Infant hearing screening at immunization clinics in South Africa

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

“…Emerging evidence from pilot community-based IHS programs has demonstrated the value and feasibility of this platform [15,17,19]. A higher yield of permanent congenital and early-onset hearing loss was reportedly detected at community level compared to that of the hospitalbased screening programs in Nigeria [19].…”

“…Universal newborn hearing screening (UNHS) programs are considered the gold standard in facilitating early detection and intervention for hearing loss and yield the best outcomes in terms of language and speech improvements in service provision suited to each context and may serve as examples for future program implementation on a wider scale [13]. This is important because Western models of hospital-based IHS for newborns may not be appropriate for the majority of developing countries [11,14,15].…”

On the threshold of effective well infant nursery hearing screening in Western Sicily

“…After the first stage screening in fact, our overall referral rate was 3.64% with a percentage value of false positives of only 3.34%; therefore we obtained, just with the first step, lower value than the most TEOAE based screening programmes from other countries such as Malaysia (12%), South Africa (11.1%), Oman (11%), Pakistan (10.2%) and Polonia (4.4%) maintaining a good coverage percentage [7,14,25,26,29]. The specificity value after first step screening was 96.7 AE 1.6% and, this percentage increased to 98.78 AE 0.3% after the second stage screening with a total number of 51 referred, 41 of which false positives (1.21%) ( Table 2).…”

“…In our pilot study, even if babies underwent screening in the third week of life, after discharge with a consequent higher risk of loss from the screen with respect to those screened before discharge, the coverage rate ranged from 90% to 92.71% with a mean value of 91% in line with JCHI, comparable to the coverage of Mexico, Hong Kong, Brazil and higher than those of 85% in Malaysia, 67% in Oman and 45% in South Africa [14,16,[23][24][25][26].…”

“…Therefore, according to the presence/absence of the audiologic risk factors, the newborns were divided into two groups: newborn with risk factor and newborn without risk factor. Family Checklists, separate for babies with or without audiological risk factors, have been developed as a type of ''roadmap'' for parents and providers of newborns, that were also trained on how ''Refer'' outcomes during the various stages of screening were not to be presented as evidence of hearing loss but rather as indication for further tests to rule out any uncertainty regarding the hearing status of the child; moreover, to not cause undue anxiety, it was decided to test the newborns at twentieth day after birth, corresponding to the second postnatal check without additional cost for 'maternity unit' [5,14]. In fact in absence of a specialist screener, and according to data literature we realized that by subjecting newborns to TEOAEs before discharge, within three days of life, there was a high percentage of ''Refer'' (false positive) also due to moisture, that is the birth debris and retained fluid in the ear canal [15][16][17][18].…”