Universal newborn hearing screening in Mexico: Results of the first 2 years

Medical School, Instituto Tecnológico y de Estudios Superiores de Monterrey (ITESM), Ave Loma Grande 2717-110, Lomas de San Francisco CP 64710, Monterrey, Nuevo León, Mexico.
International Journal of Pediatric Otorhinolaryngology (Impact Factor: 1.19). 12/2006; 70(11):1863-70. DOI: 10.1016/j.ijporl.2006.06.008
Source: PubMed


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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    • "Many other countries – some of them in Africa [28], [29], the Middle East [30], [31] and the Far East [32], [33], [34], [35] – are momentarily trying to implement such a comprehensive universal newborn hearing screening (UNHS). Among them, there are developing and emerging nations [32], [35], [36] such as Malaysia [35], Thailand [32], Mexico [37] and India [38]. In Europe, various endeavors are being undertaken to introduce universal newborn hearing screening. "
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    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.
    Full-text · Article · Jan 2008
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    • "Nepal and Bangladesh were excluded in the final analysis as the respondents reported that no infant hearing screening programme had commenced in these countries at the time of the survey despite substantial presence of multilateral institutions and donor agencies. Three more countries (Jordan, Qatar and Singapore) and Pakistan were added to the list of countries based on the results from our electronic searches of the internet and PubMed making a total of 18 countries including Hong Kong and Taiwan as shown in Table 1[32-49]. "
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    ABSTRACT: Early detection of infants with permanent hearing loss through infant hearing screening is recognised and routinely offered as a vital component of early childhood care in developed countries. This article investigates the initiatives and progress towards early detection of infants with hearing loss in developing countries against the backdrop of the dearth of epidemiological data from this region. A cross-sectional, descriptive study based on responses to a structured questionnaire eliciting information on the nature and scope of early hearing detection services; strategies for financing services; parental and professional attitudes towards screening; and the performance of screening programmes. Responses were complemented with relevant data from the internet and PubMed/Medline. Pilot projects using objective screening tests are on-going in a growing number of countries. Screening services are provided at public/private hospitals and/or community health centres and at no charge only in a few countries. Attitudes amongst parents and health care workers are typically positive towards such programmes. Screening efficiency, as measured by referral rate at discharge, was generally found to be lower than desired but several programmes achieved other international benchmarks. Coverage is generally above 90% but poor follow-up rates remain a challenge in some countries. The mean age of diagnosis is usually less than six months, even for community-based programmes. Lack of adequate resources by many governments may limit rapid nationwide introduction of services for early hearing detection and intervention, but may not deter such services altogether. Parents may be required to pay for services in some settings in line with the existing practice where healthcare services are predominantly financed by out-of-pocket spending rather than public funding. However, governments and their international development partners need to complement current voluntary initiatives through systematic scaling-up of public awareness and requisite manpower development towards sustainable service capacities at all levels of healthcare delivery.
    Full-text · Article · Feb 2007 · BMC Health Services Research
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    ABSTRACT: Infant hearing screening is emerging rapidly as a silent global revolution for the early detection of children with congenital or early onset hearing loss to ensure timely enrollment in family-oriented intervention programs for the development of spoken language. This article examines the overriding and interrelated scientific, ethical and economic considerations for early hearing detection and intervention (EHDI) in developing countries against the backdrop of relevant resolutions of the World Health Assembly (WHA) and current global programs on early childhood development of the World Bank, United Nations Children's Funds (UNICEF) and the United Nations Educational, Scientific and Cultural Organization (UNESCO). The need to determine and develop culturally appropriate EHDI programs is indicated by the significant proportions of births that occur outside regular hospitals in some countries based on lessons from ongoing projects. The key challenges and possible approaches to building local service capacities to advance this vital, social, educational and public health initiative also are highlighted.
    Full-text · Article · Dec 2005 · The Volta review
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