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Modified universal new-born hearing screening: Practical approach for developing world (Georgean experience).

Arti Rajpoot1, Anupam Mishra1, Veerendra Verma1

  • 1Department of Otorhinolaryngology and Head and Neck Surgery, King George's Medical University, Lucknow, India.

International Journal of Pediatric Otorhinolaryngology
|September 15, 2023
PubMed
Summary

A modified newborn hearing screening (NBS) strategy using risk assessment and behavioral audiometry (BoA) is proposed for developing countries. This approach enhances screening efficiency and reach for better infant hearing health outcomes.

Keywords:
Auditory evoked responseHearingOtoacoustic emissionsRisk factorScreening

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Area of Science:

  • Pediatrics
  • Audiology
  • Public Health

Background:

  • Newborn hearing screening (NBS) is crucial for early detection of hearing loss.
  • Developing countries face challenges in implementing effective NBS programs due to resource limitations.

Purpose of the Study:

  • To analyze newborn hearing screening outcomes in a developing country context.
  • To propose a modified, practical NBS strategy for improved performance in resource-limited settings.

Main Methods:

  • A descriptive study involving 8412 newborns, assessing risk factors and employing subjective (behavioral audiometry - BoA) and objective (otoacoustic emissions - OAE, auditory brainstem-evoked responses - ABR) screening methods.
  • Statistical analysis of risk factor predictivity and screening tool effectiveness, with DPOAE used as the primary objective tool in 2565 cases.

Main Results:

  • 45.5% of newborns were identified as 'at risk'. Abnormal OAE rates were 11.6% (of 2565) and 3.5% (of 8412).
  • Significant correlations were found between hearing risk and factors like consanguinity, NICU stay, and birth asphyxia. OAE demonstrated high sensitivity (99%) and accuracy (89%).
  • Behavioral audiometry (BoA) showed a sensitivity of 72.6%, with strong correlations between all tested screening methods (OAE-ABR, OAE-BoA, ABR-BoA).

Conclusions:

  • A subjective NBS approach combining questionnaire-based risk assessment and modified BoA, followed by selective objective assessment, is a practical strategy for resource-poor countries.
  • This modified strategy can potentially screen a larger population more effectively, improving early identification of hearing impairment in infants.