Background: Hearing plays a vital role in developmental of a child. Hearing loss not only affects the speech and language development of a child but also affects the social, emotional and intellectual development. Hearing is important in the first 2 years of life as this is the critical period for language acquisition. Thereby early detection and intervention for hearing loss is recommended. However, there are no standard protocols for newborn hearing screening. Hence, this study is undertaken to evaluate the appropriate protocol for early detection of hearing impairment in newborns and to ascertain the sensitivity and specificity of Distortion Product Oto-acoustic Emission (DPOAE) and Auditory Brainstem Response (ABR).Methods: A prospective study was conducted in the Department of Paediatrics and Department of Audiology and Speech Pathology in SRM Medical College Hospital and Research Centre. A total of 122 neonates were screened for hearing loss using both DPOAE and ABR before discharge from the hospital. A rescreening with ABR after 1 month was done for those infants who had hearing loss at the initial screening.Results: The study revealed that 16.4% of infants had hearing loss. The referral rate of DPOAE was 54.1% and ABR was 16.4%. ABR had higher passing rates when compared to DPOAE. In a combined screening with both DPOAE and ABR, 17 (13.9%) babies had failed DPOAE with abnormal hearing in ABR (True positives), 49 (40.2%) babies failed DPOAE but had normal hearing in ABR (False positives), 3 (2.5%) babies passed DPOAE but had hearing loss in ABR (False negatives) and 53 (43.4%) babies passed DPOAE and had normal hearing in ABR (True negatives). The association between the results of DPOAE and ABR was statistically significant (0.002). Auditory neuropathy was detected in 3 out of 122 neonates. All these 3 babies belonged to high-risk population. The prevalence of auditory neuropathy is 2.5% which is much lower when compared to other studies. The sensitivity and specificity of DPOAE is 85% and 51.9% respectively. The sensitivity and specificity of ABR was 100%.Conclusions: Present study concludes that the use of combination protocol using both DPOAE and ABR identifies babies with auditory neuropathy spectrum disorder and also ensures high sensitivity and acceptable specificity. Thus, helps in early identification and intervention of congenital hearing loss.

INTRODUCTIONIn a developing country like India, there are many health problems in school children who are the wealth and future of our country, and they require special attention to meet their needs. Children spend most of their time at school which is not only an ideal place for learning and playing, but also for screening of health problems.Screening for health problems in children is an important aspect of any community health programme. A school health programme helps in early detection of health ABSTRACTBackground: School health programmes help in early detection of health problems but the literature about its effectiveness in India is sparse. Hence, this study was undertaken. The aim of the present study is to measure the weight, height and BMI in school children and to interpret it using the IAP growth charts, to estimate the prevalence of stunting, undernutrition, overweight, obesity, refractory errors, hearing impairment and dental caries in children and to compare the prevalence of above parameters among gender and age. Methods: This is a cross sectional study, conducted between January to March 2017 in 3 suburban schools in Chennai, Tamil Nadu. A total of 631 children in the age group of 6-18 years were screened by an expert team. Weight and height was measured using standard equipments, BMI was calculated and plotted on IAP growth charts. Vision was tested using Snellen chart by an optometrist. Dental evaluation was done by a dentist and hearing screening done by an audiologist using puretone audiometry. Statistical analysis was done using Chi-square test, P value of <0.05 was considered as significant. Results: Out of 631 children, 344 were boys and 287 were girls. 507 children belonged to the primary age group (6-12 years) and 124 children belonged to the secondary age group (12-18 years). The prevalence of stunting was 0.7% and was gradually decreasing with increasing age. The overall prevalence of thinness, overweight and obesity was 10.1%, 1.5% and 7.1% respectively. Underweight was more common among the primary age group whereas obesity was more commonly seen in secondary age group. The prevalence of weight abnormalities in both the age groups and sexes were statistically significant. 19% children had visual defects and the prevalence was more in older children. Dental caries was more commonly seen in primary dentition and the prevalence was 18.9%. Due to lack of ambient conditions, only severe hearing impairment was detected. 5 (0.8%) children had severe hearing impairment. Conclusions: The burden of health problems like malnourishment, refractory errors, dental caries and hearing impairment are high in school children. With the results of the present study, we can conclude that there is a need for implementation of school health screening programmes to detect these health problems at an early stage. To bring a significant change in the community, a dedicated national school health screening program is needed.

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