27 research outputs found

    Community-based infant hearing screening in a developing country: parental uptake of follow-up services

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    <p>Abstract</p> <p>Background</p> <p>Universal newborn hearing screening is now considered an essential public health care for the early detection of disabling life-long childhood hearing impairment globally. However, like any health interventions in early childhood, parental support and participation is essential for achieving satisfactory uptake of services. This study set out to determine maternal/infant socio-demographic factors associated with follow-up compliance in community-based infant hearing screening programmes in a developing country.</p> <p>Methods</p> <p>After health educational/counselling sessions, infants attending routine childhood immunisation clinics at four primary care centres were enrolled into a two-stage infant hearing screening programme consisting of a first-stage screening with transient-evoked otoacoustic emissions and second-stage screening with automated auditory brainstem response. Infants referred after the second-stage screening were scheduled for diagnostic evaluation within three months. Maternal and infant factors associated with completion of the hearing screening protocol were determined with multivariable logistic regression analysis.</p> <p>Results</p> <p>No mother declined participation during the study period. A total of 285 out of 2,003 eligible infants were referred after the first-stage screening out of which 148 (51.9%) did not return for the second-stage, while 32 (39.0%) of the 82 infants scheduled for diagnostic evaluation defaulted. Mothers who delivered outside hospitals were significantly more likely to return for follow-up screening than those who delivered in hospitals (Odds ratio: 1.62; 95% confidence intervals: 0.98 – 2.70; p = 0.062). No other factors correlated with follow-up compliance for screening and diagnostic services.</p> <p>Conclusion</p> <p>Place of delivery was the only factor that correlated albeit marginally with infant hearing screening compliance in this population. The likely influence of issues such as the number of return visits for follow-up services, ineffective tracking system and the prevailing unfavourable cultural perception towards childhood deafness on non-compliance independently or through these factors warrant further investigation.</p

    Progress towards early detection services for infants with hearing loss in developing countries

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    BACKGROUND: Early detection of infants with permanent hearing loss through infant hearing screening is recognised and routinely offered as a vital component of early childhood care in developed countries. This article investigates the initiatives and progress towards early detection of infants with hearing loss in developing countries against the backdrop of the dearth of epidemiological data from this region. METHODS: A cross-sectional, descriptive study based on responses to a structured questionnaire eliciting information on the nature and scope of early hearing detection services; strategies for financing services; parental and professional attitudes towards screening; and the performance of screening programmes. Responses were complemented with relevant data from the internet and PubMed/Medline. RESULTS: Pilot projects using objective screening tests are on-going in a growing number of countries. Screening services are provided at public/private hospitals and/or community health centres and at no charge only in a few countries. Attitudes amongst parents and health care workers are typically positive towards such programmes. Screening efficiency, as measured by referral rate at discharge, was generally found to be lower than desired but several programmes achieved other international benchmarks. Coverage is generally above 90% but poor follow-up rates remain a challenge in some countries. The mean age of diagnosis is usually less than six months, even for community-based programmes. CONCLUSION: Lack of adequate resources by many governments may limit rapid nationwide introduction of services for early hearing detection and intervention, but may not deter such services altogether. Parents may be required to pay for services in some settings in line with the existing practice where healthcare services are predominantly financed by out-of-pocket spending rather than public funding. However, governments and their international development partners need to complement current voluntary initiatives through systematic scaling-up of public awareness and requisite manpower development towards sustainable service capacities at all levels of healthcare delivery

    Reliability of auditory steady-state response to bone conduction stimuli in assessing hearing loss in children

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    En Abstract Objective This study was designed to investigate bone Conduction (BC)/auditory steady state response (ASSR) in children with normal hearing, together with various types of hearing loss, to find out an objective method to differentiate between different types of hearing loss. Participants and methods A total of 80 children (with ages ranging between 3 and 6 years) were subjected to history taking, otological examination, and basic audiological evaluation in the form of pure-tone audiometry (air Conduction (AC), BC). Single monotic ASSR (AC, BC) was tested at 0.5, 1, 2, and 4 kHz. They were classified on the basis of hearing status into three categories (20 children each): category I, normal hearing; category II, sensorineural hearing Loss (SNHL) (subdivided into two groups: group 1, mild-to-moderate SNHL; and group 2, severe-to-profound SNHL), and category III, conductive hearing loss. Results BC thresholds were poorer for ASSR testing compared with thresholds obtained with behavioral testing in normal category using 9, 7.5, 5.5, and 10.5 dBHL at 0.5, 1, 2, and 4 kHz, respectively. In category II, in the mild-to-moderate SNHL group, it was poorer using 16.25, 5.75, 12.25, and 11.75 dBHL at the same measured frequencies. Minimum levels at which spurious BC/ASSR occurred were established in the group with severe-to-profound SNHL as 52, 66.5, 69, and 64 dBHL at 0.5, 1, 2, and 4 kHz, respectively (no BC/pure tone audiometry (PTA) could be measured). In conductive hearing loss (CHL) category, it was poorer using 12.5, 8.5, 9.5, and 9 dBHL at 0.5, 1, 2, and 4 kHz, respectively. Preliminary normal levels for BC/ASSR at 0.5, 1, 2, and 4 kHz were 23.5, 22.5, 20, and 25 dBHL, respectively. In children with conductive hearing loss, the average BC/ASSR thresholds corresponded closely to those in the normal-hearing group. Conclusion BC/ASSR thresholds could be recorded reliably in children with normal hearing and conductive hearing losses. Meanwhile, BC/ASSR may not provide a reliable measure in cases of SNHL, especially cases with moderate or greater loss due to the low levels at which spurious responses may occur
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