Related Experiment Video
Updated: Jun 12, 2026
14:05
Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
Ambient noise levels and infant hearing screening programs in developing countries: an observational report
1Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria. boolusanya@aol.com
International Journal of Audiology
|June 19, 2010
Summary
Transient-evoked otoacoustic emissions (TEOAE) screening is feasible in noisy sub-Saharan African settings up to 68 dBA. However, high false-positive rates may require auditory brainstem response for accurate infant hearing assessments.
Area of Science:
- Audiology
- Public Health
- Neonatal Care
Background:
- Current newborn hearing screening (NHS) instruments are often designed for low-noise environments.
- Sub-Saharan Africa presents unique challenges for neonatal hearing screening due to higher ambient noise levels.
- Assessing the efficacy of TEOAE in diverse environmental conditions is crucial for global health equity.
Purpose of the Study:
- To evaluate the impact of high ambient noise on transient-evoked otoacoustic emissions (TEOAE) screening in infants in Lagos, Nigeria.
- To determine the feasibility and accuracy of TEOAE screening in a resource-limited setting.
- To identify potential challenges and propose solutions for effective neonatal hearing screening in sub-Saharan Africa.
Main Methods:
- Conducted newborn/infant hearing screening (NHS) on 11,893 infants in hospital and community settings in Lagos, Nigeria.
- Utilized two automated TEOAE screening devices (Echo-Screen and ECHOCHECK).
- Measured ambient noise levels, ranging from 55.6-90.5 dBA, across different screening sites.
Main Results:
- One TEOAE device model was unusable due to high ambient noise levels.
- No significant correlation was found between average noise levels and overall TEOAE referral rates.
- False-positive rates for TEOAE screening varied significantly, ranging from 1.4% to 13.8% across sites.
Conclusions:
- Transient-evoked otoacoustic emissions (TEOAE) screening can be valid in Negroid infants in environments with ambient noise up to 68 dBA.
- High false-positive rates observed in noisy settings may compromise the efficiency of TEOAE screening.
- Auditory brainstem response (ABR) screening may be necessary as a supplementary test to reduce false positives and ensure timely diagnostic evaluations for infant hearing loss.
