Infant hearing loss in South Africa: Age of intervention and parental needs for support

Abstract

Hearing loss is referred to as the silent, overlooked epidemic in developing countries, and data reporting the mean age of diagnosis and intervention is virtually non-existent due to limited systematic or routine screening programs. The objective of this paper is to present findings of recent practice in early diagnosis and intervention services in an urban South African context, with specific reference to parental needs for support. Data was collected by means of questionnaire surveys for 54 parents of children with congenital or early-onset hearing loss, followed by focus group discussions conducted with 10 parents. The results of this study indicate the mean age of diagnosis to be 23 months (+/-18 SD), the mean age of initial hearing-aid fitting to be 28 months (+/-19 SD), and the mean age of enrollment into an early intervention program to be 31 months (+/-19 SD). In addition, results signify that this diverse and challenging population of parents of young hearing-impaired children largely depends on the ongoing support, guidance, and commitment of the pediatric audiologist.

Profound childhood hearing loss in a South Africa cohort: Risk profile, diagnosis and age of intervention

“…On average, caregivers suspected hearing loss by 11.3 months of age, with a delay of 5.3 months until eventual diagnosis. In spite of the age of parental suspicion corresponding with a Nigerian sample [61], this study's results indicate ages of suspicion and diagnosis much earlier than recent South African reports [23][24][25]. Children with profound hearing losses are however known to be identified at earlier ages than children with less severe degrees of hearing loss, since the symptoms of profound hearing loss are more apparent and may prompt parents to seek audiological evaluation sooner [34].…”

“…As a result, the average age of hearing loss diagnosis in South Africa has been reported to be between 23 to 44.5 months [23][24][25], in contrast to the recommended age of 3 months [26].…”

“…Contextual data on profound childhood hearing loss, in particular, is non-existing. A report from the Western Cape province on a representative sample of 54 children with hearing loss, most (61%) with severe to profound hearing loss, indicated the average age of initial hearing aid fitting and enrolment in early intervention to be 28 and 31 months respectively [23]. A survey conducted amongst speech therapy and audiology departments within public sector hospitals in South Africa reported that within a sample of 76 children aged 18 months or younger that were fitted with hearing aids 12 months prior to the survey, less than 7% received hearing aids by the age of 6 months, as recommended [19,26,27].…”

“…However, the initiation of early intervention services are often delayed in the resource limited settings such as sub-Saharan Africa, where poor healthcare infrastructure, the lack of audiological services and widespread poverty impede the attainment of developed world benchmarks for intervention [4,23,26,35].…”

Efficacy of a community-based infant hearing screening program utilizing existing clinic personnel in Western Cape, South Africa

“…Although this is significantly lower than previous findings in the Western Cape of 23 months of age [37], it is higher than the recommended benchmark of 4 months of age for clinic-based screening programs [13]. It must also be noted that the mean age at first screen at the clinic was 7 weeks and at first tertiary hospital visit was 11.9 weeks of age for this sample group.…”