The purpose of this study was to assess the feasibility of implementing an outpatient model of a newborn hearing screening program with a particular focus on determining how compliance with the follow-up appointment related to specific socio-economic and demographic factors associated with the mother.
Mothers who delivered their babies in public hospitals in Recife, northeast Brazil, were invited to participate in a two-step program. In Step 1 they were interviewed with regard to specific socio-economic and demographic factors, and then scheduled for a hearing screening test for their baby 1 month after discharge. In Step 2, the baby's hearing was screened using transient otoacoustic emissions.
A total of 1035 mothers consented to participate in Step 1, but only 149 returned to participate in Step 2 (14.3%). Analysis of the socio-economic and demographic factors indicated that mothers who did not comply with the scheduled newborn hearing screening (NHS) test generally had less than a high school education and came from primarily lower income families who lived in rural areas outside of Recife.
The results of this study highlight some socio-economic and demographic factors of the population of northeast Brazil that contribute to a low compliance rate for an outpatient model of a newborn hearing screening program. Possible solutions to the low compliance rate are considered.
"While no defi nitive pattern could be observed between the referral rates and ambient noise levels across all sites, the high false-positive rates associated with TEOAE in this study would underscore the need for a second-stage screening with AABR to bring the overall referral rates within the recommended limit of 4% (JCIH, 2007). This is without prejudice to the possible reduction that could be achieved through a second-stage screening with the same technology on a return visit after several days, as has been reported with TEOAE in some studies from other developing countries (Tanon-Anoh et al, 2010; Griz et al, 2009; Tasci et al, 2009; Bansal et al, 2008). However, it was unlikely that the reduction achieved from the combined TEOAE/AABR in this population was possible with a TEOAE-only protocol given the age profi le in "
[Show abstract][Hide abstract] ABSTRACT: Considering that current newborn/infant hearing screening (NHS) instruments were designed primarily for use in developed countries, this study set out to ascertain the potential effects of higher ambient noise levels on transient-evoked otoacoustic emissions (TEOAE) in sub-Saharan Africa. Data was drawn from two hospital-based and community-based NHS programs in Lagos, Nigeria, with a total screened population of 11 893 infants. Two automated TEOAE screening devices-Echo-Screen and ECHOCHECK-were available for this study. Ambient noise levels ranged from 61.0-90.5 dBA in the hospital wards and 55.6-82.5 dBA in the community health centers. One TEOAE model could not be activated at the prevailing noise levels. No significant pattern was observed in average noise levels and overall TEOAE referrals across all screening sites. However, the false-positive rates ranged from 1.4-13.8%. This study suggests that valid TEOAE screening is attainable in the Negroid race in settings with ambient noise levels up to 68 dBA but the associated high false-positive rates may necessitate additional screening with auditory brainstem response to achieve acceptable overall referral rates for timely diagnostic evaluation.
International journal of audiology 08/2010; 49(8):535-41. DOI:10.3109/14992021003717768 · 1.84 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Screening programs at primary health care immunization clinics have been proposed as an alternative to hospital-based programs in South Africa. The objective of this study was to evaluate the first systematic community-based infant hearing screening program in a developing South African community in the Western Cape.
A community-based universal infant hearing screening program initiated at eight primary health care clinics in the Cape Metropolitan area was evaluated over a 19-month research period. During this time 6227 infants that were candidates for screening attended their 6, 10 or 14-week immunization visit at the relevant clinic. Clinic nurses were trained as screening personnel. A two-stage distortion product otoacoustic emissions screening protocol was utilized. The target disorder was uni- or bilateral hearing loss and infants referring the first screen were scheduled for a 4-week follow-up visit at the clinic. Diagnostic audiological and medical evaluations were scheduled at referral hospitals when indicated. The study evaluated the efficacy of the program based on coverage, referral and follow-up rates and diagnostic outcomes according to guidelines specified by the Health Professions Council of South Africa 2007 Position Statement.
Overall coverage rate across the eight clinics was 32.4% with 2018 infants (aged 0-14 weeks) screened. The mean age of the sample at first stage screen was 3.9 weeks of age and 13.5 weeks of age for first hospital visit. Overall first stage screen referral rate was 9.5% with 62 subjects (3%) referred for diagnostic services at hospital level after a follow-up screen. The average follow-up rate for rescreens at clinic level was 85.1% and for initial diagnostic assessments at hospital level it was 91.8%. Prevalence rates were 4.5/1000 with significant hearing loss, including sensorineural (1.5/1000) and conductive (3/1000) losses, and 12.9/1000 for subjects with middle ear effusion.
The community-based infant hearing screening program was valuable in attaining high follow-up return rates but reaching sufficient coverage may require dedicated screening personnel as opposed to existing nursing personnel.
International journal of pediatric otorhinolaryngology 02/2012; 76(4):552-9. DOI:10.1016/j.ijporl.2012.01.015 · 1.19 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The results of a genetic epidemiological study of hereditary deafness (HD) in ten raions (districts) of Kirov oblast (administrative region), Russia, are presented. A total of 122 075 people have been examined. Segregation analysis of all families with diagnosed HD has demonstrated a good fit to either the autosomal dominant (AD) or autosomal recessive (AR) mode of inheritance. The total prevalence rates of AD and AR HDs, as well as the specific prevalence rates of nonsyndromic and syndromic forms of HD, have been calculated for the population often raions. The HD prevalence rate in Kirov oblast has been found to be 1 : 1043 people (1 : 1453 and 1 : 3699 for the nonsyndromic and syndromic forms, respectively). This value has been found to vary in different raions, which is explained by differences in the genetic subdivision levels of the populations studied; the correlation coefficient between the HD load and random inbreeding (F(ST)) in district populations is r = 0.81 +/- 0.22. The diversity of syndromic hearing disorders is described.
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