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

2020 ◽  
pp. 096914132097306
Author(s):  
Yun Ai Wong ◽  
Rafidah Mazlan ◽  
Noor Alaudin Abdul Wahab ◽  
Roslan Ja’afar ◽  
Nurul Huda Bani ◽  
...  

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.

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_1) ◽  
pp. 1202-1206 ◽  
Author(s):  
Cheryl B. Prince ◽  
Lloyd Miyashiro ◽  
Yusnita Weirather ◽  
Patricia Heu

Objective. Universal Newborn Hearing Screening began in 2 Honolulu hospitals in 1992, and by 1999, all 14 civilian birthing facilities in Hawaii were providing screening. Examination of 1998 Hawaii data indicated that approximately 13% of infants who did not pass initial hearing screening in the hospital did not return for the indicated follow-up. The purpose of this study was to determine the epidemiologic profile of infants who were born in 1999 and did not return for follow-up. Methods. A population-based, cohort study of the hearing screening completion rates among the 13 civilian birthing facilities in Hawaii that provided data to the Department of Health was conducted. Analysis included a bivariate analysis of the demographic characteristics of infants who completed the screening/follow-up process compared with those who did not and logistic regression modeling to ascertain the demographic profile of infants at high risk for being lost to follow-up. Results. Of 12 456 infants, hearing screening data could be linked to the birth certificate file, and a final disposition regarding completion of the screening/follow-up process was determined for 10 328 (83%). Less than 2% (n = 176) of the linked infants failed to complete the screening/follow-up procedures. Low birth weight and white infants and infants born to women who had not completed high school were approximately twice as likely not to complete the screening as were their normal birth weight or nonwhite counterparts. Conclusions. Failure to complete the hearing screening follow-up may be related to cultural differences that have been previously reported in other maternal and child health studies of the diverse populations in Hawaii. The results of this study will allow the Hawaii Newborn Hearing Screening Program to target its efforts and limited resources toward infants who are at higher risk of not completing the screening and who may need special attention to encourage their mothers to complete the screening process, and to move quickly with rescreening infants whose initial tests are positive so that infants are not lost to follow-up.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Doncarli ◽  
H Tillaut ◽  
V Goulet

Abstract Background The French newborn hearing screening programme set up in 2014 aims to identify affected children as early as possible to allow appropriate care. Our goal was to evaluate the implementation of this programme at the national level. Methods The programme consist in a screening using a test (T1) and a retest (T2) in the maternity hospital in all newborns. In some region, a delayed test (T3) is performed afterwards in children for whom it was not possible to confirm normal hearing. Children suspected of deafness subsequently enter the diagnosis phase. We defined evaluation indicators after stakeholders consultation. We developed a web application to collect aggregated data on live births. We estimated the rate of coverage, refusal, children suspected of hearing loss at the end of the screening phase and the prevalence of bilateral deafness. Results In 2015, one year after the initiation of the programme, the coverage rate was already very high (88%) and even more so in 2016 (96%). Parental acceptance was very good (refusal: 0.1%). By the end of 2016, 19 out 27 regions had added a T3. The rate of suspicion of bilateral hearing loss was decreased by using a T3 (1.4% vs 0.9%). Bilateral deafness rate, estimated after a 2-years follow up, was 1.3‰ although it was estimated only on 51.5% of suspected children for whom diagnosis data had been transmitted. Conclusions The objective of a 90% coverage set by the French ministry of health has been met after 2 years of operation of the program. T3 appears useful in relieving diagnostic structures from false positives. Our estimated prevalence of bilateral deafness could be more accurate if data collection was improved but is consistent with prevalence reported in North America. Key messages The universal newborn hearing screening program has been successfully set up in France in terms of coverage. Future work should focus on improving the collection of follow up data to better characterise diagnosed children.


2021 ◽  
Vol 104 (1) ◽  
pp. 95-99

Objective: 1) To share the experience in establishing the first province to set up the universal newborn hearing screening (UNHS) in Thailand. 2) To report the results of four consecutive years of UNHS in Trang. Materials and Methods: All newborns in Trang province, between October 2013 and September 2017, who received UNHS, were included in this study. The present study was a descriptive study. Results: There were three main obstacles to be solved to establish the program. There was no supported budget from the central government to run the UNHS. There was a lack of audiologists or trained personnel to run the UNHS. Finally, there was no province in Thailand that has done the project before. A budget for the Trang’s UNHS project was allocated, which was 3,100,000 baht from the Trang provincial administrative organization, to purchase hearing screening machines for every community hospital. The personnel to run the UNHS, which were nurses, were trained in every hospital. The protocols, referral, and follow-up programs were newly designed to establish the hospital network for the program. There were 28,254 newborns in Trang and 27,983 (99.04%) were screened. The high-risk newborns were 1,415 (5.1%). The low-risk group was 26,568 (94.9%). The referral rate of transient evoked otoacoustic emission (TEOAE) was 5.9%. In the low-risk past screening group, there was one newborn (0.005%) that presented later with delayed speech and profound hearing loss after 1½ years and the MRI showed bilateral IAC stenosis. There were two newborns with severe hearing loss, one was Mondini dysplasia, and the other was normal on imaging, in 169 unpassed low-risk newborns. In the high-risk group, 73 (5.2%) were unpassed. After diagnostic tests, 71 (97.2%) were normal, one had severe hearing loss with normal imaging, and the other had bilateral microtia. The incidence of bilateral severe SNHL in high-risk newborn was (1/1,415) 0.71:1,000 births. The incidence of bilateral severe SNHL in low-risk newborn was (3/26,568) 0.11:1,000 births. After two years of follow-up, there was no delayed speech due to hearing loss in all the present study newborns. Conclusion: The rate of congenital hearing loss is not as high as in the literature, but the UNHS is still important to the newborns and their parents. Keywords: UNHS in Trang, Province-based UNHS, Incidence of hearing loss in newborn


2001 ◽  
Vol 60 (2) ◽  
pp. 123-130 ◽  
Author(s):  
Anna H Messner ◽  
Melissa Price ◽  
Karen Kwast ◽  
Kimber Gallagher ◽  
Joan Forte

2019 ◽  
Vol 32 (12) ◽  
pp. 767
Author(s):  
Catarina Oliveira ◽  
Marta Machado ◽  
Raquel Zenha ◽  
Luísa Azevedo ◽  
Luísa Monteiro ◽  
...  

Introduction: Congenital deafness or early acquired deafness affects 1 to 3 out of 1000 newborns without risk factors and 20 to 40 out of 1000 newborns with risk factors. The universal newborn hearing screening enables its early identification. Children with congenital deafness/early acquired deafness have a higher prevalence of other conditions, especially ophthalmologic and neurodevelopmental ones, and at least 30% to 40% have at least one associated comorbidity.Material and Methods: We carried out a cross-sectional, multicenter study in which 83% (n = 30) of the hospitals/maternity hospitals of the National Health Service participated.Results: All surveyed hospitals/maternity hospitals routinely performed universal newborn hearing screening to all newborns before discharge; 63% referred children with risk factors for hearing loss to Otorhinolaryngology. All children with congenital deafness/early acquired deafness are referred to: Pediatrics in 23% hospitals/maternity hospitals. In 23 hospitals/maternity hospitals, all children with congenital deafness/early acquired deafness are referred to: Speech Therapy in 44% hospitals/ maternity hospitals; Ophthalmology in 17% hospitals/maternity hospitals; National System of Early Intervention in Childhood in 30% hospitals/maternity hospitals; 22% of hospitals/maternity hospitals refer all children with congenital deafness/early acquired deafness, with no identified cause, to Clinical Genetics clinics. The number of diagnoses of deafness in the years 2014 and 2015 was 2.5 and 1.5 per 1000 newborns, respectively, in 15 hospitals/maternity hospitals.Discussion: Awareness of universal newborn hearing screening seems to be widely spread in the National Health Service. The number of children with SC / SPA, as well as the percentage of different types of deafness diagnosed, were identical to those found in other studies and shows its importance. The assessment / follow-up of these children by specialties other than the otolaryngology was heterogeneous in different health entities and revealed that not all children with risk factors for deafness follow up advised by existing standards.Conclusion: Results show that Portugal made an important path in the screening and follow-up of children with SC / SPA. It is important, with the ultimate aim of continually improving the care of these children, to reflect on the involvement of specialties other than otolaryngology, such as the National Early Childhood Intervention System in the follow-up of these children.


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