Avaliação da qualidade de um programa de Triagem Auditiva Neonatal em um hospital público do Rio Grande do Norte

Introduction: Neonatal Hearing Screening (NHS) is essential for identification hearing loss in a timely manner. In Brazil, there are disparities between the programs that provide NHS, pointing to the need to monitor them. Purpose: to evaluate the quality indicators of a NHS program at a hospital located in Rio Grande do Norte. Methodology: this is a retrospective study, using secondary data, whose population consisted of live births, between the years 2015 and 2019. Universality indicators, retest rates, retest follow-up and referral for diagnosis were considered hearing loss, age at completion of NHS, attendance at diagnosis and conclusion and initiation of speech therapy and Hearing Aid (HA) fitting. Percentages and averages were calculated. Results: the average of the universality indicator was 67.2%. As for the retest, there was variation between 6.1 and 10.4%, while the follow-up of the retest ranged from 38 to 65.4% and the referral rate for auditory diagnosis, from 0.8 to 1.5 %. The percentage of neonates who underwent screening before 30 days was 97.4%. Throughout the study period, attendance at the diagnosis and conclusion, initiation of speech therapy and fitting of HA were not achieved. Conclusion: in the investigated program, only the index indicators of retesting, referral for auditory diagnosis and age of completion of NHS are within the recommended range.Introdução: a Triagem Auditiva Neonatal (TAN) é essencial para a identificação da deficiência auditiva em tempo oportuno. No Brasil, há disparidades entre os programas que fornecem a TAN, apontando para a necessidade de monitorá-los. Objetivo: avaliar os indicadores de qualidade de um programa de TAN em um hospital localizado no Rio Grande do Norte. Metodologia: trata-se de um estudo retrospectivo, com uso de dados secundários, cuja população consistiu nos nascidos vivos, entre os anos de 2015 e 2019. Foram considerados os indicadores de universalidade, os índices de reteste, follow-up do reteste e encaminhamento para diagnóstico auditivo, a idade de conclusão da TAN, o comparecimento ao diagnóstico e conclusão e o início da terapia fonoaudiológica e adaptação de Aparelho de Amplificação Sonora Individual (AASI), calculando-se porcentagens e médias. Resultados: a média do indicador de universalidade foi de 67,2%. Quanto ao reteste, houve variação entre 6,1 e 10,4%, ao passo que o follow-up do reteste oscilou de 38 a 65,4% e o índice de encaminhamento para diagnóstico auditivo, de 0,8 a 1,5%. A porcentagem de neonatos que realizaram a triagem, antes dos 30 dias, foi de 97,4%. Em todo o período estudado, o comparecimento ao diagnóstico e conclusão, início de terapia fonoaudiológica e adaptação de AASI não foram alcançados. Conclusão: no programa averiguado, apenas os indicadores índices de reteste, encaminhamento para diagnóstico auditivo e idade de conclusão da TAN encontram-se dentro do preconizado

Time trend of audiological procedures in the Brazilian Public Health System

ABSTRACT Purpose: to analyze the time trend of audiological procedures in the Brazilian Public Health System (SUS) between 2008 and 2019 in the geographical regions of Brazil. Methods: a time series ecological study with data on audiological procedures from the SUS Outpatient Information System. The study calculated annual indices of audiological procedures with joinpoint regression for the trend analysis. The progress in the provision of procedures between the initial and final years in the series and the distribution of identified records was calculated. Results: altogether, 38,500,404 records were found in the study period. The South (178.84/10,000 inhabitants) and North of Brazil (130.97/10,000 inhabitants), respectively, had the highest and lowest mean procedure indices. Both were the only regions with a trend towards a significant increase in procedures. In Brazil, they increased by 56.91%, with an emphasis on the increase in “otoacoustic evoked emissions in neonatal hearing screening” and a decrease in “visual reinforcement audiometry (air/bone conduction).” In the distribution, procedures concentrated on basic audiological assessments. Conclusion: audiological procedures have increased at SUS, but there are discrepancies between procedures and geographical regions of Brazil

The prevalence of risk for hearing impairment in newborns with congenital syphilis in a newborn hearing screening program (NHS)

ObjectiveTo study the prevalence of risk for hearing impairment in neonates with congenital syphilis in a newborn hearing screening program.Study designThe study design is retrospective, documentary, and is cross-sectional. The sample consisted of newborns who were born between January 2019 and December 2021 and who underwent neonatal hearing screening in a public maternity hospital. Demographic data and the presence and specification of risk indicators for hearing impairment (RIHL) were collected. In retest cases, the results and the final score were also collected. For data analysis, the Kruskal–Wallis and Conover-Iman post-hoc tests were used, comparing the groups that passed and failed the hearing screening that had RIHL, using a significance level of p of <0.5.ResultsAmong the RIHL observed in the sample, prematurity was more frequent in newborns who passed the screening (55.26%) than in those who failed the test (45.67%). Congenital syphilis was the ninth most frequent RIHL (8.04%) among the newborns who passed the test and the 15th factor (3.03%), with the highest occurrence in those who failed the hearing screening. When comparing the two groups (pass and fail), we found significant differences (p < 0.05) between them.ConclusionCongenital syphilis was the ninth risk indicator for the most common hearing impairment and, in isolation, did not present a risk for failure in neonatal hearing screening. Notably, congenital syphilis can cause late hearing loss during child development. Thus, there is an indication of audiological monitoring of these neonates