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.
- SourceAvailable from: scielo.br[Show abstract] [Hide abstract]
ABSTRACT: The aim of this study was to measure the frequency of hearing loss in a sample of typical public high-school students exposed to recreational noise, and determine associated risk factors. The sample was made up of 214 teenagers from a high-school in Mexico City; subjects were selected randomly per strata. We applied a questionnaire to identify risk factors for hearing loss and performed a battery of audiologic tests consisting of otoscopy, tympanometry, and pure-tone audiometry. The mean age of the sample was 16 +/- 1.07 years; 73% were male and 27%, female. Hearing loss was found in 21% of students. The main hearing loss-related risk factor was exposure to recreational noise: frequent attendance at discotheques and pop-music concerts; use of personal stereos; and noise exposure in school workshops. The high frequency of hearing loss in high school students from one Mexico City school (nearly one fifth of the sample) was found to be related to noise exposure mainly during recreational activities.Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública 12/2009; 25(12):2553-61. DOI:10.1590/S0102-311X2009001200003 · 0.89 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Early neurodevelopment disabilities (END) such as cerebral palsy (CP), deafness, blindness, epilepsy, and mental retardation (MR) are very important public health concerns. Although no strong data on END can be obtained in Mexico, the few papers concerning END epidemiology deserve systematic and critical review. Thus, this was the objective of the present paper. We performed a systematic review of papers published reporting on the prevalence of END in Mexico. We performed a search in several medical data bases such as PubMed, Artemisa, ImBioMed, and LiLaCS. Each paper was downloaded, read and discussed. We only selected papers published between 1999 and 2008. No data on CP and epilepsy prevalence in infants have been found. Data on deafness prevalence report hearing loss in 0.65/1,000 healthy newborns, and in 2.6/100 in high-risk very premature infants. With regard to blindness, prevalence of retinopathy of premature infants in any stage was reported at ca 10.61 and 22.2/100 in high-risk premature infants. Congenital hypothyroidism (CH) prevalence in infants was found in 4.2/10,000 live newborns after a national universal screening survey. No universal data regarding the prevalence of END in Mexico have been investigated, with the exception of CH. Mexico needs more research to determine epidemiologic data focused on designing actions to prevent, treat, and rehabilitate END.Arquivos de neuro-psiquiatria 10/2009; 67(3A):736-40. DOI:10.1590/S0004-282X2009000400038 · 1.01 Impact Factor
- [Show abstract] [Hide abstract]
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