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Takai S, Adachi M, Takahashi H, Shirakura M, Honkura Y, Yamauchi D, Katori Y. HDR syndrome, detected in the neonatal period by newborn hearing screening. Auris Nasus Larynx 2024; 51:406-410. [PMID: 37640596 DOI: 10.1016/j.anl.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023]
Abstract
Hypoparathyroidism, deafness, and renal dysplasia (HDR) syndrome is an autosomal dominant disorder. Because HDR syndrome is caused by haploinsufficiency in GATA3, it exhibits variation in the onset and progression of hearing loss. In previous reports, the automated auditory brainstem response (AABR) was considered insufficient to detect sensorineural hearing loss caused by HDR syndrome. We report a case of HDR syndrome whose congenital hearing loss was detected by newborn hearing screening (NHS) using AABR. In this case, HDR syndrome was suspected due to hearing loss, hypocalcemia, and her family history. Genetic testing confirmed the diagnosis of HDR syndrome at 5 months of age. Because the phenotype of hearing loss due to HDR syndrome is variable and includes progressive hearing loss, these cases may not be detected by the HNS. However, most of the previous reports were published before the NHS became common and given the frequency of hearing loss complications in HDR syndrome. We consider that there is a reasonable number of HDR syndrome cases with abnormalities on the NHS. We believe that the NHS may also be useful for early detection of hearing loss due to HDR syndrome.
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Affiliation(s)
- Shunsuke Takai
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Mika Adachi
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hiyori Takahashi
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Masayuki Shirakura
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Yohei Honkura
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Daisuke Yamauchi
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Yukio Katori
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
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Hoeve HLJ, Goedegebure A, Carr G, Davis A, Mackey AR, Bussé AML, Uhlén IM, Qirjazi B, Kik J, Simonsz HJ, Heijnsdijk EAM. Modelling the cost-effectiveness of a newborn hearing screening programme; usability and pitfalls. Int J Audiol 2024; 63:235-241. [PMID: 36799623 DOI: 10.1080/14992027.2023.2177892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/18/2023]
Abstract
OBJECTIVE The EUSCREEN project concerns the study of European vision and hearing screening programmes. Part of the project was the development of a cost-effectiveness model to analyse such programmes. We describe the development and usability of an online tool to enable stakeholders to design, analyse or modify a newborn hearing screening (NHS) programme. DESIGN Data from literature, from existing NHS programmes, and observations by users were used to develop and refine the tool. Required inputs include prevalence of the hearing impairment, test sequence and its timing, attendance, sensitivity, and specificity of each screening step. Outputs include the number of cases detected and the costs of screening and diagnostics. STUDY SAMPLE Eleven NHS programmes with reliable data. RESULTS Three analyses are presented, exploring the effect of low attendance, number of screening steps, testing in the maternity ward, or screening at a later age, on the benefits and costs of the programme. Knowledge of the epidemiology of a staged screening programme is crucial when using the tool. CONCLUSIONS This study presents a tool intended to aid stakeholders to design a new or analyse an existing hearing screening programme in terms of benefits and costs.
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Affiliation(s)
- Hans L J Hoeve
- Department of Otorhinolaryngology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Gwen Carr
- Independent Consultant in Early Hearing Detection and Intervention, Ribble Valley, UK
| | - Adrian Davis
- Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK
| | | | - Andrea M L Bussé
- Department of Otorhinolaryngology, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | | | - Birkena Qirjazi
- Department of Ear, Nose and Throat Diseases - Ophthalmology, University of Medicine of Tirana, Tirana, Albania
| | - Jan Kik
- Department of Ophthalmology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Huibert J Simonsz
- Department of Ophthalmology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Eveline A M Heijnsdijk
- Department of Otorhinolaryngology, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Department of Public Health, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
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Madzivhandila AG, le Roux T, Biagio de Jager L. Neonatal hearing screening using a smartphone-based otoacoustic emission device: A comparative study. Int J Pediatr Otorhinolaryngol 2024; 177:111862. [PMID: 38295684 DOI: 10.1016/j.ijporl.2024.111862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/14/2023] [Accepted: 01/09/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE Increasing options are becoming available for clinicians and healthcare professionals who use smartphone-based applications (apps) to identify hearing loss. The use of smartphone-based apps for newborn hearing screening (NHS) has been proposed as an alternative screening method in NHS programs. This study aims to compare the screening outcomes of a smartphone-based otoacoustic emission (OAE) screening device to a commercially available OAE screening device. METHODS NHS was conducted in the post-natal maternity ward and neonatal intensive care unit (NICU) of two tertiary public healthcare hospitals over a period of 8 months. Within participant DPOAE and TEOAE screening outcomes of a smartphone-based OAE device (hearOAE) were compared to that of the Otodynamics ILO V6. RESULTS A total of 176 infants (n = 352 ears; 48.9 % female) underwent NHS (DPOAE n = 176; TEOAE n = 176). The mean age at was 4.5 days (SD 11.3). Signal-to-noise ratio (SNR) were higher with the hearOAE with TEOAE NHS, and equivalent or higher SNR at four out of six frequencies with DPOAEs. Mean and total noise levels were significantly lower for the hearOAE compared to the Otodynamics with DPOAEs noise levels of five out of six frequencies being equivalent to, or lower than the Otodynamics (p < 0.001). Lower noise levels are likely to be advantageous in less-than-ideal test conditions. Inter-device DPOAE comparison indicated no statistically significant difference in the refer rate between the devices (p = 0.238). DPOAE pass rates between devices differed in 6 ears (p > 0.05), and in 20 ears for TEOAEs, with the hearOAE demonstrating a higher TEOAE pass rate (p = 0.009). The hearOAE did, however, demonstrate lower noise levels at three out five frequencies, which may have impacted the pass rate. No statistically significant correlation was found between the independent variables and the screening outcome (pass/refer) for TEOAEs using either device (p = 0.105 to 0.810). A high concordance of NHS outcomes within-participants of 89.7 % and 85.0 % for DPOAE and TEOAE respectively, was measured. CONCLUSIONS The mHealth based OAE device demonstrated good agreement in NHS outcomes compared to a commercially available device. This verifies the performance of the novel smartphone based OAE device, and may facilitate increased accessibility of decentralised NHS service in resource constrained populations.
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Affiliation(s)
| | - Talita le Roux
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
| | - Leigh Biagio de Jager
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa.
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Singh S, Maheshwari A, Boppana S. CMV-induced Hearing Loss. Newborn (Clarksville) 2023; 2:249-262. [PMID: 38348106 PMCID: PMC10860330 DOI: 10.5005/jp-journals-11002-0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Congenital cytomegalovirus (cCMV) infection is the most common fetal viral infection and contributes to about 25% of childhood hearing loss by the age of 4 years. It is the leading nongenetic cause of sensorineural hearing loss (SNHL). Infants born to seroimmune mothers are not completely protected from SNHL, although the severity of their hearing loss may be milder than that seen in those whose mothers had a primary infection. Both direct cytopathic effects and localized inflammatory responses contribute to the pathogenesis of cytomegalovirus (CMV)-induced hearing loss. Hearing loss may be delayed onset, progressive or fluctuating in nature, and therefore, a significant proportion will be missed by universal newborn hearing screening (NHS) and warrants close monitoring of hearing function at least until 5-6 years of age. A multidisciplinary approach is required for the management of hearing loss. These children may need assistive hearing devices or cochlear implantation depending on the severity of their hearing loss. In addition, early intervention services such as speech or occupational therapy could help better communication, language, and social skill outcomes. Preventive measures to decrease intrauterine CMV transmission that have been evaluated include personal protective measures, passive immunoprophylaxis and valacyclovir treatment during pregnancy in mothers with primary CMV infection. Several vaccine candidates are currently in testing and one candidate vaccine in phase 3 trials. Until a CMV vaccine becomes available, behavioral and educational interventions may be the most effective strategy to prevent maternal CMV infection.
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Affiliation(s)
- Srijan Singh
- Department of Neonatology, Kailash Hospital, Noida, Uttar Pradesh, India
- Global Newborn Society (https://www.globalnewbornsociety.org/), Clarksville, Maryland, United States of America
| | - Akhil Maheshwari
- Global Newborn Society (https://www.globalnewbornsociety.org/), Clarksville, Maryland, United States of America
- Department of Pediatrics, Louisiana State University, Shreveport, Louisiana, United States of America
| | - Suresh Boppana
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
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Alothman N, Alotaibi M, Alshawairkh G, Almutairi M, Aldosari R, Alblowi R, Alqhtany A. Loss to follow-up in a newborn hearing screening program in Saudi Arabia. Int J Pediatr Otorhinolaryngol 2023; 172:111688. [PMID: 37517140 DOI: 10.1016/j.ijporl.2023.111688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 06/24/2023] [Accepted: 07/20/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVES Newborn hearing screening (NHS) program was officially initiated in Saudi Arabia in 2016. Although the rate of follow-up default is considered one of the major challenges to the NHS program, no studies have investigated the NHS rate of follow-up default and its reasons in Saudi Arabia. This study aimed to investigate the rate of follow-up default in a hospital-based NHS program and the possible reasons for it. METHODS All newborns who were delivered at a tertiary hospital-based NHS program between June 2020 and February 2022 were retrospectively included. The number of live births, newborns who passed NHS, newborns who referred NHS, and newborns who did not complete the appropriate screening or diagnostic stages were reviewed. In a prospective study, parents of all newborns who defaulted the follow-up on screening or diagnosis were telephonically interviewed about the reasons for their follow-up default. RESULTS In total, 2312 newborns were screened. Screening coverage of 96% and referral rate of 0.6% were found, which align well with the international benchmark. The follow-up default was 18%, which was higher than the benchmark. Parents of all newborns who defaulted the follow-up (n = 424) were also included. The most frequent reasons for follow-up default were related to the parents' unawareness of the recommended follow-up screening (39.5%) and their perception that follow-up was not necessary (24.7%). Coronavirus disease 2019 was also reported by 15.8% of the parents as a reason for follow-up default. CONCLUSION Lack of knowledge regarding recommendations made for follow-up and the importance of NHS were the most common reasons for default. Reducing follow-up defaults is essential for successful NHS programs, which can be achieved by implementing a tracking system to remind and encourage parents. Further studies are needed to evaluate the national NHS and investigate the reasons for follow-up defaults from different demographic regions in Saudi Arabia.
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Affiliation(s)
- Noura Alothman
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, PO Box 84428, Riyadh, 11671, Saudi Arabia.
| | - Munira Alotaibi
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, PO Box 84428, Riyadh, 11671, Saudi Arabia
| | - Ghadeer Alshawairkh
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, PO Box 84428, Riyadh, 11671, Saudi Arabia
| | - Maryam Almutairi
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, PO Box 84428, Riyadh, 11671, Saudi Arabia
| | - Rawan Aldosari
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, PO Box 84428, Riyadh, 11671, Saudi Arabia
| | - Razan Alblowi
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, PO Box 84428, Riyadh, 11671, Saudi Arabia
| | - Amal Alqhtany
- Department of Rehabilitation Services, King Abdullah bin Abdulaziz University Hospital (KAAUH), PO Box 84428, Riyadh, 11671, Saudi Arabia
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Collins A, Beswick R, Driscoll C, Kei J. Conductive hearing loss in newborns: Hearing profile, risk factors, and occasions of service. Int J Pediatr Otorhinolaryngol 2023; 171:111630. [PMID: 37354864 DOI: 10.1016/j.ijporl.2023.111630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/19/2023] [Accepted: 06/11/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVE Infants diagnosed with a conductive hearing loss (CHL) are at increased risk of developmental delays. Using a sample of infants diagnosed with CHL through UNHS, this study aimed to investigate the relationship between specific demographic or clinical characteristics and 1) occasions of service to reach a hearing diagnosis and 2) the profile of CHL. METHODS Retrospective analysis was conducted for all infants with CHL born between 01/01/2007 and 31/12/2018 who had received UNHS. Chi squared analysis was conducted on data from 1208 records. RESULTS Infants with ≥1 risk factor for hearing loss were more likely to attend more than three occasions of service. Infants who were bilateral refer/medical exclusion, Torres Strait Islander, had ≥1 risk factors for hearing loss or were born pre-term had greater proportions of bilateral CHL than unilateral CHL. Mild to moderate was the most frequent degree of CHL, although a unilateral or bilateral CHL did not have an association with the severity of CHL. Compared to other risk factors, infants with a syndrome had greater proportions of bilateral than unilateral CHL. Risk factors of craniofacial abnormality, prolonged ventilation, or syndrome had greater proportions of mild to moderate CHL than moderate or greater. On average, infants were diagnosed with a CHL at 37.29 weeks of age. CONCLUSION These findings highlight the relationship between clinical/demographic characteristics and occasions of service to diagnose CHL in children, including the CHL profile. An understanding of this relationship may help clinicians to better plan, assess and manage infants diagnosed with a CHL through UNHS.
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Affiliation(s)
- Alison Collins
- Hearing Research Unit for Children, Division of Audiology, School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, 4072, Australia; Children's Health Queensland Hospital and Health Service, Child and Youth Community Health Service, 10 Chapel Street, Nundah, Queensland, 4012, Australia.
| | - Rachael Beswick
- Children's Health Queensland Hospital and Health Service, Child and Youth Community Health Service, 10 Chapel Street, Nundah, Queensland, 4012, Australia.
| | - Carlie Driscoll
- Hearing Research Unit for Children, Division of Audiology, School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, 4072, Australia.
| | - Joseph Kei
- Hearing Research Unit for Children, Division of Audiology, School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, 4072, Australia.
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Wilding MR, Hibbert JSR, Tucker JA, Magee CE, Bauer-Staeb C, Wood SA. Prevalence of moderate or greater permanent childhood hearing impairment and effectiveness of targeted surveillance for babies who pass newborn hearing screening. Int J Audiol 2023:1-8. [PMID: 37395525 DOI: 10.1080/14992027.2023.2227763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
OBJECTIVE To assess the utility of targeted surveillance for the identification of moderate to profound PCHI in babies who pass newborn hearing screening in England and have risk factors. DESIGN Retrospective analysis. STUDY SAMPLE A total of 3,957,891 children born 01/04/2012-31/03/2018 in England. RESULTS A total of 7148 PCHI cases were identified (1.81 per 1,000 babies). 6,707 followed an immediate referral from the screen (1 per 16 referrals), 51 followed targeted surveillance referral (1 per 540 referrals) and 390 without a referral. Audiology uptake was higher following an immediate referral (96.7% overall, 77.2% within NHSP-defined timescales) than following targeted surveillance (63.8% overall, 51.1% within 52 weeks of birth). The screening was 94.5% sensitive overall, with similar sensitivities for each of the risk factors. General linearised logistic regression models identified syndrome as the risk factor with the highest odds ratio (14.08 for all babies, 22.19 for babies without immediate referral). Close family history of hearing loss was the next highest (10.93 for all babies, 12.29 for babies without immediate referral). CONCLUSION The evidence for a targeted surveillance programme, based on risk factors, for babies in England who pass the newborn screen is not strong.
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Affiliation(s)
| | | | - Julie A Tucker
- Newborn Hearing Screening Programme, NHS England, England, UK
| | | | - Clarissa Bauer-Staeb
- Department of Health and Social Care, Office for Health Improvement and Disparities, England, UK
| | - Sally A Wood
- Newborn Hearing Screening Programme, NHS England, England, UK
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Bianchin G, Palma S, Polizzi V, Kaleci S, Stagi P, Cappai M, Baiocchi MP, Benincasa P, Brandolini C, Casadio L, Di Sarro S, Farneti D, Galli A, Ghiselli S, Iadicicco P, Landuzzi E, Limarzo M, Locatelli C, Murri A, Nanni L, Rozzi E, Sandri F, Saponaro A, Zanotti S, Zarro N, Zucchini E, Ciorba A, Genovese E. A regional-based newborn hearing screening program: the Emilia-Romagna model after ten years of legislation. Ann Ig 2023; 35:297-307. [PMID: 35861691 DOI: 10.7416/ai.2022.2539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
Background Hearing loss, occurring in 1-3/1,000 newborns in the well-babies population, is one of the most common congenital diseases, and hearing screening at birth still represents the only means for its early detection. Since 2011 the Emilia Romagna Regional Health Agency has recommended Newborn Hearing Screening for all babies at its birth points and for newborns moving to the region. The aims of this study are to analyze the results of this regional-based Newborn Hearing Screening program and to discuss the impact of the legislative endorsement on the organization. Material and methods This is an observational retrospective chart study. The recordings of well-babies and babies at Neonatal Intensive Care Units were collected during the period from January 1st 2015 to December 31st 2020. The following data were included: Newborn Hearing Screening coverage, percentage of refer at otoacoustic emissions, prevalence and entity of hearing loss, unilateral/bilateral rate, presence of audiological risk factors. Results More than 99% of a total of 198,396 newborns underwent the Newborn Hearing Screening test during the period January 1st 2015 to December 31st 2020, with a coverage ranging between 99.6% and 99.9%. Overall, the percentage of confirmed hearing loss cases was about 17-30 % of refer cases, 745 children received a diagnosis of hearing loss (prevalence 3.7/1,000). Considering profound hearing loss cases, these represent 13% of bilateral hearing loss. Conclusion A regional-based Newborn Hearing Screening program is valuable and cost-effective. In our experience, the centralization of the data system and of the data control is crucial in order to implement its efficiency and effectiveness. Healthcare policies, tracking systems and public awareness are decisive for a successful programme implementation.
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Affiliation(s)
- G Bianchin
- Department of Audiology, Santa Maria Nuova Hospital, Center for Clinical and Basic Research (IRCCS), Reggio Emilia, Italy
| | - S Palma
- Audiology, Primary Care Unit, AUSL, Modena, Italy
| | - V Polizzi
- Department of Audiology, Santa Maria Nuova Hospital, Center for Clinical and Basic Research (IRCCS), Reggio Emilia, Italy
| | - S Kaleci
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Transplant, Oncological and Regen-erative Medicine, University of Modena and Reggio Emilia, Italy
| | - P Stagi
- Mental Health Department, AUSL Toscana Centro, Empoli, Italy
| | - M Cappai
- General Direction for Health, Healthcare and Welfare, Emilia Romagna Region, Bologna, Italy
| | - M P Baiocchi
- Child Neuropsychiatry Service, AUSL Romagna, Rimini, Italy
| | - P Benincasa
- ENT Unit, Ramazzini Hospital, Carpi AUSL, Modena, Italy
| | - C Brandolini
- ENT and Audiology Unit, DIMES, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - L Casadio
- Paediatrics and Neonatology Unit, Ravenna Hospital, AUSL Romagna, Ravenna, Italy
| | - S Di Sarro
- Mental Health Department AUSL Bologna, Italy
| | - D Farneti
- Audiologic Phoniatric Service, ENT Department, AUSL Romagna, Infermi Hospital, Rimini, Italy
| | - A Galli
- Child Neuropsychiatry Service, Ravenna, AUSL Romagna, Italy
| | - S Ghiselli
- ENT Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - P Iadicicco
- Audiology, SS Specialized Surgery ORL Faenza - UOC ORL Forlì-Faenza, Surgical Department ORL Forlì AUSL, Ro-magna, Italy
| | - E Landuzzi
- Child Neuropsychiatry Service, AUSL Bologna, Italy
| | - M Limarzo
- Department of Surgical Specialities, Otorhinolaryngology Unit, Bufalini Hospital, Cesena, Italy
| | - C Locatelli
- Neonatology Unit, St. Orsola-Malpighi Polyclinic, Bologna, Italy
| | - A Murri
- ENT Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - L Nanni
- Child Neuropsychiatry Service, Ravenna, AUSL Romagna, Italy
| | - E Rozzi
- General Direction for Health, Healthcare and Welfare, Emilia Romagna Region, Bologna, Italy
| | - F Sandri
- Neonatal Intensive Care Unit, Maggiore Hospital, Bologna, Italy
| | - A Saponaro
- General Direction for Health, Healthcare and Welfare, Emilia Romagna Region, Bologna, Italy
| | - S Zanotti
- Child Neuropsychiatry Service, AUSL, Parma, Italy
| | - N Zarro
- ENT Unit, Maggiore Hospital, Bologna, Italy
| | - E Zucchini
- Child Neuropsychiatry Service, AUSL Romagna, Imola, Italy
| | - A Ciorba
- ENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, Italy
| | - E Genovese
- Audiology, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Italy
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Wen C, Yang X, Cheng X, Zhang W, Li Y, Wang J, Wang C, Ruan Y, Zhao L, Lu H, Li Y, Bai Y, Yu Y, Li Y, Xie J, Qi BE, En H, Liu H, Fu X, Huang L, Han D. Optimized concurrent hearing and genetic screening in Beijing, China: A cross-sectional study. Biosci Trends 2023; 17:148-159. [PMID: 37062750 DOI: 10.5582/bst.2023.01051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Concurrent screening has been proven to provide a comprehensive approach for management of congenital deafness and prevention of ototoxicity. The SLC26A4 gene is associated with late-onset hearing loss and is of great clinical concern. For much earlier detection of newborns with deafness-causing mutations in the SLC26A4 gene, the Beijing Municipal Government launched a chip for optimized genetic screening of 15 variants of 4 genes causing deafness based on a chip to screen for 9 variants of 4 genes, and 6 variants of the SLC26A4 gene have now been added. To ascertain the advantage of a screening chip including 15 variants of 4 genes, the trends in concurrent hearing and genetic screening were analyzed in 2019 and 2020. Subjects were 76,460 newborns who underwent concurrent hearing and genetic screening at 24 maternal and child care centers in Beijing from January 2019 to December 2020. Hearing screening was conducted using transiently evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAE), or the automated auditory brainstem response (AABR). Dried blood spots were collected for genetic testing and 15 variants of 4 genes, namely GJB2, SLC26A4, mtDNA 12S rRNA, and GJB3, were screened for using a DNA microarray platform. The initial referral rate for hearing screening decreased from 3.60% (1,502/41,690) in 2019 to 3.23% (1,124/34,770) in 2020, and the total referral rate for hearing screening dropped form 0.57% (236/41,690) in 2019 to 0.54% (187/34,770) in 2020, indicating the reduced false positive rate of newborn hearing screening and policies to prevent hearing loss conducted by the Beijing Municipal Government have had a significant effect. Positivity according to genetic screening was similar in 2019 (4.970%, 2,072/41,690) and 2020 (4.863%,1,691/34,770), and the most frequent mutant alleles were c.235 del C in the GJB2 gene, followed by c.919-2 A > G in the SLC26A4 gene, and c.299 del AT in the GJB2 gene. In this cohort study, 71.43% (5/7) of newborns with 2 variants of the SLC26A4 gene were screened for newly added mutations, and 28.57% (2/7) of newborns with 2 variants of the SLC26A4 gene passed hearing screening, suggesting that a screening chip including 15 variants of 4 genes was superior at early detection of hearing loss, and especially in early identification of newborns with deafness-causing mutations in the SLC26A4 gene. These findings have clinical significance.
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Affiliation(s)
- Cheng Wen
- Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Xiaozhe Yang
- Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Xiaohua Cheng
- Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Wei Zhang
- Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Yichen Li
- Maternal and Child Health, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Jing Wang
- Maternal and Child Health, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Chuan Wang
- Maternal and Child Health Hospital of Chao Yang District, Beijing, China
| | - Yu Ruan
- Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Liping Zhao
- Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Hongli Lu
- CapitalBio Corporation & National Engineering Research Center for Beijing Biochip Technology, Beijing, China
| | - Yingxin Li
- CapitalBio Corporation & National Engineering Research Center for Beijing Biochip Technology, Beijing, China
| | - Yue Bai
- CapitalBio Corporation & National Engineering Research Center for Beijing Biochip Technology, Beijing, China
| | - Yiding Yu
- Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Yue Li
- Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Jinge Xie
- Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Bei-Er Qi
- Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Hui En
- Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Hui Liu
- Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Xinxing Fu
- Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Lihui Huang
- Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Demin Han
- Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, China
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Graham C, Gina A, Seeley J, Saman Y. Development of a questionnaire to assess mothers' knowledge, attitudes and practice with regard to childhood hearing loss and Universal Newborn Hearing Screening. Int J Pediatr Otorhinolaryngol 2023; 165:111449. [PMID: 36657328 DOI: 10.1016/j.ijporl.2023.111449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/19/2022] [Accepted: 01/11/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND The assessment of the validity and reliability of measurement tools in research provides quality data. However, evidence of the validity and reliability of parental knowledge and attitude regarding childhood hearing loss and newborn hearing screening is scarce. OBJECTIVE To design a Knowledge, Attitudes and Practice (KAP) survey tool regarding childhood hearing loss and a Universal Newborn Hearing Screening Programme of the rural Amajuba district, KwaZulu-Natal, South Africa, and then test for validity and test-retest repeatability. METHODS Face validity was conducted with 20 mothers and a content validity index was determined by two rounds of assessments, the first by 7 experts and the second by 3 experts. The kappa statistic was used to measure the stability of the tool using data from 160 mothers where repeated measurements were applied at two-week intervals. The feasibility of developing a tool was assessed by applying the criteria of science, population and resources. RESULTS The KAP tool was developed with twenty-nine items. For face validity, 97% of the participants reported that the items were clear, wording was appropriate and easy to read and the language was natural. Content validity produced excellent results with a scale and content validity index of 1. Test-retest repeatability for the KAP tool was good with a Cohen's kappa coefficient of 0.87 (95% CI: 0.87, 0.87). Individually, the knowledge scale had a kappa of 0.86 (95% CI: 0.77, 0.95); the attitude scale had a kappa of 0.87 (95% CI: 0.76, 0.99): the practice scale had a kappa of 0.86 (95% CI: 0.75, 0.97) and the awareness scale had a kappa of 0.92 (0.83, 1.00). The development of a KAP tool was shown to be feasible, given sufficient time, funds, motivation and a study population. CONCLUSION The study produced a valid and reliable tool that can be useful in generating quality evidence of a community's KAP with respect to childhood hearing loss and newborn hearing screening. Evidence gathered could be used to tailor health education and health promotion material for a Universal New-born Hearing Screening (UNHS) programme in a culturally sensitive manner to promote service uptake.
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Affiliation(s)
- Christine Graham
- Department of ENT, Nelson Mandela School of Medicine, University of KwaZulu-Natal, 719 Umbilo Road, Berea, 4001, Durban, South Africa.
| | - Ayanda Gina
- Discipline of Audiology, University of KwaZulu-Natal, WestVille Campus, University Road, Durban, 4001, South Africa
| | - Janet Seeley
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Yougan Saman
- Ear, Nose and Throat Department, University Hospitals of Leicester, Groby Road, Leicester, LE3 9QP, UK; Department of Neuroscience, Psychology and Behaviour, University of Leicester, University Road, Leicester, LE1 7RH, UK
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Chhajed M, Madaan P, Saini L, Kaur S, Udani V. Normative Values for Auditory Brainstem Responses and Wave V Thresholds in Indian Neonates and Infants. Indian J Otolaryngol Head Neck Surg 2022; 74:3658-3661. [PMID: 36742655 PMCID: PMC9895165 DOI: 10.1007/s12070-020-02347-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/21/2020] [Indexed: 02/07/2023] Open
Abstract
Click-evoked auditory-brainstem-response (ABR) is widely used for hearing screening in neonates and infants. However, their normative values are based on small studies. This retrospective study was done at a tertiary-care centre where click-ABR based screening is done in all newborns. ABR records (Nihon-Kohden machine, model MEB-9400K) of 420 healthy neonates (preterm 75; full-term 32) and infants (113) done over a period 4 years (2014-2018) were analysed retrospectively. Sick neonates and those with Wave V threshold > 40 dbnHL were excluded. Infants were divided into four groups based on post-conceptual age, Group A (75): 34-36 weeks; Group B (44): 37-40weeks; Group C (188):41 weeks-1 month; and Group D (113): 1-6months. The mean absolute latencies for wave I, wave III, and wave V varied from 1.45-1.56 milliseconds (ms), 4.14-4.37 ms, and 6.36-6.81 ms respectively. Interpeak latencies for I-V and I-III varied from 4.91 ms to 5.22 ms and 2.69 ms to 2.81 ms respectively. Older infants had lower absolute and interpeak latencies. Late preterm babies were not different from term babies suggesting early maturation of brainstem pathways.
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Affiliation(s)
- Monika Chhajed
- Department of Pediatrics, Chaitanya Hospital, Chandigarh, India
| | - Priyanka Madaan
- Pediatric Neurology Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Lokesh Saini
- Pediatric Neurology Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Saranjit Kaur
- Department of Pediatrics, Chaitanya Hospital, Chandigarh, India
| | - Vrajesh Udani
- P.D, Hinduja National Hospital and Medical Research Centre, Mumbai, India
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Malas M, Aboalfaraj A, Alamoudi H, Kurdi A, Alahmadi T, Zawawi F. Pediatricians' knowledge and attitude toward hearing loss and newborn hearing screening programs. Int J Pediatr Otorhinolaryngol 2022; 161:111265. [PMID: 35952536 DOI: 10.1016/j.ijporl.2022.111265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 07/24/2022] [Accepted: 07/29/2022] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Early detection of hearing loss is important to the management of infants and young children with hearing loss. Pediatricians are often the first to encounter a child suspected to have hearing loss. The objective of this study is to evaluate the knowledge and attitude of newborn hearing screening and management of hearing in among pediatricians. METHODS A cross-sectional survey-based study utilizing a validated questionnaire that was distributed to pediatricians in single tertiary academic health care institution that aims to evaluate the knowledge and attitudes related to children with hearing loss and newborn hearing screening. RESULTS A total of 67 pediatricians agreed to participate and were involved in our study. Mean age was 35 years and 44.1% were males. The majority (79.4%) thought it was very important to have a newborn hearing screening program. However, two-thirds (64.7%) were unsure that there is a universal hearing screening program in the country. Never the less, the majority of the respondents (75%) were at least somewhat confident in explaining the hearing screening program process in our institution. There was a gap in the knowledge of our pediatricians with regard to the process of dealing with a newborn who failed screening program and the candidacy for cochlear implants. Also, some participants were unsure whether to refer a child with hearing impairment to an otolaryngologist or not. Most of the participants thought that physicians need more information related to permanent hearing loss. CONCLUSION There are gaps in Pediatricians knowledge and awareness towards hearing loss assessment and management in newborns. This likely requires further academic collaboration between specialties to improve the care of newborns. Future research should focus on the auditory and speech outcome and rehabilitation awareness.
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Collins A, Beswick R, Driscoll C, Kei J. Clinical characteristics of infants identified with a conductive hearing loss through universal newborn hearing screening: A population-based sample. Int J Pediatr Otorhinolaryngol 2022; 161:111268. [PMID: 35964490 DOI: 10.1016/j.ijporl.2022.111268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 05/31/2022] [Accepted: 07/31/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Universal Newborn Hearing Screening (UNHS) aims to identify infants born with a permanent hearing loss. However, many are also diagnosed with a conductive hearing loss (CHL) and are at subsequent risk for developmental delays. The aim of this study was to investigate the prevalence of CHL and determine which clinical characteristics collected at birth, predict CHL within UNHS. MATERIALS AND METHODS Retrospective analysis was conducted on all infants born between January 01, 2007 and December 31, 2018. During this period, 731,234 infants were screened, 9802 were direct referrals, and 1208 identified with a CHL. Chi squared analysis and logistic regression was conducted to determine CHL prevalence and identify which clinical characteristics predict CHL. RESULTS The prevalence of CHL was 12.32%. Following adjustments for collinearity, clinical characteristics that could predict CHL were: bilateral referrals/medical exclusions to screen (Odds ratio, OR 1.89; 95% CI: 1.65-2.1), ≥1 risk factor for hearing loss (OR 2.03; 95% CI: 1.76-2.34), pre-term birth (OR 1.82; 95% CI: 1.57-2.10), male (OR 1.21; 95% CI: 1.07-1.37), and Indigenous status: 'Aboriginal (not Torres Strait Islander)' (OR 1.27; 95% CI:1.03-1.57 and 'not stated' (OR 2.95; 95% CI: 2.02-4.30). CONCLUSION CHL within UNHS was highly prevalent, with six clinical characteristics that can predict that likelihood of an infant being diagnosed with a CHL. This data could be used to create alternative care pathways for infants with CHL, enabling early and targeted assessments, thereby reducing the risk of developmental delays for these infants.
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Hussein D, D'Alessandro HD, Batuk MÖ, Ekhwan A, Sennaroğlu G. Views of Syrian Mothers in Ankara on Infant Hearing Loss: Cross-sectional Survey. Matern Child Health J 2022; 26:2247-2253. [PMID: 36065040 PMCID: PMC9444090 DOI: 10.1007/s10995-022-03488-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 06/25/2022] [Accepted: 07/20/2022] [Indexed: 11/28/2022]
Abstract
Background Mothers’ awareness of hearing loss, its risk factors, and available detection and intervention choices have been well known to play an essential role in the early detection and intervention of hearing loss. Objective To investigate the knowledge and attitude of Syrian mothers toward infant hearing loss, early identification, and intervention. Methods The “Maternal Views on Infant Hearing Loss” questionnaire was adapted and translated into Arabic and then administered to 100 Syrian mothers living in different neighborhoods in Ankara within the age range of 18–68 years old. The internal consistency for the main domains of the questionnaire was tested by Cronbach’s alpha coefficient. Descriptive statistics and Spearman’s rank correlation coefficient were used to evaluate the responses. Results The highest level of knowledge about the risk factors was about noise exposure (76%), while the lowest level of knowledge was about jaundice (25%). While 98% of the mothers had a positive attitude toward early detection, 97% of them did not mind the early intervention. Conclusions The present findings showed the need to improve mothers’ awareness about infant hearing loss risk factors, available detection, and intervention. Such results may help in performing programs that aim to increase awareness about hearing loss. Supplementary Information The online version contains supplementary material available at 10.1007/s10995-022-03488-1.
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Affiliation(s)
- Diala Hussein
- Faculty of Health Sciences, Department of Audiology, Hacettepe University, Ankara, Turkey.
| | | | - Merve Özbal Batuk
- Faculty of Health Sciences, Department of Audiology, Hacettepe University, Ankara, Turkey
| | - Amar Ekhwan
- Faculty of Health Sciences, Department of Audiology, Hacettepe University, Ankara, Turkey
| | - Gonca Sennaroğlu
- Faculty of Health Sciences, Department of Audiology, Hacettepe University, Ankara, Turkey
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Mackey AR, Bussé AML, Del Vecchio V, Mäki-Torkko E, Uhlén IM. Protocol and programme factors associated with referral and loss to follow-up from newborn hearing screening: a systematic review. BMC Pediatr 2022; 22:473. [PMID: 35932008 PMCID: PMC9354382 DOI: 10.1186/s12887-022-03218-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 03/14/2022] [Indexed: 11/17/2022] Open
Abstract
Background An effective newborn hearing screening programme has low referral rate and low loss to follow-up (LTFU) rate after referral from initial screening. This systematic review identified studies evaluating the effect of protocol and programme factors on these two outcomes, including the screening method used and the infant group. Methods Five databases were searched (latest: April 2021). Included studies reported original data from newborn hearing screening and described the target outcomes against a protocol or programme level factor. Studies were excluded if results were only available for one risk condition, for each ear, or for < 100 infants, or if methodological bias was observed. Included studies were evaluated for quality across three domains: sample, screening and outcome, using modified criteria from the Ottawa-Newcastle and QUADAS-2 scales. Findings from the included studies were synthesised in tables, figures and text. Results Fifty-eight studies reported on referral rate, 8 on LTFU rate, and 35 on both. Only 15 studies defined LTFU. Substantial diversity in referral and LTFU rate was observed across studies. Twelve of fourteen studies that evaluated screening method showed lower referral rates with aABR compared to TEOAE for well babies (WB). Rescreening before hospital discharge and screening after 3 days of age reduced referral rates. Studies investigating LTFU reported lower rates for programmes that had audiologist involvement, did not require fees for step 2, were embedded in a larger regional or national programme, and scheduled follow-up in a location accessible to the families. In programmes with low overall LTFU, higher LTFU was observed for infants from the NICU compared to WB. Conclusion Although poor reporting and exclusion of non-English articles may limit the generalisability from this review, key influential factors for referral and LTFU rates were identified. Including aABR in WB screening can effectively reduce referral rates, but it is not the only solution. The reported referral and LTFU rates vary largely across studies, implying the contribution of several parameters identified in this review and the context in which the programme is performed. Extra attention should be paid to infants with higher risk for hearing impairment to ensure their return to follow-up. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03218-0.
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Affiliation(s)
- Allison R Mackey
- Karolinska Institutet, Department of Clinical Science Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska University Hospital, Huddinge, 141 86, Stockholm, Sweden.
| | - Andrea M L Bussé
- Department of Otorhinolaryngology and Head and Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Valeria Del Vecchio
- Department of Neuroscience, University of Padua, Bologna, Italy.,Unit of Audiology, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Elina Mäki-Torkko
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Inger M Uhlén
- Karolinska Institutet, Department of Clinical Science Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska University Hospital, Huddinge, 141 86, Stockholm, Sweden
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Ghiselli S, Laborai A, Biasucci G, Carvelli M, Salsi D, Cuda D. Auditory evaluation of infants born to COVID19 positive mothers. Am J Otolaryngol 2022; 43:103379. [PMID: 35144104 PMCID: PMC8816906 DOI: 10.1016/j.amjoto.2022.103379] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/29/2021] [Accepted: 01/30/2022] [Indexed: 12/11/2022]
Abstract
COVID-19 infection can cause a wide spectrum of symptoms. The audio-vestibular system can also be involved, but there is still debate about this so findings need to be considered carefully. Furthermore, mother to fetus intrauterine transmission of COVID-19 infection in pregnant women is controversial. Few studies are available about the audio-vestibular symptomatology of newborns with intrauterine COVID19 exposure. Objectives This study investigates the possible correlation between the COVID19 gestational infection and hearing impairment onset in newborns. The involvement of hearing in COVID19 is verified so the timing and methodology of audiological evaluation of children can be planned. Methods Children were subject to newborn hearing screening and audiological evaluation. Newborn hearing screening is carried out prior to hospital discharge using the Automatic Transient Evoked Otoacoustic Emissions test. Audiological evaluation is performed within the child age of 4 months by using maternal, pregnancy, and perinatal case history, COVID19 case history, otoscopy, acoustic immittance test, Distortion Product Otoacoustic Emissions test, and the Auditory Brainstem Response test. Results 63 children were included in the study. 82.5% of these children were subjects of the newborn hearing screening program. The remaining 11 newborns were not subjected to hearing screening due to isolation measures and their audiological evaluation was carried out directly. Only one of 52 screened neonates showed a bilateral REFER test result but hearing threshold was normal at audiological evaluation. Audiological evaluation showed normal bilateral ABR thresholds in 59/63 children. Four children (6.3% of the total) had ABR threshold alterations but two showed normal threshold at ABR retest performed within 1 month of the first. The other two infants showed monolateral ABR alterations but one of these had a concomitant middle ear effusion. In conclusion, only one child (1.6% of the sample) had an altered ABR. This child had shown one positive SARS-CoV-2 swab in the absence of risk factors for hearing loss. Conclusion This study finds no evidence that maternal COVID19 infection is a risk factor in the development of congenital hearing loss in newborns.
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Nakano A, Arimoto Y, Mutai H, Nara K, Inoue S, Matsunaga T. Clinical and genetic analysis of children with hearing loss and bilateral enlarged vestibular aqueducts. Int J Pediatr Otorhinolaryngol 2022; 152:110975. [PMID: 34801268 DOI: 10.1016/j.ijporl.2021.110975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 08/28/2021] [Accepted: 11/08/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To evaluate the clinical and genetic features of children with hearing loss associated with one of the most common malformations of the inner ear: bilateral enlargement of vestibular aqueducts (EVA). METHODS Clinical and genetic features were investigated in 28 children with hearing loss diagnosed with bilateral EVA by computed tomography from January 2008 to September 2019. RESULTS Fourteen subjects had undergone newborn hearing screening (NHS). Nine subjects (64.3%) were referred in both ears, 4 subjects (28.6%) were referred in one ear, and one subject (7.1%) passed in both ears. Nineteen of 26 subjects (73.1%) who were followed for more than 3 years had hearing fluctuations, while 17 (65.4%) had hearing loss progression. Eleven of 28 subjects (39.2%) had vertigo attacks. Pathogenic variants were identified in two alleles of the SLC26A4 gene in 24 of 27 subjects (88.9%) by sequencing of all exons and flanking introns, leading to genetic diagnosis of Pendred syndrome/DFNB4. Our results indicate that genetic screening for specific SLC26A4 variants using a commercial clinical laboratory test in Japan would have achieved genetic diagnoses in 13 of the 27 subjects (54.2%). Although there was no statistically significance in the frequency of hearing fluctuation or progression depending on the presence or absence of the gene variant, mean hearing level was severe in subjects with two pathogenic variants in SLC26A4 gene. The most common variant detected in our subjects was p.His723Arg (13 alleles, 27.1%), followed by c. 919-2A > G (four alleles, 8.3%). Two novel variants were detected in this study: c.1544+1G > T and c.1614+5G > A. CONCLUSIONS Our data suggest that some subjects may present with bilateral EVA that cannot be detected by NHS. We estimated that genetic diagnosis for SLC264 gene would not have been made in almost half subjects with the commercial genetic screening approach used in the present study in Japan. Although there were some limitations in this study, the subjects with pathogenic variants in two alleles of the SLC26A4 gene could have more severe hearing loss.
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Affiliation(s)
- Atsuko Nakano
- Division of Otorhinolaryngology, Chiba Children's Hospital, 579-1 Heta-cho, Chiba-shi, Chiba, 266-0007, Japan.
| | - Yukiko Arimoto
- Division of Otorhinolaryngology, Chiba Children's Hospital, 579-1 Heta-cho, Chiba-shi, Chiba, 266-0007, Japan
| | - Hideki Mutai
- Division of Hearing and Balance Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan
| | - Kiyomitsu Nara
- Division of Hearing and Balance Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan
| | - Satomi Inoue
- Medical Genetics Center, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan
| | - Tatsuo Matsunaga
- Division of Hearing and Balance Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan; Medical Genetics Center, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan
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Abstract
Compelling evidence indicates that some newborns harboring genetic variants associated with hearing loss might not be identified by current physiologic newborn hearing screening (NBHS) rendering current NBHS protocols suboptimal. Incorporating genomic sequencing into NBHS would improve clinical diagnosis and decrease time to early intervention efforts.
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Affiliation(s)
- Calli Ober Mitchell
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, NRB 160, 77 Avenue Louis Pasteur, Boston, MA 02115, USA. https://twitter.com/CalliMitchell3
| | - Cynthia Casson Morton
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, NRB 160, 77 Avenue Louis Pasteur, Boston, MA 02115, USA; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Broad Institute of MIT and Harvard, Cambridge, MA, USA; Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, UK.
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Abstract
MATERIALS AND METHODS Data were collected through a nationwide survey conducted in 2018. All maternity wards active in Italy in 2017 were included. BACKGROUND The aims of this paper were to present data on the implementation and coverage of simultane-ous Universal Neonatal Hearing and Vision Screening programmes and to evaluate the organization and management of these healthcare procedures in Italy. CONCLUSIONS Our results show that implementation of simultaneous hearing and vision screening increased the coverage of both screening tests and is a new multi-disciplinary approach to sensorineural disability. The use of both ABR and TEOAE tests in the hearing screening decreases the number of newborns sent for audiological evaluation, with a notable reduction of costs. The consideration that ocular problems are two to three times more common in deaf and hearing impaired children than their in hearing peers, confirms the importance of establishing guidelines for simultaneous hearing and vision screening, that favors the formation of a multi-disciplinary team (pediatrician, audio-logist, ophthalmologist). RESULTS HEARING SCREENING. Overall 427,365 newborns out of 448,386 (95.3%) received the hearing screening test (first level) in 391 out of the 409 maternity hospitals (95.5%), with a national mean referral rate of 3.63% (SD ± 4.58). A statistically significant increase (p<0.034) of newborns sent to audiological examination was found in maternity hospitals with Neonatal Intensive Care Unit (NICU) with "TEOAE only" protocol (9.32% SD ± 7.57), compared to those with "TEOAE/AABR" (3.0% SD ± 3.29). VISION SCREENING. Overall 335,262 newborns out of 448,386 (74.7%) received vision screening (Red Reflex test) for vision impairment in 302 out of 409 maternity hospitals (73.8%), before nursery discharge. The mean referral rate, recorded in only 22 maternity hospitals out of 302 (7.2%), was 0.48% with a rate of lost to follow up of 0.75 %.
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Affiliation(s)
- L Bubbico
- ENT Specialist INAPP /Italian Institute of Social Medicine, Department of Sensorineural Disabilities Research, Rome, Italy
| | - S Ferlito
- University of Catania School of Medicine, Department of Surgical medical sciences and advanced technologies, Catania, Italy
| | - G Antonelli
- University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, Verona, Italy
| | - A Martini
- University of Padua, Department of Neurosciences, Padua, Italy
| | - N Pescosolido
- University of Rome Sapienza, Department of Ophthalmology, Rome, Italy
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Chiriboga LF, Sideri KP, Ferraresi Rodrigues Figueiredo SN, Monteiro Pinto ES, Chiriboga Arteta LM. Outcomes of a universal neonatal hearing screening program of 9941 newborns over a one-year period in Campinas, Brazil. Int J Pediatr Otorhinolaryngol 2021; 148:110839. [PMID: 34274888 DOI: 10.1016/j.ijporl.2021.110839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/01/2021] [Accepted: 07/11/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To characterize the outcomes of a universal neonatal hearing screening program in Brazil. METHODS Retrospective documentary analysis of the hearing screening of the neonates born in the hospital from August 2019 to July 2020. The universal neonatal hearing screening program performed the examination of TEOAE in newborn without risk factors for hearing loss and TEOAE and aABR in neonates with risk factors for hearing loss. RESULTS 9941 neonatal records were studied, 9088 newborns (91,42%) with no risk factors for hearing loss and 849 newborns (8.54%) with risk factors for hearing loss. 4 newborns (0.04%) had hearing loss in the group without risk factors and 16 newborns (1.88%) in the group with risk factors. In retesting those newborns who failed the UNHS test stage, we had 4 newborns (0.04%) without risk factors and 2 newborns (0,24%) with risk factors who evaded and did not return to service. CONCLUSION It was possible to survey the outcomes of one year of the UNHS service and observe that the coverage rate of the service was 99.96%. The use of the combined methodology guaranteed a number of forwardings for less returns. Through this study, it was possible to observe that this service complies with the quality indicators recommended by the guidelines.
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Affiliation(s)
- Laura Franco Chiriboga
- Universal Neonatal Hearing Screening Program, Hospital Maternidade de Campinas, Campinas, São Paulo, Brazil.
| | - Karolina Pessote Sideri
- Universal Neonatal Hearing Screening Program, Hospital Maternidade de Campinas, Campinas, São Paulo, Brazil.
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Raynor E, Holmes C, Crowson M, Peskoe S, Planey A, Lantos PM. Loss to follow up of failed hearing screen and missed opportunities to detect congenital cytomegalovirus are better identified with the implementation of a new electronic health record system protocol. Int J Pediatr Otorhinolaryngol 2021; 148:110818. [PMID: 34198229 DOI: 10.1016/j.ijporl.2021.110818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 06/20/2021] [Accepted: 06/24/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Congenital CMV (cCMV) is the leading cause of non-genetic sensorineural hearing loss. Babies with cCMV can present with hearing loss any time but failing the initial hearing screen should trigger cCMV testing. cCMV must be identified within 3 weeks after birth to differentiate congenital from acquired CMV, yet follow-up hearing screens may not occur until after 21 days. A new electronic health record protocol to test cCMV in babies who fail their initial hearing screen was established at our institution in 2013. The purpose of this study is to evaluate adherence and deviations from this protocol. METHODS All term infants born in 2013-2016 who failed initial hearing screen were included. The records were reviewed retrospectively. Demographic data, dates of hearing screens, CMV testing results and follow-up hearing test results were collected. RESULTS A total of 19,069 newborn babies were screened between 2013 and 2016. Babies who were in the neonatal intensive care unit whether premature or not were excluded as these infants are often in the hospital longer than 3 weeks so audiologic diagnostic testing may be delayed. Among term newborns screened, 1358 failed initial screen and 444 failed subsequent hearing testing prior to discharge. We identified 60 babies who did not follow up and 59 underwent additional audiologic testing. Overall 38 babies were tested for cCMV with 2 positives. We found an increase in cCMV testing over time and a significant decrease between physical distance from birth hospital and outpatient audiologic follow-up testing within 21 days of birth. DISCUSSION Our results are consistent with a 0.4% rate of cCMV in full-term babies who failed their newborn hearing screen. From 2013 to 2016, more babies received CMV tests, but post-screening follow up was still delayed. Further research is necessary to address factors affecting follow up. Use of electronic health record eased identification of results and improved tracking.
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Affiliation(s)
- Eileen Raynor
- Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, USA.
| | - Christine Holmes
- Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, USA
| | - Matthew Crowson
- Department of Otolaryngology-Head & Neck Surgery, Toronto, Canada
| | - Sarah Peskoe
- Department of Surgery Biostatistics Core, Duke University Medical Center, USA
| | - Arrianna Planey
- Department of Health Policy and Management, University of North Carolina, Chapel Hill, USA
| | - Paul M Lantos
- Departments of Internal Medicine and Pediatrics, Duke University Medical Center, USA
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22
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Johnson KA, Catanzarite V. The Term Newborn: Postnatal Screening and Testing. Clin Perinatol 2021; 48:555-72. [PMID: 34353580 DOI: 10.1016/j.clp.2021.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Prenatal genetic screening, including evaluation for inherited genetic disorders, aneuploidy risk assessment, and sonographic assessment, combined with a thorough newborn examination and standard newborn screening, including blood, hearing, and congenital heart disease screening, can reveal conditions requiring further evaluation after delivery. Abnormal prenatal or newborn screening results should prompt additional diagnostic testing guided by maternal fetal medicine, perinatal genetics, or pediatric specialists.
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Mathew R, Bajo FR, Hatton N, Buttfield L, Gowrishankar S, Vickers D, Donnelly N, Tysome J, Bance M, Axon P. Assessment of the cochlear implant pathway for newborn hearing screening referrals. Cochlear Implants Int 2021; 22:345-352. [PMID: 34232110 DOI: 10.1080/14670100.2021.1948163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To evaluate the cochlear implant (CI) assessment pathway for children referred through the newborn hearing screening programme (NHSP) and identify potential reasons for delay in CI surgery at a large UK centre. METHODS Retrospective analysis of electronic notes of children referred through NHSP from 2016 to 2019. Key points in the assessment pathway from referral to switch-on were assessed. RESULTS Of the 46 referrals, 44 went on to have CI surgery. Median age at CI surgery was 15 months (interquartile range (IQR) 13 to 17 months). Only 5% of referrals were implanted before the age of 12 months. Delayed referral and the presence of otitis media with effusion (OME) were associated with delayed implantation. The median period of monitoring for OME was 48 days (IQR 20 to 93 days), with a natural resolution rate of only 11%. The median time from surgery to switch-on was 5 weeks (IQR 4.1 to 5.4 weeks). CONCLUSION Achieving implantation prior to the age of 12 months for NHSP referrals can be challenging for a variety of reasons. The delays in the system and the steps that our implant programme has taken to address these will be highlighted.
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Affiliation(s)
- Rajeev Mathew
- Cambridge University Hospitals Foundation trust, Addenbrooke's Hospital, Cambridge, UK
| | | | - Nicola Hatton
- Cambridge University Hospitals Foundation trust, Addenbrooke's Hospital, Cambridge, UK
| | - Louise Buttfield
- Cambridge University Hospitals Foundation trust, Addenbrooke's Hospital, Cambridge, UK
| | | | - Deborah Vickers
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Neil Donnelly
- Cambridge University Hospitals Foundation trust, Addenbrooke's Hospital, Cambridge, UK
| | - James Tysome
- Cambridge University Hospitals Foundation trust, Addenbrooke's Hospital, Cambridge, UK
| | - Manohar Bance
- Cambridge University Hospitals Foundation trust, Addenbrooke's Hospital, Cambridge, UK.,School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Patrick Axon
- Cambridge University Hospitals Foundation trust, Addenbrooke's Hospital, Cambridge, UK
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Blanař V, Škvrňáková J, Pellant A, Vodička J, Praisler J, Boháčová E, Dršata J, Šenkeřík M, Chrobok V. Effectiveness of Neonatal Hearing Screening System: A 12-Year Single Centre Study in the Czech Republic. J Pediatr Nurs 2021; 59:e32-e37. [PMID: 33551192 DOI: 10.1016/j.pedn.2021.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/20/2021] [Accepted: 01/20/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE The study aims to evaluate the number of examined newborns and the results of screening for twelve years (2008-2019) and to assess the effectiveness of the established system of neonatal hearing screening. DESIGN AND METHODS The study was designed as a retrospective longitudinal data analysis. The data included all the children (19,043) born in the hospital and also children (74) transferred from other healthcare facilities. A total of 19,117 children were included in the research group. RESULTS In the first three years, a higher number of children did not pass the hearing screening, which was followed by a declining trend in the following years. After the first year of screening (2008), there was an improvement in diagnosis linked with a decrease in false-positive screening results (from 9.4% to 6.4%; p = 0.002). From 2008 to 2015, the ratio of children with positive screening to those with negative screening had a steady or declining trend. CONCLUSIONS The results showed a reduction in false-positive results after the first year of the screening program, probably due to improved care management and a gradual increase in the skills of the nurses performing the screening. PRACTICE IMPLICATIONS The cornerstones of neonatal hearing screening are a sufficient number of trained neonatology nurses, their mutual substitutability and the availability of a hearing screening device in the newborn ward every day. The results imply the importance of periodic evaluation of the obtained data, enabling early detection of possible deficiencies in the hearing screening system.
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Affiliation(s)
- Vít Blanař
- Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic; Department of Otorhinolaryngology and Head and Neck Surgery, Pardubice Hospital, Hospitals of the Pardubice Region, Czech Republic.
| | - Jana Škvrňáková
- Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic; Department of Otorhinolaryngology and Head and Neck Surgery, Pardubice Hospital, Hospitals of the Pardubice Region, Czech Republic.
| | - Arnošt Pellant
- Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic; Department of Otorhinolaryngology and Head and Neck Surgery, Pardubice Hospital, Hospitals of the Pardubice Region, Czech Republic.
| | - Jan Vodička
- Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic; Department of Otorhinolaryngology and Head and Neck Surgery, Pardubice Hospital, Hospitals of the Pardubice Region, Czech Republic.
| | - Jaroslav Praisler
- Department of Otorhinolaryngology and Head and Neck Surgery, Pardubice Hospital, Hospitals of the Pardubice Region, Czech Republic.
| | - Eva Boháčová
- Department of Otorhinolaryngology and Head and Neck Surgery, Pardubice Hospital, Hospitals of the Pardubice Region, Czech Republic.
| | - Jakub Dršata
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Czech Republic.
| | - Marian Šenkeřík
- Department of Paediatrics, Pardubice Hospital, Hospitals of the Pardubice Region, Czech Republic.
| | - Viktor Chrobok
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Czech Republic.
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Kishino A, Masuda T, Nomura Y, Shigihara S, Oshima T. Comparison between MB11 BERAphone® and ALGO2e color for hearing screening in Japanese healthy newborns. Int J Pediatr Otorhinolaryngol 2021; 144:110673. [PMID: 33756391 DOI: 10.1016/j.ijporl.2021.110673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 02/19/2021] [Accepted: 03/07/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Since 2001, newborn hearing screening has been performed in Japan. OBJECTIVE This study compared newborn hearing screening results between the MAICO MB11 BERAphone (MB11) and the Natus ALGO2e color (ALGO) Automated Auditory Brainstem Response (AABR) devices among healthy Japanese newborns. MATERIALS AND METHODS From December 2014 to April 2018, 1477 healthy newborns were screened by MB11 and 267 by ALGO. Data from at-risk newborns were not included. Outcomes were 'Pass' and 'Refer' rates, specificity, false-positive rates, and assessment duration. Infants with a Refer result were examined using Interacoustics Eclipse. RESULTS MB11 identified 1425 (96.5%) as Pass and 52 (3.5%) as Refer. ALGO identified 263 (98.5%) as Pass and four (1.5%) as Refer. Specificity and false-positive rates were 97.7% and 2.3% for MB11 and 98.5% and 1.5% for ALGO, respectively. Using MB11, the total mean assessment time was 320.2 ± 220.7 s, with 315.6 ± 214.2 s for Pass and 628.6 ± 288.8 s for Refer. CONCLUSIONS MB11 is useful for hearing screening in healthy Japanese newborns and is fast and easy to operate. MB11 showed high specificity equivalent to ALGO.
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Malesci R, Del Vecchio V, Bruzzese D, Burattini E, Auletta G, Errichiello M, Fetoni AR, Franzè A, Laria C, Toscano F, Caso A, Marciano E. Performance and characteristics of the Newborn Hearing Screening Program in Campania region (Italy) between 2013 and 2019. Eur Arch Otorhinolaryngol 2021. [PMID: 33768315 DOI: 10.1007/s00405-021-06748-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/11/2021] [Indexed: 11/06/2022]
Abstract
Purpose Universal newborn hearing screening (UNHS) in the first month of life is crucial for facilitating both early hearing detection and intervention (EHDI) of significant permanent hearing impairment (PHI). In Campania region, UNHS has been introduced in 2003 by the Regional Council Resolution and started on January 2007. The aim of this paper is to update a previous article describing the performance of the program since its implementation in the period between 2013 and 2019. Methods A longitudinal retrospective study was carried at the Regional Reference Center III on 350,178 babies born in the analysis period. The paper reports the main results of overall coverage, referral rate, lost-to-follow-up rate,yield for PHI and shall determine various risk factor associations with hearing impairment Results In Campania region, 318,878 newborns were enrolled at I level, with a coverage rate of 91.06%, 301,818 (86.18%) Well Infant Nurseries (WIN) and 17,060 (5.35%) Neonatal Intensive Care Unit (NICU) babies. PHI was identified in 413 children, 288 (69.73%) bilaterally and 125 (30.26%) unilaterally. The overall cumulative incidence rate of PHI was 1.29 per 1000 live-born infants (95% CI 1.17–1.42) with a quite steady tendency during the whole study period. Conclusions This study confirms the feasibility and effectiveness of UNHS in Campania region also in a setting with major socioeconomic and health organization restrictions.The program meets quality benchmarks to evaluate the progress of UNHS. Nowadays, it is possible to achieve an early diagnosis of all types of HL avoiding the consequences of hearing deprivation.
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Bussé AML, Mackey AR, Hoeve HLJ, Goedegebure A, Carr G, Uhlén IM, Simonsz HJ. Assessment of hearing screening programmes across 47 countries or regions I: provision of newborn hearing screening. Int J Audiol 2021; 60:821-830. [PMID: 33688794 DOI: 10.1080/14992027.2021.1886350] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Newborn hearing screening (NHS) varies regarding number and type of tests, location, age, professionals and funding. We compared the provision of existing screening programmes. DESIGN A questionnaire containing nine domains: demography, administration, existing screening, coverage, tests, diagnosis, treatment, cost and adverse effects, was presented to hearing screening experts. Responses were verified. Clusters were identified based on number of screening steps and use of OAE or aABR, either for all infants or for well and high-risk infants (dual-protocol). STUDY SAMPLE Fifty-two experts completed the questionnaire sufficiently: 40 European countries, Russia, Malawi, Rwanda, India and China. RESULTS It took considerable effort to find experts for all countries with sufficient time and knowledge. Data essential for evaluation are often not collected. Infants are first screened in maternity wards in most countries. Human development index and health expenditure were high among countries with dual protocols, three screening steps, including aABR, and low among countries without NHS and countries using OAE for all infants. Nationwide implementation of NHS took 6 years, on average. CONCLUSION The extent and complexity of NHS programmes are primarily related to health expenditure and HDI. Data collection should be improved to facilitate comparison of NHS programmes across borders.
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Affiliation(s)
- Andrea M L Bussé
- Department of Otorhinolaryngology and Head, Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Hans L J Hoeve
- Department of Otorhinolaryngology and Head, Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology and Head, Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Gwen Carr
- Independent consultant in Early Hearing Detection, Intervention and Family Centered Practice, London, UK
| | | | - Huibert J Simonsz
- Department of Otorhinolaryngology and Head, Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
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Mackey AR, Bussé AML, Hoeve HLJ, Goedegebure A, Carr G, Simonsz HJ, Uhlén IM. Assessment of hearing screening programmes across 47 countries or regions II: coverage, referral, follow-up and detection rates from newborn hearing screening. Int J Audiol 2021; 60:831-840. [PMID: 33686919 DOI: 10.1080/14992027.2021.1886351] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To assess the performance of newborn hearing screening (NHS) programmes, through selected quality measures and their relationship to protocol design. DESIGN NHS coverage, referral, follow-up and detection rates were aggregated. Referral rates were compared to age at screening step 1, number of steps, and test method: OAE or aABR. STUDY SAMPLE A questionnaire on existing hearing screening was completed by experts from countries in Europe, plus Russia, Malawi, Rwanda, India and China. RESULTS Out of 47 countries or regions, NHS coverage rates were reported from 26, referral rates from 23, follow up from 12 and detection rates from 13. Median coverage rate for step 1 was 96%. Referral rate from step 1 was 6-22% where screening may be performed <24 h from birth, 2-15% for >24 h, and 4% for >72 h. Referral rates to diagnostic assessment averaged 2.1% after one to two steps using OAE only, 1.7% after two steps including aABR, and 0.8% after three to four steps including aABR. Median detection rate for bilateral permanent hearing impairment ≥40dB was 1 per 1000 infants. CONCLUSION Referral rates were related to age, test method and number of screening steps. Quality measures were not available for many NHS programmes.
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Affiliation(s)
| | - Andrea M L Bussé
- Department of Otorhinolaryngology and Head and Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Hans L J Hoeve
- Department of Otorhinolaryngology and Head and Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology and Head and Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Gwen Carr
- Early Hearing Detection, Intervention and Family Centered Practice, London, UK
| | - Huibert J Simonsz
- Department of Otorhinolaryngology and Head and Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
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Palma S, Roversi MF, Alberici MP, Negri M, Chiossi C, Berardi A, Genovese E. Newborn hearing screening programme based on an integrated hospital and community care system. Results of the first 4 years of activity. Int J Pediatr Otorhinolaryngol 2021; 141:110554. [PMID: 33341716 DOI: 10.1016/j.ijporl.2020.110554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
Since January 2012, babies born in the province of Modena, Italy, have routinely undergone hearing testing as part of a two-stage screening programme. Newborn hearing screening (NHS) has been based on an integrated hospital and community care system and this study aims to assess screening coverage, referral rates, the prevalence, type and extent of hearing loss several years into the programme. Data were collected from January 1, 2012 to December 31, 2015. Coverage was over 99% in all five facilities of the province. The ratio of "fails of the screening" to the total number of infants tested varied over the period from 1.2% to 0.9% in the third level facility, and from 0.8% to 0.4% in the other four. Although hearing loss was mainly associated with dysmorphic\syndromic diseases or a family history of hearing loss, some 23% of cases were identified with no known risk factors. We highlight the importance of the NHSP and the need for strong support from healthcare administrators to ensure high coverage. This is especially true since although the prevalence of hearing loss was higher among infants with audiological risk factors, several cases of hearing loss were found in newborns with no known risk factors.
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Affiliation(s)
| | - Maria Federica Roversi
- Paediatric Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
| | | | | | | | - Alberto Berardi
- Paediatric Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
| | - Elisabetta Genovese
- Audiology, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.
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Kataoka Y, Maeda Y, Fukushima K, Sugaya A, Shigehara A, Kariya S, Nishizaki K. Prevalence and risk factors for delayed-onset hearing loss in early childhood: A population-based observational study in Okayama Prefecture, Japan. Int J Pediatr Otorhinolaryngol 2020; 138:110298. [PMID: 32877874 DOI: 10.1016/j.ijporl.2020.110298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/04/2020] [Accepted: 08/04/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim of this study was to retrospectively document prevalence rates of delayed-onset hearing loss (DOHL) under 7 years old after passing the newborn hearing screening (NHS) program using its database in Okayama Prefecture, as well as records from Okayama Kanariya Gakuen (OKG, Auditory Center for Hearing Impaired Children, Okayama Prefecture, Japan). We explored the percentage of children with DOHL among all children who underwent the NHS and surveyed risk factors abstracted from their clinical records. METHODS We collected data of 1171 children, who first visited OKG from April 2006 to March 2018. DOHL children were defined as bilaterally hearing-impaired children who were diagnosed under 7 years old after passing the NHS at birth. Based on the medical records, we investigated age at diagnosis, hearing levels, and risk factors. As population-based data of 168,104 children, the percentage of DOHL subjects was retrospectively calculated among the total number of children who underwent the NHS in Okayama Prefecture from April 2005 to March 2017. RESULTS During the period, we identified 96 children with bilateral DOHL, of which 34 children had failed the NHS unilaterally and 62 had passed the NHS bilaterally. Among all children who underwent the NHS in Okayama Prefecture, the prevalence rate of DOHL in unilaterally referred infants was 5.2%, and 0.037% in bilaterally passed children. The prevalence of bilateral DOHL was 0.057% overall. Unilaterally referred children with DOHL were diagnosed at an average of 13.9 months, while bilaterally passed children with DOHL were diagnosed at an average of 42.3 months. Approximately 59.4% of children with DOHL had risk factors, among which family history of hearing loss was the most frequent. CONCLUSION We propose the first English report of DOHL prevalence in the prefecture population in Japann, which is among the largest community-based population ever reported. The NHS is not a perfect strategy to detect all early-childhood hearing loss; therefore, careful assessment of hearing throughout childhood is recommended, especially in children with risk factors of hearing loss. Further interventional strategies must be established, such as regular hearing screening in high-risk children and assessments of hearing and speech/language development in public communities and nursery schools.
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Affiliation(s)
- Yuko Kataoka
- Department of Otolaryngology, Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Japan.
| | - Yukihide Maeda
- Department of Otolaryngology, Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Japan
| | | | - Akiko Sugaya
- Department of Otolaryngology, Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Japan
| | - Akiko Shigehara
- National Hospital Organization Okayama Medical Center, Department of Otorhinolaryngology, Japan
| | - Shin Kariya
- Department of Otolaryngology, Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Japan
| | - Kazunori Nishizaki
- Department of Otolaryngology, Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Japan
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Wen C, Li X, Huang L, Wang X, Zhao X, Cheng X, Nie W, Tang X, Ge F, He D, Hu S, Zheng J, Zhang D, Wen C, Zhang J, Wang C, Ma L, Lin Y, Chen Y, Gao M, Han J. Current status of universal newborn hearing screening program at 26 institutions in China. Int J Pediatr Otorhinolaryngol 2020; 138:110131. [PMID: 32717628 DOI: 10.1016/j.ijporl.2020.110131] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The present study aimed to determine the status of a universal newborn hearing screening (UNHS) program being conducted in parts of China, by comparing differences in the program findings between 2016 and 2017, as well as across regions in China. METHODS This study investigated a nationally representative sample of newborns from 26 provinces, autonomous regions, and municipalities in mainland China. A ''Newborn Hearing Screening Survey'' questionnaire was sent to 43 hearing screening institutions throughout China and the data were analyzed, with appropriate quality control throughout the study process. RESULTS Twenty-six questionnaires, covering 55.88% (19/34) of the provincial administrative regions in China were appropriately completed. The overall sampling frame comprised 238,795 (year 2016) and 229,185 (year 2017) newborns, respectively. We found differences between two years, the initial screening coverage in 2017 (96.10%) was higher than that in 2016 (94.96%); the referral rate at initial screening in 2017 (9.21%) was lower than that in 2016 (10.26%); and the rescreening rate in 2017 (73.50%) was higher than that in 2016 (68.44%). We found differences across three regions, the rescreening rate were highest in West China, the referral rate at rescreening and the referral rate to diagnostic audiological assessment diagnosis were both highest, while the hearing-loss rate was lowest, in the East China in two years. Overall, 61.54% (n = 16) reported using otoacoustic emissions (OAEs), while 38.46% (n = 10) reported using OAEs in combination with automated auditory brainstem response (AABR) tests, for the initial screening. For rescreening, most sites (n = 19, 73.08%) reported using OAEs in combination with AABR, followed by OAEs only (n = 4, 15.38%) and AABR only (n = 3, 11.54%). Of the twenty-six institutions, 57.69% (n = 15) were equipped with a digital information management system for UNHS program, East China had the highest rate of it (81.82%, 9/11). CONCLUSIONS This study indicated that implementation of a UNHS program had essentially been achieved in many regions of China under the guidance of technical specifications for newborn hearing screening. Compared with 2016, the overall quality of the UNHS program had improved in 2017 and that in East China was better than in the Midland and West China. However, national quality control of the UNHS program is still required to enhance the quality of the program and public education needs to be emphasized to improve the rescreening and reception rate.
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Affiliation(s)
- Cheng Wen
- Beijing Tongren Hospital, Capital Medical University, Beijing, 100005, China; Beijing Institute of Otolaryngology, Beijing, China; Key Laboratory of Otolaryngology, Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Xingming Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Lihui Huang
- Beijing Tongren Hospital, Capital Medical University, Beijing, 100005, China; Beijing Institute of Otolaryngology, Beijing, China; Key Laboratory of Otolaryngology, Head and Neck Surgery, Ministry of Education, Beijing, China.
| | - Xianlei Wang
- Beijing Tongren Hospital, Capital Medical University, Beijing, 100005, China; Beijing Institute of Otolaryngology, Beijing, China; Key Laboratory of Otolaryngology, Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Xuelei Zhao
- Beijing Tongren Hospital, Capital Medical University, Beijing, 100005, China; Beijing Institute of Otolaryngology, Beijing, China; Key Laboratory of Otolaryngology, Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Xiaohua Cheng
- Beijing Tongren Hospital, Capital Medical University, Beijing, 100005, China; Beijing Institute of Otolaryngology, Beijing, China; Key Laboratory of Otolaryngology, Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Wenying Nie
- Jinan Maternal and Child Health Care Center, Jinan, Shandong Province, 250001, China
| | - Xiangrong Tang
- Liuzhou Maternal and Child Health Care Center, Liuzhou, Guangxi Province, 545001, China
| | - Fang Ge
- Shijiazhuang Maternal and Child Health Hospital, Shijiazhuang, Hebei Province, 050000, China
| | - Dinghua He
- Hunan Maternal and Child Health Care Center, Changsha, Hunan Province, 410000, China
| | - Shujun Hu
- Maternal and Child Health Care Center of Luoyang, Luoyang, Henan Province, 471000, China
| | - Jin Zheng
- Maternal and Child Health Care Center of Luoyang, Luoyang, Henan Province, 471000, China
| | - Di Zhang
- Langfang Maternal and Child Health Center, Langfang, Hebei Province, 065000, China
| | - Chunxiu Wen
- Maternal and Child Health Care Center of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Province, 530000, China
| | - Jin Zhang
- Department of Otolaryngology, The People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, 830001, China
| | - Chuan Wang
- Beijing Chaoyang Maternal and Child Health Care Hospital, Beijing, 100021, China
| | - Lixia Ma
- Beijing Maternity Hospital, Beijing, 100026, China
| | - Ying Lin
- Department of Otolaryngology Head and Neck Surgery, First Affliated Hospital(Xijing Hospital), Military Medical University of Air Force, Xi'an, Shanxi Province, 710032, China
| | - Yaqiu Chen
- Tianjin Maternal and Child Health Care Center, Tianjin, 300070, China
| | - Man Gao
- Hearing Impairment Diagnosis Center, Dezhou Maternal and Child Health Care Hospital, Dezhou, Shandong Province, 253000, China
| | - Junning Han
- Zibo Maternal and Child Health Hospital, Zibo, Shandong Province, 255000, China
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Juarez JM, Shaffer AD, Chi DH. Follow-up after failed newborn hearing screening: Parental and primary care provider awareness. Am J Otolaryngol 2020; 41:102614. [PMID: 32622290 DOI: 10.1016/j.amjoto.2020.102614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE The current loss to follow-up rate after failed newborn hearing screening (NBHS) is 34.4%. Previous studies have found that lack of parental and primary care provider (PCP) awareness of NBHS results are significant contributors to loss to follow-up. The objective of this study was to identify factors associated with parental and PCP awareness of NBHS results. MATERIALS AND METHODS Retrospective cohort study. A survey asking about demographics and knowledge of NBHS testing and results was offered to parents in the waiting room of an urban pediatric primary care office. Included were biological parents ≥18 years of age of children ≤10 years of age born in Pennsylvania. Each child's chart was reviewed for PCP documentation of NBHS results. The odds of knowing NBHS results were evaluated using logistic regression. RESULTS The survey was completed by 304 parents. 74.0% were aware of their child's NBHS results. Child age ≥1 year old (OR: 0.49, 95%CI[0.29, 0.82], P = 0.007) and Hispanic ethnicity (OR: 0.38, 95%CI[0.16, 0.89], P = 0.03) were associated with decreased odds of a parent knowing NBHS results. In addition, fewer fathers knew the results of their child's NBHS compared with mothers (OR: 0.33, 95%CI[0.18, 0.62], P < 0.001). However, parental awareness was not associated with birthing facility or insurance type. 222 charts were reviewed for NBHS documentation, revealing PCP awareness in 95.5% of cases and no associations with any of the factors examined. CONCLUSIONS Factors associated with parents not knowing NBHS results included being the parent of an older child, Hispanic, or the father.
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Affiliation(s)
- Jose M Juarez
- University of Pittsburgh School of Medicine, 3550 Terrace Street, Pittsburgh, PA 15261, USA
| | - Amber D Shaffer
- UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA 15224, USA
| | - David H Chi
- UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA 15224, USA.
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Das S, Seepana R, Bakshi SS. Perspectives of newborn hearing screening in resource constrained settings. J Otol 2020; 15:174-7. [PMID: 33293921 DOI: 10.1016/j.joto.2020.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/28/2020] [Accepted: 05/05/2020] [Indexed: 11/21/2022] Open
Abstract
Newborn hearing screening is an effective strategy for early identification of hearing loss in the newborn which result in early intervention and best outcome. However implementing universal screening strategy is a challenge in many resource constrained settings. There are various limitations towards successful implementation of hearing screening program in the developing countries. The cost effectiveness of the screening program also needs to be considered in a resource constrained settings. We attempt to provide a viewpoint that can be potentially helpful for the successful implementation of hearing screening in a resource constrained settings of the developing countries.
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McInerney M, Scheperle R, Zeitlin W, Bodkin K, Uhl B. Adherence to follow-up recommendations for babies at risk for pediatric hearing loss. Int J Pediatr Otorhinolaryngol 2020; 132:109900. [PMID: 32006864 DOI: 10.1016/j.ijporl.2020.109900] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/20/2020] [Accepted: 01/20/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of this retrospective study was to evaluate the families' compliance with recommendations for continued monitoring of babies with high-risk factors for hearing loss. METHODS Hearing screening and follow-up results from 604 babies were tracked across a five-year period. Bivariate analysis, including chi-square analysis, t-tests, and one-way analyses of variance were conducted to test whether various factors predicted likelihood of follow up. RESULTS Although 86% of the babies returned for the initial follow-up appointment, few completed the protocol or were diagnosed with hearing loss (10.3%). Excluding the babies who never returned, the average age for initial assessment was near the recommended 3-month target (3.5 months). However, babies were last seen at 9.4 months on average, which is earlier than recommended. Some factors positively predicted follow-up: receipt of ototoxic medication, hyperbilirubinemia requiring transfusion, ECMO, syndromes associated with hearing loss, craniofacial anomalies, and passing the newborn hearing screening. Others were negatively predictive: NICU stay >5 days, younger maternal age, and failing the newborn screening. There was no relationship between the results of the last test and whether the families continued with monitoring. Babies with risks categorized as more likely to be associated with delayed onset hearing loss were more often late to the initial follow up, but also followed up for a longer period of time. CONCLUSIONS These results demonstrate the need to focus on the barriers unique to babies with risk factors for late onset/progressive hearing loss in addition to those barriers that generally affect loss to follow up. Tools for parental engagement are recommended.
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Affiliation(s)
- Maryrose McInerney
- Montclair State University, 1 Normal Ave, Montclair, NJ, 07043, USA; Hackensack Meridian Health, Hackensack University Medical Center, Joseph M. Sanzari Children's Hospital, 30 Prospect Ave., Hackensack, NJ, 07601, USA.
| | - Rachel Scheperle
- Montclair State University, 1 Normal Ave, Montclair, NJ, 07043, USA; St. Louis Children's Hospital, One Children's Place, St. Louis, MO, 63110, USA.
| | - Wendy Zeitlin
- Montclair State University, 1 Normal Ave, Montclair, NJ, 07043, USA.
| | - Kenneth Bodkin
- Hackensack Meridian Health, Hackensack University Medical Center, Joseph M. Sanzari Children's Hospital, 30 Prospect Ave., Hackensack, NJ, 07601, USA.
| | - Barbara Uhl
- Hackensack Meridian Health, Hackensack University Medical Center, Joseph M. Sanzari Children's Hospital, 30 Prospect Ave., Hackensack, NJ, 07601, USA.
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Sato T, Nakazawa M, Takahashi S, Mizuno T, Ishikawa K, Yamada T. Outcomes of regional-based newborn hearing screening for 35,461 newborns for 5 years in Akita, Japan. Int J Pediatr Otorhinolaryngol 2020; 131:109870. [PMID: 31951982 DOI: 10.1016/j.ijporl.2020.109870] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 01/07/2020] [Accepted: 01/07/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Newborn hearing screening (NHS) has been actively performed since 2001 in Akita, Japan. The NHS coverage rate has increased yearly, and performance has been consistently >90% since 2012. The purpose of this study was to summarize NHS outcomes in the Akita prefecture of Japan and to obtain new insights for from our summarized data for the future. METHODS A total of 35,461 newborns in hospitals and clinics where hearing screening was performed in Akita from 2012 to 2016 were included. The outcome data of NHS were collected for analysis. RESULTS The overall screening coverage rate for hearing loss was 94.7%. Of the screened infants, 0.53% received a referral on the 2-stage automated auditory brainstem response (ABR), and 80.4% of referred infants had a check-up at the hospital to receive a diagnostic hearing examination. Finally, the prevalence of bilateral congenital hearing loss was 0.14%, that of bilateral moderate to profound hearing loss was 0.12%, and that of unilateral congenital hearing loss was 0.10%. Furthermore, the average consultation period in infants with risk factors was significantly later than that in infants without risk factors (p = 0.0015). Follow-up for infants diagnosed with normal hearing after diagnostic hearing examination revealed that 4.7% suffered bilateral moderate to profound hearing loss later. This percentage is significantly higher than that of the general group (p < 0.001). CONCLUSION The prevalence of bilateral congenital hearing loss was 0.14% in Akita and 0.12% of infants were diagnosed with bilateral moderate to severe hearing loss. Medical personnel should be enlightened regarding the importance of performing hearing diagnostic examinations until 3 months of age. Even if infants were diagnosed with normal hearing after a diagnostic examination, we strongly suggest continuing follow-up until they are able to perform pure tone audiometry with accuracy.
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Affiliation(s)
- Teruyuki Sato
- Department of Otorhinolaryngology, Omagari Kousei Medical Center, Daisen, Japan.
| | - Misao Nakazawa
- Department of Otorhinolaryngology, Akita Prefectural Center for Rehabilitation and Psychiatric Medicine, Daisen, Japan; Department of Otorhinolaryngology, Nakadori General Hospital, Akita, Japan
| | - Shin Takahashi
- Department of Otorhinolaryngology, Head & Neck Surgery. Akita University Graduate School of Medicine, Akita, Japan; Takahashi ENT & Eye Clinic, Yokote, Japan
| | - Tomomi Mizuno
- Department of Otorhinolaryngology, Head & Neck Surgery. Akita University Graduate School of Medicine, Akita, Japan
| | - Kazuo Ishikawa
- Department of Otorhinolaryngology, Japanese Red Cross Akita Hospital, Akita, Japan
| | - Takechiyo Yamada
- Department of Otorhinolaryngology, Head & Neck Surgery. Akita University Graduate School of Medicine, Akita, Japan
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Shirane M, Ganaha A, Nakashima T, Shimoara S, Yasunaga T, Ichihara S, Kageyama S, Matsuda Y, Tono T. Comprehensive hearing care network for early identification and intervention in children with congenital and late-onset/acquired hearing loss: 8 years' experience in Miyazaki. Int J Pediatr Otorhinolaryngol 2020; 131:109881. [PMID: 31978747 DOI: 10.1016/j.ijporl.2020.109881] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 01/11/2020] [Accepted: 01/13/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE In 2010, we established the Miyazaki Comprehensive Hearing Care Network (MCHCN) for early identification and intervention in children with congenital and late-onset/acquired hearing loss with the cooperation of related administrative bodies in Miyazaki prefecture. The central roles of the MCHCN program are played by the Hearing Care Center (HCC) at the University of Miyazaki Hospital established in 2010 to facilitate audiological diagnoses, hearing aid interventions, and educational efforts, as well as linkage with the Department of Otolaryngology for surgical interventions. Herein, we aimed to present the main outcomes of the MCHCN program organized by the HCC at the University of Miyazaki Hospital. METHODS The MCHCN consists of two different networks, the Newborn Hearing Screening Network (NHSN) and the Pediatric Hearing Care Network (PHCN). All children suspected of having hearing loss by Newborn Hearing Screening (NHS) are referred to the HCC via the NHSN. In addition, children suspected of late-onset/acquired hearing loss by municipality-led health checkups, pediatricians, public health nurses, and childcare workers are referred to the HCC via the PHCN. Children who were born in Miyazaki prefecture between January 2010 and December 2017 and referred to the HCC for detailed hearing examination were included in this study. RESULTS Within the study period, 89,390 infants were born in Miyazaki prefecture, and 84,737 (94.9%) of them underwent NHS. A total of 698 infants and 182 children with suspected hearing loss were referred to the HCC via the NHSN and PHCN, respectively. Of the 880 referrals, 169 were diagnosed with hearing loss, which included 80 children with bilateral hearing loss and 89 children with unilateral hearing loss. Of the 80 children with bilateral hearing loss, 76 began wearing hearing aids and 15 had cochlear implants in the follow-up period. In children with bilateral conductive hearing loss, 4 children with bilateral middle ear anomalies underwent ossiculoplasty, following which two of these children no longer required hearing aids. Imaging assessments performed on 71 of the 89 children with unilateral hearing loss revealed that 20 of the 30 (66%) children who underwent CT exhibited ossicular anomalies and 28 out of the 48 (58%) children who underwent MRI were found to have ipsilateral cochlear nerve hypoplasia. Among the 169 children with hearing loss, no follow-up loss was observed during the period of this study. CONCLUSION The MCHCN that was organized at the initiative of the HCC at the University of Miyazaki Hospital has enabled the provision of comprehensive and continuous support, ranging from diagnosis to intervention, not only for children with suspected hearing loss referred based on their NHS results but also for those who pass the screening. Via this system, children with late-onset/acquired hearing loss can be identified early and can receive medical interventions tailored to the cause of their hearing loss while simultaneously avoiding a loss to follow-up.
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Affiliation(s)
- Miho Shirane
- Miyazaki University Hospital Hearing Care Center, Miyazaki, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
| | - Akira Ganaha
- Miyazaki University Hospital Hearing Care Center, Miyazaki, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
| | - Takahiro Nakashima
- Miyazaki University Hospital Hearing Care Center, Miyazaki, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
| | - Shoken Shimoara
- Miyazaki University Hospital Hearing Care Center, Miyazaki, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
| | - Taro Yasunaga
- Miyazaki University Hospital Hearing Care Center, Miyazaki, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
| | - Sakura Ichihara
- Miyazaki University Hospital Hearing Care Center, Miyazaki, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
| | - Saki Kageyama
- National Hospital Organization Miyakonojo Medical Center, 5033-1 Iwayoshi, Miyakonojo, 885-0014, Japan.
| | - Yusuke Matsuda
- Kagoshima City Hospital, 37-1 Uearata, Kagoshima, 890-8760, Japan.
| | - Tetsuya Tono
- Miyazaki University Hospital Hearing Care Center, Miyazaki, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
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Martínez Pacheco MDC, Sequí Canet JM, Donzo Tobele M. Early Detection Programmes for Child Hearing Loss in Spain: Current Practices. Acta Otorrinolaringol Esp (Engl Ed) 2021; 72:37-50. [PMID: 32156438 DOI: 10.1016/j.otorri.2019.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 09/03/2019] [Indexed: 11/20/2022]
Abstract
INTRODUCTION AND OBJECTIVE In 2003, The Ministry of Health and Consumption, together with the Autonomous Communities (CCAA), approved a minimum and basic document concerning the establishment of Early Hearing Detection and Intervention State Programmes. Since then, the Commission for the early detection of hearing loss (CODEPEH) has made several updates and recommendations to improve these programmes. The objective of this study is to carry out a comparative analysis of how the CCAA established their Early Hearing Detection and Intervention programs and if they integrate the recommendations made by CODEPEH until 2017. MATERIAL AND METHOD The programmes (or related documents) of 16 CCAA available on line or paper are reviewed RESULTS: The 16 Early Hearing Detection and Intervention strategies analyzed are different, either in the number of test to be performed, the time in which they are performed or the techniques used. More than a third of these programmes were published before 2010 and have not been updated. Otoacoustic emissions is the chosen technique as the first screening test in nine of the 16 CCAA. Only one CCAA incorporates the salivary polymerase chain reaction test for cytomegalovirus in children with altered screening test. CONCLUSION All CCAA perform Early Hearing Detection and Intervention programmes but the heterogeneity does not allow drawing reliable conclusions about the result of the screening process and it would be necessary to aim for unification with the elaboration of a national programme and an integrated general database.
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Ong KMC, Rivera AS, Chan AL, Chiong CM. Determining concordance and cost impact of otoacoustic emission and automated auditory brainstem response in newborn hearing screening in a tertiary hospital. Int J Pediatr Otorhinolaryngol 2020; 128:109704. [PMID: 31606683 DOI: 10.1016/j.ijporl.2019.109704] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/28/2019] [Accepted: 09/30/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE This study compared otoacoustic emission (OAE) and automated auditory brainstem response (AABR) in terms of concordance and cost impact for newborn hearing screening (NBHS) in the Philippine setting. METHODS This was a prospective observational study to assess concordance between OAE and AABR involving 253 infants. Each infant underwent OAE and AABR testing. Infants who passed both tests were not required to follow up for additional testing. Infants who failed in any test were scheduled for repeat screening and diagnostic ABR after 1 month. Concordance was computed using B-statistic. FOR COST ANALYSIS 4 scenarios were compared to 1-step both tests scenario: (1) OAE alone, (2) AABR alone, (3) 2-step OAE, and (4) 2-step AABR in terms of number of infants with hearing loss (HL) detected, cost of diagnosis, and economic loss from lack of treatment. RESULTS There was high concordance between OAE and AABR (B-statistic = 0.8). AABR had a higher refer rate (18.58%) than OAE (10.27%) but higher number of detected babies with HL. Cost analysis favored an AABR alone scenario while the 2-step OAE protocol fared poorly. CONCLUSION A change from 2-step OAE to AABR alone is worth considering in our institution.
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Affiliation(s)
- Kimberly Mae C Ong
- University of the Philippines (UP) Manila College of Medicine-Philippine General Hospital, Manila, Philippines.
| | - Adovich S Rivera
- Northwestern University-Feinberg School of Medicine, Chicago, IL, USA
| | - Abner L Chan
- University of the Philippines (UP) Manila College of Medicine-Philippine General Hospital, Manila, Philippines
| | - Charlotte M Chiong
- University of the Philippines (UP) Manila College of Medicine-Philippine General Hospital, Manila, Philippines; UP Manila-National Institutes of Health (NIH), Manila, Philippines.
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Chung YS, Oh SH, Park SK. Referral rates for newborn hearing screening based on the test time. Int J Pediatr Otorhinolaryngol 2019; 127:109664. [PMID: 31521889 DOI: 10.1016/j.ijporl.2019.109664] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/21/2019] [Accepted: 08/28/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To suggest the optimal timing for newborn hearing screening to obtain an ideal and stable referral rate in well babies and in babies in neonatal intensive care units (NICU). METHODS This study analyzed nationwide hearing screening data of 71,596 newborns in the low-income families who received support from the government in 2017. The referral rate for neonatal hearing screening, based on the period from birth to screening, was compared in well babies (n = 68,206) who were born healthy or hospitalized in the NICU for < 5 days and moved to a well-baby nursery and babies (n = 3,390) who were in the NICU for ≥ 5 days. RESULTS In well babies, most screenings (73.1%) were performed in the first three days of life. Most babies (74%) in the NICU underwent screening within the first 20 days after birth. The referral rates for babies at 32-60 days after birth differed from those of other screening days, except for the rates at 21-31 days after birth. Referral rates for NHS at > 60 days after birth were significantly higher than those for other periods in babies overall. However, the incidence of hearing loss according to age did not differ significantly within or between groups. CONCLUSIONS Referral rates based on the period from birth to screening were significantly different between well babies and NICU babies. To reduce and ensure stable referral rates, we recommend that the hearing screening be performed between 2 and 20 days after birth for well babies and between 5 and 31 days after birth for NICU babies.
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Affiliation(s)
- You Sun Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Republic of Korea
| | - Seung-Ha Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Su-Kyoung Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
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Satish HS, Anil Kumar R, Viswanatha B. Screening of Newborn Hearing at a Tertiary Care Hospital in South India. Indian J Otolaryngol Head Neck Surg 2019; 71:1383-1390. [PMID: 31750182 DOI: 10.1007/s12070-018-1454-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 07/12/2018] [Indexed: 11/27/2022] Open
Abstract
Hearing loss can have a devastating impact on the cognitive development and psychological well-being of children and their families. Newborn hearing screening should be given special attention especially in a country like ours where the burden of this disability is heavy. Screening all newborns irrespective of risk factors helps in better detection, and hence further management can be initiated at appropriate time. To implement newborn hearing screening at Vanivilas hospital and to estimate the incidence of hearing loss among the high risk groups. To create awareness about the need for detecting childhood deafness among parents and general population. To develop a centre of excellence for evaluation, intervention and rehabilitation for hearing impaired in a tertiary care hospital. Prospective study. All neonates born in Vanivilas Hospital attached to Bangalore Medical College and Research Institute underwent hearing screening using four stage protocols with otoacoustic emission (OAE) tests and final confirmation with Brainstem evoked response audiometry (BERA) tests. May 2015-May 2017. Number of newborns screened were 26,487, and 19 (0.717/1000) newborns were detected to have hearing impairment. The incidence of hearing loss among high risk group was 0.188/1000, and among the non risk group was 0.528/1000. Newborn hearing screening must be made mandatory and multi-staged protocol based screening for hearing loss should be implemented. This will make newborn screening programme more efficient and also will help in initiating treatment at an early stage so that further damage can be prevented.
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Affiliation(s)
| | - Ramabhadraiah Anil Kumar
- Department of ENT, Bangalore Medical College and Research Institute, Fort, K.R. Road, Bengaluru, Karnataka 560002 India
| | - Borlingegowda Viswanatha
- Department of ENT, Bangalore Medical College and Research Institute, Fort, K.R. Road, Bengaluru, Karnataka 560002 India
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Thangavelu K, Martakis K, Fabian S, Venkateswaran M, Roth B, Beutner D, Lang‐Roth R. Prevalence and risk factors for hearing loss in high-risk neonates in Germany. Acta Paediatr 2019; 108:1972-1977. [PMID: 31074050 DOI: 10.1111/apa.14837] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 02/11/2019] [Accepted: 05/06/2019] [Indexed: 11/29/2022]
Abstract
AIM Hearing loss in infants is often diagnosed late, despite universal screening programmes. Risk factors of hearing impairment in high-risk neonates, identified from population-based studies, can inform policy around targeted screening. Our aim was to determine the prevalence and the risk factors of hearing loss in a high-risk neonatal population. METHODS This was a retrospective cohort study of neonates hospitalised at the University Hospital Cologne, Germany from January 2009 to December 2014 and were part of the newborn hearing screening programme. Multivariable regression analyses using the lasso approach was performed. RESULTS Data were available for 4512 (43% female) neonates with a mean gestational age at birth of 35.5 weeks. The prevalence of hearing loss was 1.6%, and 42 (0.9%) neonates had permanent hearing loss. Craniofacial anomalies, hyperbilirubinaemia requiring exchange transfusion, oxygen supplementation after 36 weeks of gestation and hydrops fetalis showed associations with permanent hearing loss. CONCLUSION Our findings of risk factors for hearing loss were consistent with other studies. However, some commonly demonstrated risk factors such as perinatal infections, meningitis, sepsis and ototoxic drugs did not show significant associations in our cohort. Targeted screening based on risk factors may help early identification of hearing loss in neonates.
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Affiliation(s)
- Kruthika Thangavelu
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Marburg University of Gießen and Marburg Marburg Germany
| | - Kyriakos Martakis
- Department of International Health, CAPHRI ‐ Care and Public Health Research Institute Maastricht University Maastricht The Netherlands
- Department of Pediatrics, Faculty of Medicine and University Hospital Cologne University of Cologne Cologne Germany
| | - Silke Fabian
- Department of Otorhinolaryngology, Head and Neck Surgery University of Cologne Cologne Germany
| | - Mahima Venkateswaran
- Global Health Cluster, Division for Health Services Norwegian Institute of Public Health Oslo Norway
| | - Bernhard Roth
- Department of Pediatrics, Faculty of Medicine and University Hospital Cologne University of Cologne Cologne Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery University of Göttingen Göttingen Germany
| | - Ruth Lang‐Roth
- Department of Otorhinolaryngology, Head and Neck Surgery University of Cologne Cologne Germany
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Ciorba A, Hatzopoulos S, Corazzi V, Cogliandolo C, Aimoni C, Bianchini C, Stomeo F, Pelucchi S. Newborn hearing screening at the Neonatal Intensive Care Unit and Auditory Brainstem Maturation in preterm infants. Int J Pediatr Otorhinolaryngol 2019; 123:110-115. [PMID: 31096068 DOI: 10.1016/j.ijporl.2019.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/31/2019] [Accepted: 05/04/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Aim of this study is to report and discuss the results of 4 years of Newborn hearing screening (NHS) program at the Neonatal Intensive Care Unit (NICU), particularly evaluating the clinical ABR results. METHODS Retrospective study. NHS data from NICU newborns, admitted for ≥5 days, in the period from January 1st, 2013 and December 31st, 2016, were retrieved and analyzed. NHS results were classified as following: (i) "pass" when both ears for both the a-TEOAE (automated Transient-Evoked Otoacoustic Emissions) and the a-ABR (automated Auditory Brainstem Response) protocol resulted as "pass"; (ii) "fail" when one ear, at either one of the two performed tests resulted as "fail"; (iii) "missing" when the newborns were not tested with both protocols. All "fail" and "missing" newborns were retested (with both tests): in the case of a second "fail" result, a clinical ABR was performed within a period of 3 months. RESULTS A total of 1191 newborns were screened. From those, 1044/1191 resulted as "pass", 108/1191 as "fail", and 39/1191 as "missing". During the re-testing of these 147 newborns, 43 were assigned as "missing", 63 were assigned as "pass" (showing bilaterally a wave V identifiable within 30 dB nHL) and 25 failed the retest and/or did not present an identifiable wave V within 30 dB nHL. Among the 147 retested infants, we identified a group of 16 subjects who resulted as NHS "refer" and who, during the audiological follow-up, showed either: (i) a unilateral or bilateral wave V identifiable over 30 dB nHL, at the first clinical ABR assessment; or (ii) a bilateral wave V identifiable within 30 dB nHL, in a following clinical ABR test during the first year of life. These 16 subjects were defined to have an 'Auditory Brainstem Maturation' issue. CONCLUSIONS A possible "maturation" of the ABR response (and therefore of the auditory pathway) has been hypothesised in 16 out of 1191 infants (1.3%). A delay of the auditory pathway maturation in preterm babies compared to term newborns has already been suggested in the literature. A possible delay of the NHS retest could be considered, in selected cases, with significant savings in economic resources and parental anxiety.
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Affiliation(s)
- Andrea Ciorba
- ENT & Audiology Department, University Hospital of Ferrara, Via A. Moro 8, Loc Cona, Ferrara, 44124, Italy.
| | - Stavros Hatzopoulos
- ENT & Audiology Department, University Hospital of Ferrara, Via A. Moro 8, Loc Cona, Ferrara, 44124, Italy
| | - Virginia Corazzi
- ENT & Audiology Department, University Hospital of Ferrara, Via A. Moro 8, Loc Cona, Ferrara, 44124, Italy
| | - Cristina Cogliandolo
- ENT & Audiology Department, University Hospital of Ferrara, Via A. Moro 8, Loc Cona, Ferrara, 44124, Italy
| | - Claudia Aimoni
- ENT & Audiology Department, University Hospital of Ferrara, Via A. Moro 8, Loc Cona, Ferrara, 44124, Italy
| | - Chiara Bianchini
- ENT & Audiology Department, University Hospital of Ferrara, Via A. Moro 8, Loc Cona, Ferrara, 44124, Italy
| | - Francesco Stomeo
- ENT & Audiology Department, University Hospital of Ferrara, Via A. Moro 8, Loc Cona, Ferrara, 44124, Italy
| | - Stefano Pelucchi
- ENT & Audiology Department, University Hospital of Ferrara, Via A. Moro 8, Loc Cona, Ferrara, 44124, Italy
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Yücel A, Alataş N, Yücel H, Güllüev M, Özsöz E, Uğur C. Newborn hearing screening results of refugees living in our city and the factors affecting the results. Int J Pediatr Otorhinolaryngol 2019; 123:187-190. [PMID: 31129457 DOI: 10.1016/j.ijporl.2019.05.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 05/15/2019] [Accepted: 05/15/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate the changes in the risk factors affecting the results of the Newborn Hearing Screening (NHS) and the hearing test results of the Syrian refugees in our city. METHODS Syrian and Turkish newborns, born in our hospital between 01.01.2016 and 31.12.2017 and referred to our hospital from environmental hospitals for NHS, were included in this study. NHS results and risk factors were analyzed. RESULTS 786 Syrian and 7230 Turkish newborns were included in this study. 53 (6,74%) infants referred in both ears, 26 (3,30%) infants in the one ear. There was a significant relationship between the presence of hearing loss and the history of intensive care unit admittance, presence and absence of low birth weight and neonatal icterus at Syrian newborns. In the same period, 20 (0,3%) Turkish infants referred bilaterally and 45 (0,6%) newborns unilaterally (25 right ear, 20 left ear). There was a significant difference between Turkish and Syrian newborns in terms of very low and low birth weight and intensive care unit admittance. CONCLUSIONS The rate of hearing loss in Syrian refugee patients is quite high. Pregnant refugee women who are forced to migrate because of war face many risk factors and these people need to be included into the newborn hearing screening programs in the country where they took refuge in.
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Affiliation(s)
- Abitter Yücel
- Department of Otorhinolaryngology Head and Neck Surgery, University of Health Sciences, Konya Health Application Research Center, Konya, Turkey.
| | - Necat Alataş
- Department of Otorhinolaryngology Head and Neck Surgery, Usak University, Uşak, Turkey.
| | - Hilal Yücel
- Department of Otorhinolaryngology Head and Neck Surgery, University of Health Sciences, Konya Education Research Hospital, Turkey.
| | - Mustafa Güllüev
- Department of Otorhinolaryngology Head and Neck Surgery, University of Health Sciences, Konya Education Research Hospital, Turkey.
| | - Ekrem Özsöz
- Department of Otorhinolaryngology Head and Neck Surgery, University of Health Sciences, Konya Education Research Hospital, Turkey.
| | - Cüneyt Uğur
- Department of Pediatry, University of Health Sciences, Konya Health Application Research Center, Turkey.
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Wasser J, Ari-Even Roth D, Herzberg O, Lerner-Geva L, Rubin L. Assessing and monitoring the impact of the national newborn hearing screening program in Israel. Isr J Health Policy Res 2019; 8:30. [PMID: 30857547 PMCID: PMC6410489 DOI: 10.1186/s13584-019-0296-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 02/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Israeli Newborn Hearing Screening Program (NHSP) began operating nationally in January 2010. The program includes the Otoacoustic Emissions (OAE) test for all newborns and Automated Auditory Brainstem Response (A-ABR) test for failed OAE and infants at risk for auditory neuropathy spectrum disorders. NHSP targets are diagnosis of hearing impairment by age three months and initiation of habilitation by six months. OBJECTIVES (1) Review NHSP coverage; (2) Assess NHSP impact on age at diagnosis for hearing impairment and age at initiation of habilitation; (3) Identify contributing factors and barriers to NHSP success. METHODS (1) Analysis of screening coverage and referral rates for the NHSP; (2) Analysis of demographic data, results of coverage, age at diagnosis and initiation of habilitation for hearing impaired infants pre-implementation and post-implementation of NHSP from 10 habilitation centers; (3) Telephone interviews with parents whose infants failed the screening and were referred for further testing. RESULTS The NHSP coverage was 98.7% (95.1 to 100%) for approximately 179,000 live births per year for 2014-2016 and average referral rates were under 3%. After three years of program implementation, median age at diagnosis was 3.7 months compared to 9.5 months prior to NHSP. The median age at initiation of habilitation after three years of NHSP was 9.4 months compared to 19.0 prior to NHSP. Parents (84% of 483 sampled) with infants aged 4-6 months participated in the telephone survey. While 84% of parents reported receiving a verbal explanation of the screening results, more than half of the parents reported not receiving written material. Parental report of understanding the test results and a heightened level of concern over the failed screen were associated with timely follow-up. CONCLUSIONS The findings indicate high screening coverage. The program reduced ages at diagnosis and initiation of habilitation for hearing impaired infants. Further steps needed to streamline the NHSP are improving communication among caregivers to parents to reduce anxiety; increasing efficiency in transferring information between service providers using advanced technology while ensuring continuum of care; reducing wait time for follow-up testing in order to meet program objectives. Establishment of a routine monitoring system is underway.
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Affiliation(s)
- Janice Wasser
- Department of Maternal and Child Health, Public Health Services, Ministry of Health, Jerusalem, Israel.
| | - Daphne Ari-Even Roth
- Department of Communication Disorders, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Hearing, Speech and Language Center, Sheba Medical Centre, Tel HaShomer, Israel
| | - Orly Herzberg
- Department of Communication Disorders, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Chief Communication Disorders Clinician, Medical Directorate, Ministry of Health, Tel Aviv, Israel
| | - Liat Lerner-Geva
- Women and Children's Health Research Unit, The Gertner Institute for Epidemiology and Health Policy, Tel HaShomer, Israel.,School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lisa Rubin
- Department of Maternal and Child Health, Public Health Services, Ministry of Health, Jerusalem, Israel.,School of Public Health, University of Haifa, Haifa, Israel
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Abstract
Hearing loss is the most common congenital defect. With early diagnosis and intervention, we are able to improve speech and language outcomes in this population. In this article, we discuss the implications of the newborn hearing screen, as well as diagnostic interventions, management, and intervention, and the increasing role of congenital cytomegalovirus screening.
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Affiliation(s)
- Kavita Dedhia
- Department of Pediatric Otolaryngology, Emory University, 2015 Uppergate Drive, Atlanta, GA 30324, USA.
| | - Elise Graham
- Department of Pediatric Otolaryngology, University of Utah, 100 North Mario Capercchi Drive, Salt Lake City, UT 84113, USA
| | - Albert Park
- Department of Pediatric Otolaryngology, University of Utah, 100 North Mario Capercchi Drive, Salt Lake City, UT 84113, USA
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Kanji A, Khoza-Shangase K, Moroe N. Newborn hearing screening protocols and their outcomes: A systematic review. Int J Pediatr Otorhinolaryngol 2018; 115:104-109. [PMID: 30368368 DOI: 10.1016/j.ijporl.2018.09.026] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To conduct a review of the most current research in objective measures used within newborn hearing screening protocols with the aim of exploring the actual protocols in terms of the types of measures used and their frequency of use within a protocol, as well as their outcomes in terms of sensitivity, specificity, false positives, and false negatives in different countries worldwide. METHODS A systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Electronic databases such as PubMed, Google Scholar and Science Direct were used for the literature search. A total of 422 articles were identified, of which only 15 formed part of the current study. The 15 articles that met the study's criteria were reviewed. Pertinent data and findings from the review were tabulated and qualitatively analysed under the following headings: country; objective screening and/or diagnostic measures; details of screening protocol; results (including false positive and negative findings, sensitivity and/or specificity), conclusion and/or recommendations. These tabulated findings were then discussed with conclusions and recommendations offered. RESULTS Findings reported in this paper are based on a qualitative rather than a quantitative analysis of the reviewed data. Generally, findings in this review revealed firstly, that there is a lack of uniformity in protocols adopted within newborn hearing screening. Secondly, many of the screening protocols reviewed consist of two or more tiers or stages, with transient evoked otoacoustic emissions (TEOAEs) and automated auditory brainstem response (AABR) being most commonly used. Thirdly, DPOAEs appear to be less commonly used when compared to TEOAEs. Lastly, a question around routine inclusion of AABR as part of the NHS protocol remains inconclusively answered. CONCLUSIONS There is sufficient evidence to suggest that the inclusion of AABR within a NHS programme is effective in achieving better hearing screening outcomes. The use of AABR in combination with OAEs within a test-battery approach or cross-check principle to screening is appropriate, but the inclusion of AABR to facilitate appropriate referral for diagnostic assessment needs to be systematically studied.
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Sunwoo W, Lee WW, Choi BY. Extremely common radiographic finding of cochlear nerve deficiency among infants with prelingual single-sided deafness and its clinical implications. Int J Pediatr Otorhinolaryngol 2018; 112:176-181. [PMID: 30055729 DOI: 10.1016/j.ijporl.2018.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/04/2018] [Accepted: 07/07/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To clarify the common radiographic findings of audiologically documented prelingual single-sided deafness (SSD) and identify the prevalence of cochlear nerve deficiency (CND) in SSD infants referred from the newborn hearing screening program. METHODS Between March 2012 and March 2017, the records of all infants referred to our otology clinic after undergoing newborn hearing screening program were retrospectively reviewed. Twenty-four consecutive well infants without risk factors who had a confirmed diagnosis of prelingual SSD under the age of 1 year and who underwent internal auditory canal (IAC) magnetic resonance imaging (MRI) were included. The sizes of cochlear nerve (CN), IAC, and cochlear nerve canal (CNC) were measured on MRI. The presence of CND was visually determined by comparing the CN size to the ipsilateral facial nerve (FN) in the affected side via an oblique sagittal view of IAC MRI and defined when CN was absent or smaller than FN. RESULTS CND was seen in all 24 deaf ears (100%) on MRI. There was one with incomplete partition type I, and another with combined cochleovestibular nerve absence. Twenty-four subjects demonstrated either an absent (20/24, 83.3%) or small (4/24, 16.7%) CN. When the absent and small CN groups were compared, the former group had a higher prevalence of narrow CNC and narrow IAC. Of the 20 infants without identifiable CN on the affected side, 17 (85%) had narrow IAC and 17 (85%) had narrow CNC. In the 20 ears with absent CN, only one had both normal-sized IAC and CNC. CONCLUSION The contribution of CND to prelingual SSD in Korean infants reached 100%, according to IAC MRI alone.
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Affiliation(s)
- Woongsang Sunwoo
- Department of Otorhinolaryngology-Head & Neck Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Won-Wook Lee
- Department of Otorhinolaryngology-Head & Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Byung Yoon Choi
- Department of Otorhinolaryngology-Head & Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
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Rahimi V, Mohammadkhani G, Javadi F. Improving universal newborn hearing screening outcomes by conducting it with thyroid screening. Int J Pediatr Otorhinolaryngol 2018; 111:111-114. [PMID: 29958592 DOI: 10.1016/j.ijporl.2018.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/01/2018] [Accepted: 06/02/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES One of the most important factors that can improve hearing screening indicators is testing infants after 48 h of birth. The neonatal thyroid screening program is done during the third to fifth day after birth in many countries. So this screening is done at the appropriate time for hearing screening. The aim of the present study was to evaluate hearing screening outcomes (the referral rate, false positive rate, and positive predictive value) conducted with the thyroid screening at the healthcare centers and compare the results with hospital before discharge the infant. METHODS This was a prospective exploratory cohort study. The study population included all the newborns at a hospital (group 1) and newborns who were referred to healthcare centers for thyroid screening (group 2), except for infants with risk factors, from March 2012 to December 2017. Transient evoked otoacoustic emissions (TEOAE) and automatic auditory brainstem response (AABR) were used for the evaluation. The results were compared between the two groups. RESULTS Of the 4729 newborns, who participated in the study, 3001 were referred from a hospital (group 1) and 1728 from two healthcare centers (group 2). The referral rate in group 1 and 2 was 16.1% and 7.6%, respectively. Also, the false positive rate in group 1 and 2 was 15.9% and 7.6%, respectively. Our study showed that the referral rate and false positive rate of hearing screening in group 2 were significantly lower than that in group 1 (p < 0.001). The positive predictive value in group 1 was significantly higher than that in group 2 (p < 0.05). There was no significant sex difference in any of the variables. CONCLUSIONS Our results showed that performing the hearing screening during the thyroid program, instead of the hospital could be significantly improved screening outcomes and suggest that hearing and thyroid screening together after discharge from the hospital could be a good opportunity to introduce new framework for hearing screening in many countries.
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Affiliation(s)
- Vida Rahimi
- Department of Audiology, School of Rehabilitation, Tehran University of Medical Science, Tehran, Iran.
| | - Ghassem Mohammadkhani
- Department of Audiology, School of Rehabilitation, Tehran University of Medical Science, Tehran, Iran
| | - Farzaneh Javadi
- Department of Prevention of Disease, Welfare Organization of Tehran, Tehran, Iran
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Chakrabarti S. State of deaf children in West Bengal, India: What can be done to improve outcome. Int J Pediatr Otorhinolaryngol 2018; 110:37-42. [PMID: 29859584 DOI: 10.1016/j.ijporl.2018.04.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/13/2018] [Accepted: 04/26/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Prelingual deafness in children demands urgent action as best outcome is dependent on earliest possible diagnosis and intervention. Objective of this study was to determine age of suspicion, diagnosis, intervention, and outcome in a representative group of deaf children in West Bengal, India, and suggest ways of improving these parameters. METHODS In this cross-sectional study, ages of suspicion, diagnosis, intervention and outcome of 303 randomly selected deaf children were elicited from a cohort of 1316 children with deafness identified in an earlier study. RESULTS Median ages of suspicion, diagnosis and amplification were 18, 72 and 84 months respectively. Age of suspicion was significantly related to parental education (p < 0.05); age of diagnosis to parental education and socio-economic status (p < 0.001) and children's geographic location (p < 0.01). Following diagnosis, 86% of children received hearing aids but only 6% used their aids consistently; 86% were non-verbal, 12% could communicate with a mixture of speech and gesture and only 2% with speech alone. CONCLUSION Current situation of deaf children in West Bengal, and evidence indicates, in much of India, is insupportable. However, widely diverse socio-economic conditions and scarcity of public health infrastructure preclude one solution of the problem for the whole country. In absence of the ideal universal newborn hearing screening, rigorously monitored and costed pilot programs of different models of early detection and intervention using newborn hearing screening, targeted screening and trial of calibrated noisemakers by primary care workers should be tried to see which works best where, so that successful programs can be scaled up over time.
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Affiliation(s)
- Suniti Chakrabarti
- Pratibandhi Kalyan Kendra, Abinash Mukherjee Road, Hooghly, West Bengal, PIN 712103, India.
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50
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Rawlinson WD, Palasanthiran P, Hall B, Al Yazidi L, Cannon MJ, Cottier C, van Zuylen WJ, Wilkinson M. Neonates with congenital Cytomegalovirus and hearing loss identified via the universal newborn hearing screening program. J Clin Virol 2018; 102:110-115. [PMID: 29571077 DOI: 10.1016/j.jcv.2018.03.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 03/11/2018] [Accepted: 03/14/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Congenital cytomegalovirus (CMV) is the most common non-genetic cause of sensorineural hearing loss. Currently, there are no universal CMV screening programs for newborns or routine CMV testing of neonates with hearing loss in Australia, or elsewhere. OBJECTIVES This study was undertaken to determine the prevalence of congenital CMV infection in infants with hearing loss identified using routine resources via the Australian universal neonatal hearing screening (UNHS) program. STUDY DESIGN Infants who failed UNHS, referred for audiological testing and found to have permanent hearing loss were screened for CMV via PCR of urine and saliva. Congenital CMV was diagnosed if CMV was detected in infants ≤30 days of age, or using retrospective testing on stored new born screening cards, retrospective testing, or using clinical criteria if >30 days of age. The cohort was analyzed for time of testing and prevalence of congenital CMV determined. RESULTS The Audiology Department reviewed 1669 infants who failed UNHS between 2009 and 2016. Thirty percent (502/1669) had permanent hearing loss confirmed, of whom 336/502 were offered CMV testing. A definite (n = 11) or probable (n = 8) diagnosis of congenital CMV occurred in 19/323 (5.9%), of whom definite diagnoses were made in 4/19 on tests positive prior to 21 days of life, in 5/19 who were positive on neonatal blood screening card (NBSC) testing, in 2/19 who were positive on placental testing. In 8/19 probable diagnoses were made based on positive testing between ages 23-42 days and a consistent clinical syndrome in the absence of another cause for hearing loss after genetic and other testing. CMV testing mirrored the timing of audiological testing, with ∼40% completing audiology and CMV testing by 21 days, and 64% by 30 days. CONCLUSION This program, utilizing existing clinical services identified probable congenital CMV in ∼6% of a large cohort failing UNHS with permanent hearing loss, of whom more than half were definite diagnoses. No additional assets were required to those already existing in this tertiary referral pediatric centre, whilst providing useful and timely data for clinical and audiological management.
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Affiliation(s)
- William D Rawlinson
- Serology and Virology Division, NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia; School of Medical Sciences & School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW, Australia.
| | - Pamela Palasanthiran
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital & School of Women's and Child Health, University of New South Wales, Sydney, NSW, Australia
| | - Beverly Hall
- Serology and Virology Division, NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Laila Al Yazidi
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital & School of Women's and Child Health, University of New South Wales, Sydney, NSW, Australia
| | - Michael J Cannon
- National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Carolyn Cottier
- Hearing Support Services, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Wendy J van Zuylen
- Serology and Virology Division, NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia; School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Monica Wilkinson
- Audiology Department, Sydney Children's Hospital, Sydney, NSW, Australia
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