Assessment of the feasibility and coverage of a modified universal hearing screening protocol for use with newborn babies of migrant workers in Beijing

Abstract

BackgroundAlthough migrant workers account for the majority of newborns in Beijing, their children are less likely to undergo appropriate universal newborn hearing screening/rescreening (UNHS) than newborns of local non-migrant residents. We hypothesised that this was at least in part due to the inadequacy of the UNHS protocol currently employed for newborn babies, and therefore aimed to modify the protocol to specifically reflect the needs of the migrant population.MethodsA total of 10,983 healthy babies born to migrant mothers between January 2007 and December 2009 at a Beijing public hospital were investigated for hearing abnormalities according to a modified UNHS protocol. This incorporated two additional/optional otoacoustic emissions (OAE) tests at 24–48 hours and 2 months after birth. Infants not passing a screening test were referred to the next test, until any hearing loss was confirmed by the auditory brainstem response (ABR) test.ResultsA total of 98.91% (10983/11104) of all newborn children underwent the initial OAE test, of which 27.22% (2990/10983) failed the test. 1712 of the failed babies underwent the second inpatient OAE test, with739 failing again; thus significantly decreasing the overall positive rate for abnormal hearing from 27.22% to 18.36% ([2990–973 /10983)]; p = 0). Overall, 1147(56.87%) babies underwent the outpatient OAE test again after1-month, of whom 228 failed and were referred for the second outpatient OAE test (i.e. 2.08% (228/10983) referral rate at 1month of age). 141 of these infants underwent the referral test, of whom 103 (73.05%) tested positive again and were referred for a final ABR test for hearing loss (i.e. final referral rate of 1.73% ([228-38/10983] at 2 months of age). Only 54 infants attended the ABR test and 35 (0.32% of the original cohort tested) were diagnosed with abnormal hearing.ConclusionsOur study shows that it is feasible and practical to achieve high coverage rates for screening hearing loss and decrease the referral rates in newborn babies of migrant workers, using a modification of the currently employed UNHS protocol.

Follow-up in newborn hearing screening – A systematic review

“…Factors for Loss to follow-up Educational disparities and lack of knowledge among parents [24,25,28,34,35,52,65,67,74] Distance [26,30,33,48,52,54,62] Work constraints [24,26,33,35,54] Unfavorable attitudes [25,49,62,67,73] Less priority given to hearing compared to other medical conditions by parents [40,62,71,73] Rescreened at some other center [34,40,48] Inaccurate contact details [35,54,72] Change of Address [33,54,68] Superstitious and cultural beliefs [24,49,54] Barriers to adequate healthcare [65,71,74] Financial constraints [28,52,…”

“…Measures to increase follow-up Database management system [28,38,60,63,64] Increased parental education [25,26,40,54] Telephone reminders [24,35,46,60] Multidisciplinary team [33,50,71] Flexibility in scheduling appointments [26,48] Visual reminders and written reports [60,71] Financial support [63,64] Handouts to parents [24,71] Psychological support [50,63] Counselling [25,46] Centralized screening facility [58] Scheduling at the time of immunization [47] Minimizing repeat visits [54] Verbal reminders [23] Text message/letters/reminders (single or in combination) [73] Reminders by community health care workers through home visits [60] Knowledge of local language and culture by screening personnel [60] Collaboration of state programs [68] Increasing knowledge of medical staff [40] Hearing screening reports sent to primary care physicians [71] Free screening and follow-up testing [33] Increasing knowledge of prospective mothers that hearing screening is of no harm [33] Scheduling follow-up testing at one week rather than six weeks…”

Identifying the optimal age to perform newborn screening for hearing loss in Uganda

“…as well as other recent publications. [ 9 14 15 16 17 ] While our newborn pass rate of 56.7% reflects a lower than average pass rate, there are numerous factors that explain this. First, 63.3% of the newborn infants screened in this study were <24 h old, which is shown to be associated with a lower pass rate.…”

Feasibility of newborn hearing screening in a public hospital setting in South Africa: A pilot study

“…Some of these studies have focused on coverage rates, referral rates and tracking systems associated with UNHS (Ng, Hui, Lam, Goh & Yeung, 2004 ; Pisacane et al ., 2013 ). Other studies have focused on the feasibility in terms of the type of screening protocol employed (Kumar et al ., 2014 ; Qi et al ., 2013 ). Feasibility studies are commonly performed in many clinical areas.…”