ETD Collection

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    Feasibility assessment of a universal newborn hearing screening programme at Rahima Moosa mother and child hospital
    (2016-10-17) Bezuidenhout, Jacqueline Kim
    Context: Universal Newborn Hearing Screening (UNHS) is not routinely performed in South African state-run hospitals. Early identification of hearing impairments and subsequent early intervention, results in improved speech and language development and overall better cognitive outcomes. Objectives: We aim to investigate the number of neonates which could be screened for hearing deficits using the currently available staff and equipment, at a single institution over a set period of time, and to describe the outcomes of the screening test. Design, setting and patients: A prospective feasibility assessment conducting screening hearing tests on neonates born at a secondary level hospital in Johannesburg, South Africa, during a three month period. Methods: Hospital-based Audiologists conducted a risk factor assessment, otoscopic examinations and Distortion-Product Otoacoustic emissions (DPOAE) testing on the ears of eligible neonates. Repeat testing was carried out on neonates who presented with refer findings on the screening test. Testing time and challenges encountered were recorded. Analysis: Data was entered into Microsoft Office Excel ©, and later analysed using STATA I/C version 11©. v Results: Of 2740 neonates born during the study period, 490 (17.9%) were identified for screening and DPOAE testing was conducted on 121 (4.4%). The majority (74.4%) were screened in the first 24 hours of life. Repeat testing was required in 57 (47.1%) neonates, but only 20 returned for follow-up. The presence of vernix caseosa and excessive ambient noise were factors negatively impacting on the screening process. No maternal or neonatal risk factors were found to be significantly associated with refer findings on the screening test. Conclusion: The existing staff was unable to screen a significant number of neonates using DPOAE testing during the study period. Implementation of UNHS under current circumstances at this research site would likely not be feasible. Key words: Universal Newborn Hearing Screening; feasibility study; resource-poor settings; otoacoustic emission; hearing loss.