The occurrence of high-risk factors for hearing loss in verylow- birth-weight neonates: A retrospective exploratory study of targeted hearing screening

Abstract

The current study aimed at determining the type and frequency of high-risk factors for hearing loss in a group of very-low-birth-weight (VLBW) neonates in a tertiary hospital in South Africa with the objective of collating evidence that could be used in arguing for or against revisiting targeted hearing screening in developing countries. Furthermore, the study aimed at investigating the relationship between the identified high-risk factors and hearing screening results. In a retrospective data review design, data were collated from files from the VLBW project; this included hearing screening records, as well as records from participant medical and audiology files. Records of 86 neonates with birth weights ranging between 680 g and 1 500 g were reviewed. Findings indicated that neonatal jaundice, exposure to human immunodeficiency virus (HIV), mechanical or assisted ventilation, and neonatal intensive care unit stay greater than 48 hours were the most frequently occurring high-risk factors for hearing loss in the current sample. These factors are consistent with those listed in the high-risk register of the Health Professions Council of South Africa for the South African context. Findings confirm the complexity of risk factors, and the influence that a variety of factors such as poor follow-up or return rate might have on the implementation of early hearing detection and intervention. The importance of establishing context-specific risk factors for effective implementation of targeted screening protocols where universal newborn hearing screening is not yet a reality was highlighted by the current study.

Prevalence and risk factors associated with non-attendance in neurodevelopmental follow-up clinic among infants with CHD

“…Our findings are consistent with other studies documenting low rates of attendance in paediatric subspecialty or follow-up clinics 18 19 , 23 , 24 In a retrospective review of very low birth weight infants, follow-up rates for patients enrolled in neonatal high-risk follow-up clinics were documented at 28% 19 . Within this study, inadequate insurance coverage and distance from the clinic site were documented reasons for low follow-up rates 19 .…”

Knowledge and cultural beliefs of mothers regarding the risk factors of infant hearing loss and awareness of audiology services

“…The findings relating to prematurity, and jaundice requiring exchange blood transfusion, are consistent with other South African studies. 32 , 22 Swanepoel, Johl and Pienaar, 21 who focused on the nature of hearing loss and associated risk profile, found that hyperbilirubinemia was one of the most prevalent risk factor. Other risk factors included birth weight less than 1500 grams, syndromes present, congenital infection, craniofacial defect and bacterial meningitis.…”

“…A study conducted in Pretoria by Swanepoel, Johl and Pienaar 21 identified South African relevant risk factors to be admission to NICU for more than five days, asphyxia and low birth weight. Additional risk factors, as identified by Kanji and Khoza-Shangase, 22 but excluded in the JCIH list, 19 include prematurity and birth asphyxia. Furthermore, the prevalence of acquired disorders due to socio-economic conditions, such as otitis media, is a reality for many children in Africa.…”

Narrative review of EHDI in South Africa

“…More recent research activities (from 2012) have focused on retrospective and, less commonly, prospective review of audiology records. The prospective studies focused on using audiology records to determine the impact of risk factors for hearing loss in low birth-weight babies (Kanji & Khoza-Shangase, 2012 ) and a study of children with serous otitis media in one province (Tiedt et al, 2013 ). Findings from these studies correlated with previous findings of the late identification of hearing loss, audiology staff shortage, as well as that South African context specific risk factors should be developed if targeted screening is to be used for early identification of hearing loss.…”