on the identification and etiology of delayed-onset hearing loss in children <2 years of age in the UNHS era. The proportion of congenital hearing loss cases attributable to genetic etiologies and congenital CMV infection appears to vary widely.
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Project description:BackgroundPermanent bilateral hearing loss (PBHL) is a serious condition in newborns, with a prevalence of at least one per 1000 live births. However, there has been no recent systematic review and meta-analysis of the effectiveness of universal newborn hearing screening programs (UNHS).MethodsWe registered our study protocol on PROSPERO CRD42020175451. Primary outcomes were any identification of PBHL (ie, PBHL diagnosed at any time), age of identification of PBHL, and neurodevelopment. Two reviewers searched standard databases to March 2022 and extracted data. We used fixed and random effects meta-analysis to pool data and graded the certainty of evidence using standard methods.ResultsThe search retrieved 2834 records. We identified five studies reporting on the effects of UNHS vs no UNHS in 1 023 610 newborns. The relative risk of being identified with PBHL before nine months in infants with UNHS compared to infants without UNHS was 3.28 (95% confidence interval (95% CI) = 1.84, 5.85, one study, 1 023 497 newborns, low certainty evidence). The mean difference in the age of identification of PBHL in infants with UNHS compared to infants without UNHS was 13.2 months earlier (95% CI = -26.3, -0.01, two studies, 197 newborns, very low certainty evidence). The relative risk of infants eventually being identified with PBHL in infants with UNHS compared to infants without UNHS was 1.01 (95% CI = 0.89, 1.14, three studies, 1 023 497 newborns, low certainty evidence). At the latest follow-up at 3-8 years, the standardised mean difference (SMD) in receptive language development between infants with UNHS compared to infants without UNHS was 0.60 z scores (95% CI = 0.07, 1.13, one study, 101 children, low certainty evidence) and the mean difference in developmental quotients was 7.72 (95% CI = -0.03, 15.47, three studies, 334 children, very low certainty evidence). The SMD in expressive language development was 0.39 z scores (95% CI = -0.20, 0.97, one study, 87 children, low certainty evidence) and the mean difference in developmental quotients was 10.10 scores (95% CI = 1.47, 18.73, 3 studies, 334 children, very low certainty evidence).ConclusionsUNHS programs result in earlier identification of PBHL and may improve neurodevelopment. UNHS should be implemented across high-, middle-, and low-income countries.RegistrationPROSPERO (CRD42020175451).
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Project description:ObjectiveTo determine whether the benefits of universal newborn hearing screening (UNHS) seen at age 8 years persist through the second decade.DesignProspective cohort study of a population sample of children with permanent childhood hearing impairment (PCHI) followed up for 17 years since birth in periods with (or without) UNHS.SettingBirth cohort of 100 000 in southern England.Participants114 teenagers aged 13-19 years, 76 with PCHI and 38 with normal hearing. All had previously their reading assessed aged 6-10 years.InterventionsBirth in periods with and without UNHS; confirmation of PCHI before and after age 9 months.Main outcome measureReading comprehension ability. Regression modelling took account of severity of hearing loss, non-verbal ability, maternal education and main language.ResultsConfirmation of PCHI by age 9 months was associated with significantly higher mean z-scores for reading comprehension (adjusted mean difference 1.17, 95% CI 0.36 to 1.97) although birth during periods with UNHS was not (adjusted mean difference 0.15, 95% CI -0.75 to 1.06). The gap between the reading comprehension z-scores of teenagers with early compared with late confirmed PCHI had widened at an adjusted mean rate of 0.06 per year (95% CI -0.02 to 0.13) during the 9.2-year mean interval since the previous assessment.ConclusionsThe benefit to reading comprehension of confirmation of PCHI by age 9 months increases during the teenage years. This strengthens the case for UNHS programmes that lead to early confirmation of permanent hearing loss.Trial registration numberISRCTN03307358.
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Project description:Universal newborn hearing screening (UNHS) is recognized as the most effective strategy for early detection of congenital hearing loss; however, screening coverage remains inadequate in many countries. In China, newborn hearing screening has been implemented for over two decades. To evaluate our policies and practices during this period and assess resource equity, health impacts, and future challenges, we conducted a nationwide survey focusing on newborn hearing screening coverage, the number of special schools for deaf-mutes, and the proportion of hearing-impaired students in mainstream education. From 2001 to 2020, China's UNHS program coverage increased from 10.9% to 94.3%, while the proportion of hearing-impaired students in mainstream education rose from 24.8% to 57.5%. Concurrently, the number of hearing-impaired students in special schools decreased from 76,554 to 34,945, and the number of special schools for deaf-mutes declined from 639 to 389. Through the implementation of the UNHS program, China has made substantial progress in improving newborn hearing health, yielding long-term benefits for those with congenital hearing loss. However, targeted resource allocation and the establishment of a national platform remain priorities for future development. Our experience may provide valuable insights for similar settings.
| S-EPMC11911654 | biostudies-literature
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Project description:This study evaluated the outcomes of training nurses engaged in a public sector newborn hearing screening (NHS) program in one urban district in South India. Twenty nurses performing NHS in Corporation Maternity Hospitals (CMH) participated in the training and evaluation. Baseline knowledge and skill of nurses regarding NHS and overall program outcomes were obtained eight months post the initial training. Knowledge was evaluated using questionnaire, skill was evaluated using Objective Structured Clinical Examination (OSCE) and agreement between screening results obtained by audiologist and nurse. Records used for documentation of screening were analysed to evaluate program outcomes. A two-day retraining was designed to address the gaps identified. Evaluations were conducted immediately post and three months post retraining following the same procedure as baseline evaluations. Gaps were identified in knowledge and skill as well as in the program outcomes. Immediate post retraining evaluation results showed overall improvement in nurses' knowledge and skill. Three months post retraining, all the nurses achieved benchmark criteria of 75% in knowledge and skill. Program outcomes, such as coverage (95.3%), refer rate (3.2%) and follow up rate (86.1%) improved post retraining. The findings of this study suggests that knowledge and skill of nurses improved with periodic training. Periodic evaluation and monitoring enhanced the overall outcomes of the program.Supplementary informationThe online version contains supplementary material available at 10.1007/s12070-021-02920-2.
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