Hospital-based universal newborn hearing screening for early detection of permanent congenital hearing loss in Lagos, Nigeria

• Published in: International journal of pediatric otorhinolaryngology 2008-07, Vol.72 (7), p.991-1001
• Main Authors: Olusanya, B.O, Wirz, S.L, Luxon, L.M
• Format: Article
• Language: English
• Subjects: Congenital hearing loss; Developing country; Early detection; Evoked Potentials, Auditory, Brain Stem; Hearing Loss - congenital; Hearing Loss - diagnosis; Hearing Loss - epidemiology; Humans; Incidence; Infant, Newborn; Neonatal hearing screening; Neonatal Screening; Nigeria - epidemiology; Otoacoustic Emissions, Spontaneous; Otolaryngology; Pediatrics; Primary health workers
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2008.03.004

Summary Objective To determine the feasibility and effectiveness of hospital-based universal newborn hearing screening programme for the early detection of permanent congenital or early-onset hearing loss (PCEHL) in Lagos, Nigeria. Methods A cross-sectional pilot study based on a two-stage universal newborn hearing screening by non-specialist health workers using transient evoked otoacoustic emissions (TEOAE) and automated auditory brainstem-response (AABR) in an inner-city maternity hospital over a consecutive period of 40 weeks. The main outcome measures were the practicality of screening by non-specialist staff with minimal training, functionality of screening instruments in an inner-city environment, screening coverage, referral rate, return rate for diagnosis, yield of PCEHL and average age of PCEHL confirmation. Results Universal hearing screening of newborns by non-specialist staff without prior audiological experience is feasible in an inner-city environment in Lagos after a training period of two-weeks. Notwithstanding excessive ambient noise within and outside the wards, it was possible to identify a test site for TEOAE screening within the hospital. The screening coverage was 98.7% (1330/1347) of all eligible newborns and the mean age of screening was 2.6 days. Forty-four babies out of the 1274 who completed the two-stage screening were referred yielding a referral rate of 3.5%. Only 16% (7/44) of babies scheduled for diagnostic evaluation returned and all were confirmed with hearing loss resulting in an incidence of 5.5 (7/1274) per 1000 live births or a programme yield of 5.3 (7/1330) per 1000. Six infants had bilateral hearing loss and the degree was severe (≥70 dB nHL) in three infants, moderate (40 dB nHL) in one infant and mild (