Newborn Hearing Screening Benefits Children, but Global Disparities Persist

Abstract

There is substantial evidence that newborn hearing screening (NHS) reduces the negative sequelae of permanent childhood hearing loss (PCHL) if performed in programs that aim to screen all newborns in a region or nation (often referred to as Universal Newborn Hearing Screening or UNHS). The World Health Organization (WHO) has called in two resolutions for the implementation of such programs and for the collection of large-scale data. To assess the global status of NHS programs we surveyed individuals potentially involved with newborn and infant hearing screening (NIHS) in 196 countries/territories (in the following text referred to as countries). Replies were returned from 158 countries. The results indicated that 38% of the world’s newborns and infants had no or minimal hearing screening and 33% screened at least 85% of the babies (hereafter referred to as UNHS). Hearing screening programs varied considerably in quality, data acquisition, and accessibility of services for children with PCHL. In this article, we summarize the main results of the survey in the context of several recent WHO publications, particularly the World Report on Hearing, which defined advances in the implementation of NHS programs in the Member States as one of three key indicators of worldwide progress in ear and hearing care (EHC).

Influence of screening devices and protocol on audiological outcome of 25 years of universal neonatal hearing and vestibular screening in Flanders

“…Neuman et al, 2021 assessed the hearing screening protocols around the world for 158 countries, representing 95 % of the world's population. 14 They showed that less than one-third of the world's newborns were enrolled in UNHS programs covering at least 85 % of all babies. 14 In the EUSCREEN project 15 the pooled coverage range for all children (high and low-risk) was 97,9 % and the median 96 % (range 79-100 %) for 26 European NHS programs plus Russia, Malawi, Rwanda, India and China.…”

“…14 They showed that less than one-third of the world's newborns were enrolled in UNHS programs covering at least 85 % of all babies. 14 In the EUSCREEN project 15 the pooled coverage range for all children (high and low-risk) was 97,9 % and the median 96 % (range 79-100 %) for 26 European NHS programs plus Russia, Malawi, Rwanda, India and China. 16 Moreover 20 out of 26 programs had a coverage of 95 % or higher.…”

“…In a worldwide evaluation of 158 countries Neumann et al 2021 showed that OAE was the preferred method in 57% of the countries, followed by OAE-AABR (30 %) and AABR only (11 %). 14 We use a two-step procedure with AABR on both occasions > 72 h and before 3-6 weeks after birth.…”

“…16,17 Screening within 24 hours after birth may result in a high referral rate because of amniotic fluid in the middle ear. In the EUSCREEN project the referral rate was 6-22 % when screening was performed < 24 h from birth, 2-15 % between 24 and 75 h after birth and 4 % > 72 h. 14 From our program only data on the second step are available with referral rates corresponding to the results of 3-4 steps screening including AABR in the literature.…”

Newborn Screening by Genomic Sequencing: Opportunities and Challenges

“…Economic analysis of newborn screening by GS is particularly complex when it overlaps with an existing screen. For countries with newborn hearing screening [ 67 ], will adding a screen by GS be economically beneficial? Because of the marginal cost of adding genes connected to hearing loss to a panel that already contains several hundred treatable disorders, the potentially small improvement in detection of infants who have or will develop hearing loss in early childhood may, nevertheless, prove worthwhile.…”