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Published on: January 23, 2017
On the threshold of effective well infant nursery hearing screening in Western Sicily
Francesco Martines1, Daniela Bentivegna, Simona Ciprì
1Università degli Studi di Palermo, Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche, Sezione di Otorinolaringoiatria, Via del Vespro, 129 - 90127 Palermo, Italy. francescomartines@unipa.it
Insights
This study demonstrates a feasible and effective well-infant nursery hearing screening program using transient evoked otoacoustic emission (TEOAE). The program successfully identifies hearing impairment early, significantly reducing the need for costly secondary audiology assessments.
Area of Science:
- Neonatal screening
- Audiology
- Public health
Background:
- Early identification of hearing impairment is crucial for infant development.
- Transient evoked otoacoustic emission (TEOAE) offers a sensitive method for hearing screening.
Purpose of the Study:
- To assess the feasibility and effectiveness of a well-infant nursery hearing screening program.
- To utilize TEOAE with high sensitivity to minimize expensive secondary audiology evaluations.
Main Methods:
- Non-specialist health workers conducted TEOAE screening on newborns.
- A four-group system based on screening results and audiological risk factors was implemented.
- Screening occurred on the 20th day of life over six consecutive years.
Main Results:
- Screening coverage increased from 89.8% to 92%.
- The four-stage screening for infants failing initial tests reduced audiology referrals to 0.91%.
- High specificity (99.4%) was achieved, with a false positive rate of 0.62%.
Conclusions:
- The TEOAE-based screening program is effective in early hearing impairment identification.
- Less than 1% of infants required audiological assessment, confirming program efficiency.
- The program is suitable for implementation in wider healthcare settings.
Objective:
To determine the feasibility and effectiveness of well-infant nursery hearing screening programme for the early identification of hearing impairment, based on transient evoked otoacoustic emission (TEOAE) with a high "screen sensitivity" reducing the number of more expensive secondary level exams.
Methods:
The newborns were screened by non-specialist health workers in well babies nursery at the twentieth day of life for 6 years consecutive. Based on PASS/FAIL criteria and presence/absence of audiological risk factors the newborns were divided into four groups each one with its personal step programme: G1 - PASS without risk factor, free to go home; G2 - PASS with risk factor, retest at the age of 7 months; G3 - FAIL without risk factor, re-screening after 2 weeks for a maximum of four times before audiology assessment; G4 - FAIL with risk factor, retest after 2 weeks.
Results:
The coverage rate increased progressively from 89.8% to 92%. The referral rate was 1.51% after second stage with a specificity value of 98.78%. The four-stage screening performed for G3 reduced the numbers of global audiology assessment to 0.91% with a final global specificity of 99.4 ± 0.4%.
Conclusion:
Less than 1% of infants underwent audiological assessment; the false positives resulted 0.62% with hearing loss global incidence of 2.95/1000 and a mean age of confirmation of 3.5 months of age. It is reasonable to think that this screening programme could be implement to overall 42 Western Sicily birth centres within few years.
