The universal newborn hearing screening in Brazil: From identification to intervention

• Published in: International journal of pediatric otorhinolaryngology 2010-05, Vol.74 (5), p.510-515
• Main Authors: Bevilacqua, Maria Cecilia, Alvarenga, Kátia de Freitas, Costa, Orozimbo Alves, Moret, Adriane Lima Mortari
• Format: Article
• Language: English
• Subjects: Brazil - epidemiology; Cochlear Implants - statistics & numerical data; Hearing Aids - statistics & numerical data; Hearing impaired; Hearing Loss, Conductive - diagnosis; Hearing Loss, Conductive - epidemiology; Hearing Loss, Sensorineural - diagnosis; Hearing Loss, Sensorineural - epidemiology; Hearing Tests - economics; Hearing Tests - methods; Hospitals, Public; Humans; Infant; Infant, Newborn; Neonatal Screening - economics; Otolaryngology; Pediatrics; Prevalence; Risk Factors; Severity of Illness Index; Transient evoked otoacoustic emissions; Universal newborn hearing screening
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2010.02.009

Abstract Objective The objective of the study is to investigate the results of the newborn hearing screening program carried out in a Public Hospital in Brazil, in the first 3 years regarding: (1) the prevalence of hearing impairment; (2) the influence of the universal hearing screening program on the age at which the diagnosis of hearing loss is defined; (3) the cost effectiveness of the program; (4) the outcomes, in terms of the age in which the hearing rehabilitation started. Methods A descriptive study of the first 3 years after starting the universal newborn hearing screening in a Public Hospital of Bauru, São Paulo state, Brazil. The screening method consists of a two-stage screening approach with transient otoacoustic emissions (TOAE), conducted by an audiologist. If the outcome in the second-stage screening is REFER, the infant is submitted to diagnostic follow-up testing and intervention at the Audiology and Speech Pathology Clinic at the University of São Paulo, campus of Bauru. The evaluation of the costs of the universal newborn hearing screening program per each screened newborn (around 4000/year) was done based on a proposal by the National Center for Hearing Assessment and Management, of the Utah State University, United States of America. Results 11,466 newborns were submitted to hearing screening, corresponding to 90.52% of the living newborns. The prevalence of sensorineural hearing loss was 0.96:1000. Of the 11 children with sensorineural hearing loss, eight children received hearing aids and five started the therapeutic process before the age of 1. Currently, four children between the ages of 11 months and 2 years old were submitted to cochlear implant surgery. The cost of hearing screening was US$7.00 and the annual cost of the universal newborn hearing screening program was US$26,940.47. Conclusion The hospital-based universal newborn hearing screening carried out through the Brazilian National Health System is viable, with promising results. However, in a country such as Brazil, which presents large socio-economic differences, the same type of analyses should be performed in several regions, so as to take into account specific aspects, to implement the newborn hearing screening along with the Public System.