Outcome of universal newborn hearing screening conducted in three referral hospitals in Cameroon

Universal newborn hearing screening (UNHS) is recommended for early identification of congenital hearing impairment (CHI). Evidence has shown that much of the impact of this condition can be mitigated through early detection and intervention. We sought to report findings of UNHS in a setting where it is not effectively implemented, describe the risk profile of potentially hearing impaired babies after screening, and determine factors associated with abnormal results. This was a hospital-based cross-sectional study carried out in three reference hospitals in Cameroon, for a period of three months from January to March 2024. We included all neonates born or admitted in any of these three facilities. Critically ill babies were excluded. A portable non-invasive otoacoustic emission (OAE) device was used. This device is exclusively used for screening, not diagnosis. Results were either "pass" or "refer", indicating that OAEs were either recorded or not detected respectively. A total of 215 babies were screened. Fifty-three out of 215 newborns had abnormal results (24.7%). Maternal age varied from 13 to 41 years, with a mean of 27.6 years. Among newborns with abnormal OAE results, maternal risk factors found were maternal alcoholism (23; 43.4%), family history of hearing loss (9; 17%), and infections (3; 5.7%). Neonatal risk factors were gentamicin administration (33; 62.3%), acute foetal distress/ neonatal asphyxia (19; 35.8%), and meningitis (7; 13.2%). Statistically significant risk factors identified on multivariate analysis included maternal alcoholism (adjusted OR 3.5, 95% CI 1.6-7.8, p = 0.002), the use of gentamicin (adjusted OR 5, 95% CI 2.3-10.8, p < 0.001), neonatal asphyxia (adjusted OR 3.3, 95% CI 1.2-6.4, p < 0.001), and meningitis (adjusted OR 6.3, 95% CI 1.1-35.7, p = 0.04). Without UNHS, many children with CHI are probably missed at the time when they would benefit most from treatment. Despite the cost-effectiveness of screening methods, and the availability of hearing specialists in some hospitals in Cameroon, UNHS is still not implemented. Risk factors for CHI are common among babies born in Cameroon. Diagnosis and management of CHI should be preceded by preventive measures, which include good perinatal care and satisfactory control of risk factors.