Universal newborn screening: a dream realized or a nightmare in the making?

Abstract

There is a very strong movement to develop universal newborn hearing screening. This effort is the end product of a long international research effort to determine the most effective means to screen newborns. Now that OAE and ABR together offer a superior mechanism to achieve universal screening, problems related to middle ear effusion, non-high-risk children and adequate resources for all aspects of identi cation, diagnosis and treatment have come to the fore. Further, what to do in the developing world is also a major problem as audiology embarks on this exciting new frontier. This paper discusses some of the issues, raises some concerns and offers a few small solutions.

A pilot project on hospital-based universal newborn hearing screening: Lessons learned

“…As such, hospitals implementing UNHS must be able to provide screening failures with the required follow-up services. In developing countries where funding and resources are sparse screening programme must be extremely accurate and cost-efficient [18].…”

Benefits and challenges of newborn hearing screening for developing countries

“…The lack of relevant data in the developing world has been attributed to several factors. Among these are the prevailing poor socio-economic conditions [14], the overwhelming burden of fatal diseases on the limited resources available to these countries [26] and the unfavourable attitudes towards childhood hearing impairment [17]. Where surveys have been done, comparative analysis is often difficult due to significant differences in methodology, categorisation and case definitions of hearing impairment.…”

“…For example the extent of the problem of permanent childhood hearing loss has not been accurately established due to the dearth of appropriate epidemiological studies in the region [14]. Routine or systematic screening for childhood hearing impairment is rarely reported [15].…”

“…The costs associated with newborn screening and follow-up services as reported in the developed countries are generally regarded to be beyond the capacity of many developing countries [14]. As a result, the prevention of hearing impairment is promoted as the main goal, and perhaps the most viable option, for hearing healthcare policy [18].…”

Newborn hearing screening: what are we missing?

“…In developing world extent of the problem of permanent childhood hearing loss has not been accurately established due to the dearth of appropriate epidemiological studies in the region 7 . World Health Organisation (WHO) estimated that of the 78 million people suspected to have disabling hearing impairment in the developing world, 8 million were children under the age of 18 years 8 .…”