Why parents refuse newborn hearing screening and default on follow-up rescreening—A South African perspective

Scheepers, Luki-Marie; Swanepoel, De Wet; Roux, Talita le

doi:10.1016/j.ijporl.2014.01.026

Cited by 51 publications

(49 citation statements)

References 28 publications

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“…Internationally, loss to follow-up is one of the greatest challenges experienced in newborn hearing screening programmes with follow-up rates in the region of 50% often being reported [29,31,35]. In contrast, follow-up rates in the current study were encouragingly high for both technology groups.…”

Section: Follow-up Ratescontrasting

confidence: 57%

Newborn hearing screening at a community-based obstetric unit: Screening and diagnostic outcomes

Kock

Swanepoel

Hall

2016

International Journal of Pediatric Otorhinolaryngology

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Objective: Postnatal visits at community-based midwife obstetric units (MOUs) have been proposed as an alternative primary healthcare screening platform in South Africa. This study evaluated the outcomes of distortion product otoacoustic emissions (DPOAEs) and automated auditory brainstem response (AABR) screening conducted by a dedicated nonprofessional screener at a community-based MOU in the Western Cape, South Africa.Methods: Universal newborn hearing screening (UNHS) at a community-based MOU was evaluated over a 16-month period. A dedicated non-professional screener was trained to follow a two-stage screening protocol targeting bilateral hearing loss. A two group comparative design was used alternating AABR (Maico MB11 BERAphone TM) and DPOAE (Bio-logic AuDX I) technology on a daily basis. Infants referring the initial screen received a follow-up appointment in two days' time and were rescreened with the same technology used at their first screen.Those referring the second stage were booked for diagnostic assessments.Results: 7452 infants were screened including 47.9% (n=3573) with DPOAE and 52.1% (n=3879) with AABR technology. Mean age at first stage screen was 6.1 days. The initial bilateral referral rate was significantly lower for AABR (4.6%) compared to DPOAE (7.0%) and dropped to 0.3% and 0.7% respectively following the second stage screenings. First rescreen and initial diagnostic follow-up rates of 90% and 92.3% were obtained for the DPOAE group and 86.6% and 90% for the AABR group. Follow-up rates showed no significant difference between technology groups. Diagnostic assessment revealed a higher prevalence rate for bilateral sensorineural hearing loss among the AABR group (1/1000) compared to the DPOAE group (0.3/1000). Screening technology had no significant influence on daily screening capacity (23 AABR/day; 24 DPOAE/day). 3Conclusions: Postnatal visits at community-based MOUs create a useful platform for hearing screening and follow-up. AABR technology with negligible disposable costs provides opportunity for AABR screening to be utilised in community-based programmes. AABR screening offers lower initial referral rates and a higher true positive rate compared to DPOAE.

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Section: Follow-up Ratescontrasting

confidence: 57%

Newborn hearing screening at a community-based obstetric unit: Screening and diagnostic outcomes

Kock

Swanepoel

Hall

2016

International Journal of Pediatric Otorhinolaryngology

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“…In developing countries like South Africa where most newborns are discharged before 24 hours after birth, OAE screening is not ideal [36,45,46]. AABR is therefore recommended for NHS screening for these younger children.…”

Section: Discussionmentioning

confidence: 99%

Outcomes with OAE and AABR screening in the first 48h—Implications for newborn hearing screening in developing countries

Dyk

Swanepoel

Hall

2015

International Journal of Pediatric Otorhinolaryngology

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Objective: Early discharge of newborns (<24 hours after birth) from birthing centres is an important barrier to successful newborn hearing screening (NHS) in developing countries. This study evaluated the outcome of NHS within the first 48 hours using an automated auditory brainstem response (AABR) device without the need for costly disposables typically required, and transient evoked otoacoustic emissions (TEOAE).Methods: NHS was performed on one hundred and fifty healthy newborns (300 ears) with TEOAE and AABR techniques before discharge at a hospital. A three-stage screening protocol was implemented consisting of an initial screen with TEOAE (GSI AUDIOscreener+) and AABR (Beraphone MB 11). Infants were screened at several time points as early as possible after birth. Infants were only re-screened if either screening technique (TEOAE or AABR) initially yielded a refer outcome. The same audiologist performed all TEOAE and AABR screenings. Results:Over the three-stage screen AABR had a significantly lower refer rate of 16.7% (24/144 subjects) compared to TEOAE (37.9%; 55/145 subjects). Screening refer rate showed a progressive decrease with increasing age. For both TEOAE and AABR, refer rate per ear screened 24 hours post birth was significantly lower than for those screened before 24 hours. For infants screened before 12 hours post birth, the AABR refer rate per ear (51.1%) was significantly lower than the TEOAE refer rate (68.9%). Overall AABR refer rate per ear was similar for infants screened between 24 to 36 hours (20.2%) and 36 to 48 hours (18.9%) but significantly lower than for TEOAE (40.7% and 41.9%, respectively). Lowest initial refer rates per ear (TEOAE 25.8%, AABR 3.2%) were obtained after 48 hours post birth. Conclusion:In light of the early post birth discharge typical in developing countries like South Africa, in-hospital screening with AABR technology is significantly more effective than TEOAEs. AABR screening with a device like the MB 11 is particularly appropriate because disposable costs are negligible.2

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“…99 NHS services are presently not included in the routine antenatal educational package in LMICs. Even if it were, health workers would themselves need to be trained and convinced of the importance of NHS to ensure that women attending the antenatal clinics received adequate information on this essential service.…”

Section: Poor or Inadequate Information From Health Care Providersmentioning

confidence: 99%

Screening for neonatal deafness in resource-poor countries: challenges and solutions

Olusanya¹

2015

RRN

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Newborn or neonatal hearing screening (NHS) is offered routinely in high-income countries as an essential and mandatory intervention for the early detection of infants with permanent congenital or early-onset hearing loss. However, NHS is rarely offered presently in the vast majority of low-and middle-income countries, which account for over 80% of the incidence and burden of permanent congenital or early-onset hearing loss worldwide. This review provides an overview of the current status of NHS programs in the most developmentally disadvantaged low-and middle-income countries with a per capita income of approximately US$6,000 or less against the backdrop of relevant recommendations for effective NHS programs. It highlights the key obstacles to the delivery and uptake of NHS services based on a review of available literature from the eligible countries. It proposes strategies for addressing these challenges and examines the crucial role of pediatricians and primary care physicians in providing leadership for the requisite multidisciplinary efforts to develop and promote effective NHS services in low-and middle-income countries.

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Why parents refuse newborn hearing screening and default on follow-up rescreening—A South African perspective

Cited by 51 publications

References 28 publications

Newborn hearing screening at a community-based obstetric unit: Screening and diagnostic outcomes

Newborn hearing screening at a community-based obstetric unit: Screening and diagnostic outcomes

Outcomes with OAE and AABR screening in the first 48h—Implications for newborn hearing screening in developing countries

Screening for neonatal deafness in resource-poor countries: challenges and solutions

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