Identifying the Optimal Age to Perform Newborn Screening for Hearing Loss in Uganda
M Walsh1, E Redshaw2, E Crossley3
1Ian Hutcheon Clinic for Children, Harpenden, UK; Ugandan Maternal and Newborn HUB, Liverpool, UK.
Insights
Newborn hearing screening in Uganda is crucial. Otoacoustic emission testing is more effective for infants 24 hours or older, suggesting an optimal age for early detection programs.
Area of Science:
- Pediatrics
- Audiology
- Public Health
Background:
- Permanent congenital hearing loss affects many newborns in developing nations.
- Uganda lacks a newborn hearing screening program, with limited research available.
- Screening opportunities exist at birth or at the 6-week immunization visit.
Purpose of the Study:
- To evaluate otoacoustic emission (OAE) testing outcomes in infants at birth versus 6 weeks of age.
- To determine the optimal timing for newborn hearing screening in Uganda.
Main Methods:
- A cross-sectional pilot study involving 60 infants in Kampala, Uganda.
- Infants were divided into two groups: newborns (postnatal ward) and 4-8 week olds (immunization clinic).
- Otoacoustic emission (OAE) testing was performed on all participants.
Main Results:
- Infants at 6 weeks (immunization clinic) had a significantly higher pass rate (90.0%) compared to newborns (56.7%).
- Newborns aged ≥24 hours showed a higher pass rate (90.9%) than those <24 hours (37%).
- Results indicate potential compromise from external ear debris and middle ear fluid in younger newborns.
Conclusions:
- Otoacoustic emission testing yields better results in infants aged 24 hours or older.
- Implementing newborn hearing screening at ≥24 hours of age in Uganda could enhance program effectiveness.
- This approach aims to maximize the cost-effectiveness of a national newborn hearing screening program.
Background:
Permanent congenital hearing loss affects up to 6/1000 births in developing countries. Currently, in Uganda there is no newborn screening for hearing loss (NSHL) program and no published work on this topic. Within the existing healthcare system there are two opportunities to deliver screening, at birth or 6 weeks of age when infants receive their immunizations.
Aim:
This study explored the outcomes of otoacoustic emission (OAE) testing in infants at birth and 6 weeks of age, to identify the optimal age for screening.
Subjects And Methods:
This cross-sectional pilot study recruited 60 consecutive infants from two health centres in Kampala, Uganda. Thirty infants were newborns recruited from the postnatal ward and 30 were aged 4-8 weeks from the immunization clinic, we performed OAE testing on all infants.
Results:
The results showed 56.7% (17/30) of newborn infants passed OAE testing compared with 90.0% (27/30) of the immunization infants, P < 0.01. Furthermore, of the 11 newborn infants aged ≥24 h of age 90.9% (10/11) passed, compared with the 19 infants <24 h of age where 37% (7/19) passed, P < 0.01.
Conclusions:
This study demonstrates a higher pass rate for OAE testing for infants ≥24 h of age compared to those <24 h of age. The overall lower pass rate of the newborn infants could be due to external ear debris and middle ear fluid compromising the OAE testing. These findings would support a NSHL programme in Uganda that offers screening to infants ≥24 h of age, to maximize the cost-effectiveness of the program.
