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Updated: Jun 5, 2026
An Automated System for Sound Localization Testing in Hearing-Impaired Listeners
Published on: March 13, 2026
Making targeted screening for infant hearing loss an effective option in less developed countries
1Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-araba, Surulere, Lagos, Nigeria.
Insights
Targeted newborn hearing screening (TNHS) using US guidelines may not be effective in Sub-Saharan Africa and Southeast Asia due to different risk factors. Pilot universal newborn hearing screening (UNHS) studies are recommended before implementing TNHS.
Area of Science:
- Global Health
- Audiology
- Pediatrics
Background:
- Developing countries bear a high burden of infant hearing loss.
- Universal newborn hearing screening (UNHS) is ideal but challenging in resource-limited settings.
- Targeted newborn hearing screening (TNHS) is often proposed for these regions.
Purpose of the Study:
- To evaluate the appropriateness of the Joint Committee on Infant Hearing (JCIH) risk factors for TNHS in Sub-Saharan Africa and Southeast Asia.
- To identify context-specific risk factors for infant hearing loss in these regions.
- To assess the feasibility and effectiveness of TNHS in resource-poor settings.
Main Methods:
- Systematic literature review of studies published in PubMed within the last 10 years.
- Analysis of evidence on the effectiveness of TNHS based on JCIH or other risk factors.
- Comparison of JCIH risk factors with epidemiological profiles of Sub-Saharan Africa and Southeast Asia.
Main Results:
- Evidence supporting TNHS based on JCIH risk factors in these regions is limited.
- Additional risk factors like maternal hypertensive disorders, lack of skilled birth attendants, non-elective cesarean delivery, and infant undernutrition are prevalent.
- Consanguinity is also a noted risk factor.
- Operational constraints may limit TNHS effectiveness in these regions.
Conclusions:
- JCIH risk factors alone may be insufficient for effective TNHS in Sub-Saharan Africa and Southeast Asia.
- Context-specific risk factor identification is crucial.
- Pilot universal newborn hearing screening (UNHS) studies are recommended to determine feasibility, efficiency, and trade-offs before widespread TNHS implementation.
Abstract:
Developing countries account for a disproportionate burden of infant hearing loss globally but the prospects of the more ideal universal newborn hearing screening (UNHS) have been debated. The Joint Committee on Infant Hearing (JCIH) of USA has consistently proposed targeted newborn hearing screening (TNHS) for such countries. This study therefore set out to examine the appropriateness of JCIH risk factors as a basis for TNHS in Sub-Saharan Africa and Southeast Asia. From a review of relevant literature published in PubMed in the last 10 years, evidence on the effectiveness of TNHS based on JCIH or other risk factors is sparse or limited. Consistent with the prevailing epidemiological profile of these countries additional putative risk factors not listed or more prevalent than those listed by JCIH such as maternal hypertensive disorders in pregnancy, lack of skilled attendant at delivery, non-elective cesarean delivery and infant undernutrition have been demonstrated besides consanguinity. While TNHS has intuitive appeal in resource-poor settings, it is likely to be fraught with diverse operational constraints that could significantly curtail its effectiveness in these two regions. Well-conducted pilot UNHS studies to determine context-specific risk factors, screening efficiency and the potential trade-offs are warranted in each country prior to embarking on TNHS where UNHS is not immediately practicable.
