International Journal of Pediatric Otorhinolaryngology
Newborn hearing screening in a developing country: Results of a pilot study in Abidjan, Côte d’ivoire
Introduction
Hearing impairment in childhood may be conductive or sensorineural or a combination of both. Impairments affect one or both ears, vary from mild to profound in degree, and may be congenital or acquired, transient, recurrent, or permanent. Permanent hearing loss is the most common sensory birth defect [1], [2]. Bilateral early and permanent childhood hearing impairment, of moderate or greater degree, can be expected to lead to major deficiencies in the development of language as well as secondary effects on the child [2]. Therefore, failure to recognize the presence of hearing loss in early childhood can severely harm the development of the child.
Universal newborn hearing screening is now considered as essential in public health care for the early detection and intervention for childhood hearing impairment [3], [4]. In our developing country, there is neither a consensus for systematic detection of child hearing loss, nor a management program for this sensorial disability. Most of the children are diagnosed at 3 or 4 years old [5] and less than 1 infant per 5 can benefit from hearing aids, the only therapeutic option currently available in our country. The aim of this study was to investigate the feasibility of neonatal hearing screening in Abidjan (Côte d’Ivoire).
Section snippets
Location and setting
This study was conducted in Abidjan, the economic capital of Côte d’Ivoire. We selected 2 healthcare centers that offered routine BCG (bacillus of Calmette and Guerin) immunization 5 days a week (from Monday to Friday) and two neonatal intensive care units (NICU) located in 2 of the 3 teaching hospitals of the city. The BCG vaccination is the first and obligatory vaccination given to children, usually in the first week of life, and is offered with no charge. The diagnostic tests were made in a
Screening coverage
In total, 150 newborns were recruited in neonatal units and 1156 in primary health care centers. Two parents in neonatal units (2/152) and 187 mothers in primary care centers (187/1343) declined the test, giving a final screening coverage of 87.4% (1306 tested/1495 babies present on the sites during the study). The average age of the population was 4.5 days (standard deviation S.D.: 2.7 days) with 5.85 days (S.D.: 3.17) for the immunization group and 3.20 days (S.D.: 0.40) for the neonatal unit
Discussion
At the end of this project, we found 6 per 1000 babies with early hearing impairment. It's higher than results of most screening studies in developed countries which report 1–3 cases of permanent childhood hearing loss (PCHL) per 1000 live births [1], [6], [7], [8], [9], when mild or unilateral hearing loss is also including. Our rate could be underestimated if we take into consideration the number of newborns whose audiological status was not determined by the screening.
It is known that early
Conclusion
Generalized hearing screening in newborns, as recommended by several health programs, is necessary in Côte d’Ivoire, taking into consideration the prevalence of early or congenital hearing loss which is about 6 in 1000 in our study. This higher rate in our context must allow authorities to introduce current arrangements for hearing screening in infancy. It is possible to implement such a hearing screening in primary health cares centers and neonatal intensive care units targeting all newborns,
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