Newborn hearing screening: an outpatient model.
ABSTRACT 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.
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ABSTRACT: Introdução programas de Triagem Auditiva Neonatal (TAN) são implantados em todo mundo objetivando a detecção precoce da deficiência auditiva. A qualidade destes programas deve ser monitorada utilizando indicadores reconhecidos internacionalmente, para que este objetivo seja alcançado. Objetivo avaliar um Serviço de Triagem Auditiva Neonatal (STAN) com base nos indicadores internacionais de qualidade. Método Coorte retrospectiva com análise dos atendimentos realizados por um STAN de Minas Gerais entre 2010 a 2011. Os resultados foram analisados segundo critérios da American Academy of Pediatrics e do Joint Committee on Infant Hearing. Resultados foram avaliadas 6.987 crianças. As proporções de encaminhamento para reteste, adesão ao reteste e encaminhamento para diagnóstico foram 8,0%, 71,9% e 2,1%, respectivamente. A proporção de crianças avaliadas nos primeiros 30 dias de vida foi 65,0%. A mediana de idade das crianças que falharam na TAN e no reteste foi significativamente maior do que para as demais. O risco de uma criança com indicador de risco para deficiência auditiva (IRDA) falhar na TAN foi 2,4 vezes maior do que para as demais. Conclusão o STAN alcançou 3 dos 4 indicadores avaliados. No entanto, ainda são necessários esforços para captação precoce de neonatos para a triagem auditiva e adesão às etapas subsequentes.Brazilian journal of otorhinolaryngology 08/2014; · 0.55 Impact Factor
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ABSTRACT: The implementation of early hearing detection in developing countries remains elusive. The fragile health care system along with insufficient funding for health care services leads to inadequate universal newborn hearing screening programs. There is a high incidence of loss to follow-up, at different stages of the program, in these countries, compromising the effect of early hearing screening programs. Strategies must be developed to improve family commitment to such programs. The objective of the present study was to examine factors that predict loss to second-stage follow-up at a municipal based, universal newborn hearing screening program in the Northeastern region of Brazil. The current cross sectional study includes 577 newborns who underwent hearing screening and failed. The population was divided into two groups: those who returned and those who were lost to second-stage screening. Differences between groups were explored and adjusted odds ratios were derived. There was a significantly increased risk of non-adherence to the universal newborn hearing screening program in mothers with low income, few prenatal care visits, minimal education and with a multiparous child. Socioeconomic factors may have a significant influence on the effectiveness of hearing screening programs in poorer regions of Brazil and other low-income countries. Improvements in health care politics, tracking system and public awareness is crucial for successful program implementation.International journal of pediatric otorhinolaryngology 08/2012; 76(11):1661-7. · 0.85 Impact Factor
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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.Genetika 03/2012; 48(3):381-8. · 0.37 Impact Factor