Quality measures of a multicentre universal newborn hearing screening program in Malaysia

Abstract

Objective To evaluate and discuss the outcomes of the universal newborn hearing screening program conducted at four public hospitals in Malaysia. Method A retrospective analysis of the universal newborn hearing screening database from each hospital was performed. The database consisted of 28,432 and 30,340 screening results of babies born in 2015 and 2016, respectively. Quality indicators (coverage rate, referral rate, return for follow-up rate, and ages at screening and diagnosis) were calculated. Results Overall coverage rate across the four hospitals was 75% in 2015 and 87.4% in 2016. Over the two years, the referral rates for the first screening ranged from 2.7% to 33.93% with only one hospital achieving the recommended benchmark of <4% in both years. The return for follow-up rates for each participating hospital was generally below the recommended benchmark of ≥95%. The mean age at screening was 3.9 ± 1.2 days and 3.3 ± 0.4 days, respectively. The mean age at diagnosis for 70 infants diagnosed with permanent hearing loss was 4.7 ± 0.7 months in 2015 and 3.6 ± 0.9 months in 2016. Conclusions Quality measures for the universal newborn hearing screening program in four public hospitals in Malaysia were lower than the required standards. Nevertheless, some quality indicators showed statistically significant improvements over the two years. Next steps involve identifying and implementing the best practice strategies to improve the outcome measures and thus the quality of the program.

Early hearing detection and intervention (EHDI) programmes for infants and young children in low-income and middle-income countries in Asia: a systematic review

“…Sixteen studies that reported a two-stage hearing screening protocol, employed OAE (TE/DP-OAE) or AABR as screening tests (individually or combined in either stage) 17–31. The other 25 studies used only OAEs (DP/TE)32–49 or AABR screening50 51 for testing in both stages.…”

“…Audiologists were the primary screening personnel in many newborn and infant programmes,17 30 34 38 44 48 54 59 61 62 83 84 followed by nurses 20 21 26 28 29 37 40 43 46 54 56 60 64. In five studies, the training provided for nurses to perform hearing screening was also briefly mentioned,28 29 40 46 60 including some certifications 56.…”

Knowledge and attitudes of primary care physicians regarding childhood hearing loss in Malaysia

“…Early hearing identification and intervention (EHDI) programs, including universal newborn hearing screening (UNHS), aim to detect hearing loss in infants by three months of age and initiate intervention by six months [ 4 ]. However, UNHS is not widely accessible in Malaysia [ 5 , 6 ]. Therefore, in developing countries like Malaysia, primary care physicians (PCPs) play a crucial role in identifying and intervening for childhood hearing loss as a first point of contact during well-child visits [ 7 ].…”