Universal newborn hearing screening in Mexico: Results of the first 2 years
ABSTRACT The purpose of this study is to present the results of the first 2 years of universal newborn hearing screening and the prevalence of congenital hearing loss in Monterrey, Mexico.
We performed a descriptive study of the first 2 years after starting of the newborn screening program in a private hospital in Mexico. The program is organized into levels. We using for initial evaluation an automated auditory brainstem response (AABR). If the test was positive, the audiologist conducted and auditory brainstem response (ABR) test and other specialized testing was performed. Babies with hearing impairment were referred for early intervention.
A total of 3066 newborns were screened (99.9%). The prevalence of sensorineural and bilateral hearing loss was of 0.65/1000 newborns. Seventy-three neonates (2.37%) had a risk factor for hearing impairment. A total of 0.22% (n=7) of those studied were referred for ABR testing. Of the patients referred to the audiologist, 100% were seen. The positive predictive value for sensorineural hearing loss was 71.4% (95% CI 30.2-94.8) and the false positive rate was 0.065%. Of the subjects screened, 100% were diagnosed before the age of 3 months, but all babies began treatment after the age of 6 months. No cochlear implants were indicated.
This is the first report of a universal hearing screening program in Mexico. Even though this study had a reduced sample, the findings of hearing loss rate in this study are similar to the results found in other countries.
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ABSTRACT: Two-stage hearing screening, with a first stage of automated otoacoustic emissions (AOAE) followed by automated auditory brainstem response (AABR), is the protocol of choice for the early detection of congenital and early-onset hearing loss (PCEHL) in a number of developed countries. However, this protocol would miss children with auditory neuropathy/auditory dys-synchrony (AN/AD). The aim of the study was to ascertain the characteristics of infants with AN/AD profile in a developing country and identify predictors of this condition in a primary care, non-hospital-based setting. Case-control analysis of the sociodemographic and medical profile of 11 infants with normal outer hair cell function, but confirmed with PCEHL, were compared to 64 infants with normal hair cell function and no PCEHL. The infants with AN/AD profile were further compared with 45 infants with PCEHL who failed transient evoked otoacoustic emissions (TEOAE). Independent predictors were determined from univariate and multiple logistic regression analyses. Factors associated with AN/AD profile in the univariate analysis were male sex (OR, 9.39: 95% CI 1.14−77.74) and hyperbilirubinaemia requiring exchange blood transfusion (OR, 5.63: CI 1.06–129.85). About 64% of the infants with AN/AD profile had a history of hyperbilirubinaemia and 54.5% were hospitalized in the first month of life for a serious illness. No independent factor was predictive of AN/AD from multiple logistic regression analysis. Infants with AN/AD profile were significantly more likely to have a history of hyperbilirubinaemia (OR, 14.00: CI 3.00−165.34) and be hospitalized in the first month of life (OR, 7.80: CI 1.80−33.77) than infants with PCEHL who failed TEOAE. There is no prognostic/selective tool for the early detection of infants with AN/AD profile in non-hospital-based settings in developing countries. AABR screening of infants with normal outer hair cells, who have a history of hyperbilirubinaemia with or without exchange blood transfusion, is recommended as far as practicable, where a two-stage TEOAE/AABR protocol is implemented.Audiological Medicine 07/2009; 6(2):120-128. DOI:10.1080/16513860802088198
Article: Early detection of hearing loss[Show abstract] [Hide abstract]
ABSTRACT: The universal newborn hearing screening (UNHS) is currently spreading in Germany, as well, even though there can be no talk of a comprehensive establishment. The introduction of UNHS in several federal states such as Hamburg, Hessen, and Schleswig-Holstein can be ascribed to the personal commitment of individual pediatric audiologists. Apart from the procurement of the screening equipment and the training of the staff responsible for the examination of the newborns, the tracking, i.e. the follow-up on children with conspicuous test results, is of utmost importance. This involves significant administration effort and work and is subject to data protection laws that can differ substantially between the various federal states. Among audiologists, there is consensus that within the first three months of a child's life, a hearing loss must be diagnosed and that between the age of 3 and 6 months, the supply of a hearing aid must have been initiated. For this purpose, screening steps 1 (usually a TEOAE measurement) and 2 (AABR testing) need to be conducted in the maternity hospital. The follow-up of step 1 then comprises the repetition of the TEOAE- and AABR measurement for conspicuous children by a specialized physician. The follow-up of step 2 comprises the confirmatory diagnostics in a pediatric audiological center. This always implies BERA diagnostics during spontaneous sleep or under sedation. The subsequent early supply of a hearing aid should generally be conducted by a (pediatric) acoustician specialized on children.01/2008; 7:Doc05.
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ABSTRACT: To determine the feasibility and effectiveness of well-infant nursery hearing screening programme for the early identification of hearing impairment, based on transient evoked otoacoustic emission (TEOAE) with a high "screen sensitivity" reducing the number of more expensive secondary level exams. The newborns were screened by non-specialist health workers in well babies nursery at the twentieth day of life for 6 years consecutive. Based on PASS/FAIL criteria and presence/absence of audiological risk factors the newborns were divided into four groups each one with its personal step programme: G1 - PASS without risk factor, free to go home; G2 - PASS with risk factor, retest at the age of 7 months; G3 - FAIL without risk factor, re-screening after 2 weeks for a maximum of four times before audiology assessment; G4 - FAIL with risk factor, retest after 2 weeks. The coverage rate increased progressively from 89.8% to 92%. The referral rate was 1.51% after second stage with a specificity value of 98.78%. The four-stage screening performed for G3 reduced the numbers of global audiology assessment to 0.91% with a final global specificity of 99.4 ± 0.4%. Less than 1% of infants underwent audiological assessment; the false positives resulted 0.62% with hearing loss global incidence of 2.95/1000 and a mean age of confirmation of 3.5 months of age. It is reasonable to think that this screening programme could be implement to overall 42 Western Sicily birth centres within few years.International journal of pediatric otorhinolaryngology 03/2012; 76(3):423-7. DOI:10.1016/j.ijporl.2011.12.024 · 1.32 Impact Factor