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Published on: January 23, 2017
Universal infant hearing screening programme in a community with predominant non-hospital births: a three-year
B O Olusanya1, O M Ebuehi, A O Somefun
1Department of Community Health and Primary Care, University of Lagos, Nigeria. boolusanya@aol.com
Insights
A community-based universal newborn hearing screening (UNHS) program in Nigeria effectively identified infants at risk for hearing loss, even those born outside hospitals. This approach shows comparable performance to hospital-based programs, highlighting its potential for early detection.
Area of Science:
- Public Health
- Audiology
- Global Health
Background:
- Assessing a pilot community-based universal newborn/infant hearing screening (UNHS) program over three years in a low-income country.
- Addressing challenges in a setting with a high proportion of out-of-hospital births.
Purpose of the Study:
- To evaluate the outcomes of a community-based UNHS program.
- To identify factors associated with screening success and dropout in a Nigerian community.
Main Methods:
- Implemented a two-stage screening: transient evoked otoacoustic emissions (TEOAE) and automated auditory brainstem-response (AABR).
- Analyzed screening coverage, referral rates, and screening results.
- Used survival analysis for age-at-screening impact and logistic regression for maternal/infant factors.
Main Results:
- Achieved 96.7% screening coverage, with 51.7% of infants born outside hospitals.
- Overall second-stage referral rate was 1.8%.
- Higher TEOAE failure rates were observed in infants born outside hospitals; low social class, delayed screening, multiple gestation, and severe jaundice predicted screen failure.
Conclusions:
- Community-based UNHS effectively enables early detection of hearing loss risk in infants born outside hospitals.
- The program's performance is comparable to traditional hospital-based UNHS.
- Maternal education initiatives may help mitigate associated risk factors for hearing loss.
Background:
To evaluate three-year outcomes of a pilot community-based universal newborn/infant hearing screening programme (UNHS) and the associated factors in a low-income country where a high proportion of births occur outside hospitals.
Methods:
A two-stage screening programme consisting of a first-stage transient evoked otoacoustic emissions and a second-stage automated auditory brainstem-response test was implemented in an inner-city community in Lagos, Nigeria from 2005 to 2008. Programme performance was measured by screening coverage, first-stage referral rate and second-stage screening results. The impact of infant's age-at-screening on otoacoustic emissions referral was assessed with survival analysis, while maternal/infant factors associated with screening results were explored by multinomial logistic regression analysis.
Results:
About 96.7% (7175) of eligible infants were screened, 51.7% of whom were born outside hospitals. Overall referral rate after second-stage screening was 1.8%. Cumulative proportion of otoacoustic emissions failures was significantly higher (p = 0.045) among infants born outside hospital compared to those born in hospitals. Low social class, screening after one month of age, multiple gestation and severe neonatal jaundice were predictive of screen failure, while multiparity, screening after one month of age and severe jaundice were independently associated with programme drop-out.
Conclusions:
Community-based UNHS facilitates early detection of infants at risk of sensorineural hearing loss born outside hospitals and the overall performance is comparable to conventional hospital-based UNHS. Maternal education at antenatal clinics may be valuable in addressing the associated risk factors.
