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Published on: June 8, 2017
Neonatal Hearing Screening Programme (NHSP): At A Rural Based Tertiary Care Centre
Yojana Sharma1, Girish Mishra1, Sushen H Bhatt1
1Department of Otorhinolaryngology and Head & Neck Surgery, Shri Krishna Hospital & Pramukh Swami Medical College, Karamsad, Anand, Gujarat 388325 India.
Insights
Universal neonatal hearing screening in India is crucial for early detection of hearing loss, preventing developmental delays. This study found a 2 per 1000 incidence of hearing impairment in Gujarat newborns, highlighting the need for improved follow-up systems.
Area of Science:
- Pediatrics
- Audiology
- Public Health
Background:
- Hearing impairment is the most common curable childhood handicap, impacting speech, language, and overall development.
- Universal neonatal hearing screening programs are established in developed nations but are nascent in India.
- Previous studies indicate a 1-6 per 1000 incidence of hearing impairment in Indian newborns.
Purpose of the Study:
- To determine the incidence of moderate to severe permanent hearing loss in neonates at a rural tertiary care hospital in Gujarat.
- To assess the feasibility of hospital-based universal newborn hearing screening in a rural Indian setting.
Main Methods:
- A 3-year non-randomized observational study involving 2534 neonates.
- A two-stage hearing screening protocol using Distortion Product Otoacoustic Emissions (DPOAE) and Brainstem Evoked Response Audiometry (BERA) for confirmation.
- Screening was conducted before hospital discharge.
Main Results:
- A 2.05% initial referral rate (52 neonates) from the DPOAE test.
- A final incidence of 7 neonates (2 per 1000) detected with hearing impairment.
- 10% of neonates had high-risk factors for hearing loss, with 1.8% diagnosed within this group.
- An overall follow-up rate of 72.7% was achieved.
Conclusions:
- Hospital-based universal newborn hearing screening is feasible in rural tertiary care centers in India.
- Non-specialist staff can effectively implement a two-stage hearing screening protocol.
- Enhanced tracking and follow-up systems are essential to improve diagnostic rates for hearing impairment.
Abstract:
Deafness is the most common curable childhood handicap. It is a well recognised fact that unidentified hearing impairment can adversely affect optimal speech and language development and therefore academic, social and emotional development. Universal neonatal hearing screening programmes are implemented in many developed countries. However it is still in its early stage in India. The incidence of hearing impairment in India is 1-6 per thousand newborns screened (Paediatrics 19:155-165, 1998; Indian J Paediatr 74(6):545-549, 2007; Status of Disability in India, pp 172-185 2000). To determine the incidence of permanent hearing loss of moderate to evere variety in neonates taking care in a tertiary care rural based hospital in Gujarat. It was a non randomised observational study done for duration of 3 years. All neonates born in Shri Krishna Hospital underwent screening using two stage protocols with DPOAE test and final confirmation done with BERA. Total 2534 neonates were screened out of them 52 failed and 2482 (97.94 %) neonates passed in the 1st DPOAE test with 2.05 % refer rate. Total 7 (2 per 1000) neonates were detected with hearing impairment. 10 % neonates had one or other high risk factor. Out of high risk neonates, 1.8 % were diagnosed with hearing impairment in high risk group. Overall the follow-up rate was 72.7 %. Hospital based universal hearing screening of new born before discharge is feasible at a rural based tertiary care centre. Non specialist staff is invaluable in achieving a satisfactory referral rate with two stage hearing screening protocol. However, more efficacious tracking and follow up system is needed to improve the follow up rate for diagnosis.
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