Quality controlled neonatal hearing screening in children 0-3 months at post natal wards in Uganda: A multi-center
Christopher Ndoleriire1, Peter Böttcher2, Michaela Hinterholzer2
1Department of Ear, Nose and Throat Surgery, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
Insights
Implementing newborn hearing screening in Uganda is feasible and necessary. Early detection of congenital hearing loss requires addressing challenges in screening coverage, referral, and follow-up rates.
Area of Science:
- Public Health
- Pediatrics
- Audiology
Background:
- Congenital and early-onset hearing loss disproportionately affects low- and middle-income countries.
- Early detection via neonatal hearing screening is crucial for timely intervention in childhood hearing loss.
- Systemic challenges hinder the implementation of neonatal hearing screening programs in resource-limited settings.
Purpose of the Study:
- To assess the feasibility of a comprehensive, quality-controlled newborn hearing screening program in Uganda.
- To establish screening standards comparable to established international programs.
- To evaluate the performance of a newborn hearing screening program in Ugandan public hospitals.
Main Methods:
- Cross-sectional, multi-center study involving five public hospitals in Uganda.
- Utilized a combined screening approach: Transient Evoked Otoacoustic Emissions and Automated Auditory Brainstem Responses.
- Data analysis performed using Microsoft Excel.
Main Results:
- Screening data from 12,996 newborns were analyzed.
- Coverage rates ranged from 4.9% to 23.2%, and referral rates from 1.2% to 42.6%.
- Loss to follow-up rates varied significantly (12.5% to 90.7%); 3 newborns (0.23 per thousand) had congenital hearing loss.
Conclusions:
- Implementation of a quality-controlled newborn hearing screening program in Uganda is feasible and essential.
- Addressing variations in coverage, referral, and follow-up rates is critical for effective congenital hearing loss management.
- The study highlights the need for improved systems to ensure early detection and intervention for hearing loss in Ugandan infants.
Introduction:
Congenital and early-onset hearing loss in low- and middle-income countries constitutes the majority of global cases of permanent childhood hearing loss. Early detection through neonatal hearing screening programs is pivotal for timely intervention. However, such programs are infrequently implemented in low- and middle-income countries due to systemic challenges.
Objective:
The primary goal was to evaluate the feasibility of establishing a comprehensive, quality-controlled newborn hearing screening (NHS) program in Uganda, following standards comparable to those in countries with well-established NHS systems.
Methods:
This cross-sectional, multi-center study evaluated the performance of a quality-controlled neonatal hearing screening program in five public hospitals in Uganda. The study used a combined screening approach of Transient Evoked Otoacoustic Emissions and Automated Auditory Brainstem Responses. Data analyses were made by Microsoft Excel.
Results:
This study analyzed data from 12,996 newborns. The findings revealed that newborn hearing screening coverage rates and referral rates across the five participating hospitals varied from 4.9 % to 23.2 % and 1.2 %-42.6 %, respectively. Notably, the loss to follow-up rates exhibited significant variation, spanning from 12.5 % to 90.7 % among the hospitals. Three children (0.23 per thousand) were identified with congenital hearing loss.
Conclusion:
This study demonstrated both the feasibility and the necessity of implementing a quality controlled newborn hearing screening program in Uganda. Addressing challenges related to coverage rates, referral rates, and loss to follow-up rates is important in early detection and effective management of congenital hearing loss.
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