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A pre-paid newborn hearing screening programme: a community-based study
1Department of Otorhinolaryngology, Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan.
Insights
A pre-paid model for newborn hearing screening using automated auditory brainstem response (AABR) proved feasible in Taiwan. This community-based approach can aid developing nations in achieving universal newborn hearing screening.
Area of Science:
- Audiology
- Public Health
- Neonatal Care
Background:
- Implementing universal newborn hearing screening (UNHS) is crucial for early detection and intervention of hearing loss.
- Challenges exist in funding and logistics for UNHS programs, particularly in resource-limited settings.
Purpose of the Study:
- To assess the feasibility of a pre-paid model for newborn hearing screening.
- To evaluate the effectiveness of a community-based screening program utilizing automated auditory brainstem response (AABR).
Main Methods:
- A coordinated screening team provided in-patient and out-patient AABR screening in Changhua County, Taiwan.
- The study involved 10 medical facilities and screened 7,139 neonates over three years.
- Follow-up procedures were implemented for infants who did not pass initial screening.
Main Results:
- The screening program achieved a high follow-up rate of 94.3% for infants referred for re-screening.
- A total of 19 infants were diagnosed with hearing loss (11 bilateral, 8 unilateral), yielding an incidence of 1.5/1000 for bilateral hearing loss.
- Screening rates varied by facility level, but referral rates were consistent across different birthing facility types.
Conclusions:
- A pre-paid, community-based AABR screening model is feasible across all levels of medical facilities.
- This model presents a viable option for developing countries aiming to implement UNHS.
Objectives:
To help obstetric hospitals and clinics to implement newborn hearing screening and to test the feasibility of a pre-paid model for screening.
Patients And Methods:
From July 2005 to August 2008, we organised a coordinated newborn hearing screening team with portable automated auditory brainstem response (AABR) to provide in-patient screening after delivery and out-patient re-screening at one month of age in birthing facilities throughout Changhua County, Taiwan. This was a community-based study organised by otolaryngologists at a tertiary referral centre.
Results:
Ten medical facilities participated in our screening programme. 7,139 out of 12,901 neonates delivered in these facilities during the period were screened for hearing loss. 105 (1.47%) babies who did not pass the in-patient screening were re-screened at one month old. Forty (0.56%) babies referred from the re-screening were sent for diagnostic work-up and six of them failed to show up. The overall follow-up rate was 94.3% (99/105). Eleven babies with bilateral hearing loss and eight babies with unilateral hearing loss were diagnosed. The incidence of bilateral hearing loss in our programme was 1.5/1000. The screening rate descended from medical centre to clinic (p < 0.0001). There was no significant difference between the referral rates for different levels of birthing facilities (p = 0.5611).
Conclusions:
Our study demonstrates that a pre-paid model using AABR is feasible at all three levels of medical facilities. Pre-paid community-based screening might be an option for developing countries in the implementation of universal newborn hearing screening.
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