Newborn hearing screening coverage and detection rates of hearing impairment across China from 2008-2016

Xuelian Yuan,Liangcheng Xiang,Yongna Yao,Jun Zhu,Kui Deng,Hanmin Liu,Xiaohong Li,Qi Li

doi:10.1186/s12887-020-02257-9

Abstract

BackgroundNewborn hearing screening (NHS) can reduce the economic and social burden of hearing impairment. To track the progress of the goal set by the National Program of Action for Child Development (NPACD) and to estimate the detection rates of hearing impairment, the present study examined NHS coverage in 2008–2010 and 2016 and the detection of hearing impairment across China in 2016.MethodsLicensed medical institutions across China were surveyed in 2012 and 2018 by the National Center for Birth Defects Monitoring of China to collect data for the 2008–2010 period and for 2016 on live births, initial screening rates (total and referral), secondary screening rates (total and referral), and rates of hearing impairment diagnosis among infants who were referred in the secondary screening. To calculate universal newborn hearing screening (UNHS) coverage, the number of newborns who received NHS within 4 weeks after birth was divided by the number of live births. The detection rate of hearing impairment was calculated by combining referral rates on primary and secondary screening with the rate of diagnosis.ResultsNational UNHS coverage increased from 29.9% in 2008 to 86.5% in 2016, with different regions showing different increases. During this period, the number of provinces with UNHS coverage over 90.0% increased from 2 to 17, with UNHS coverage in 2016 being substantially higher in eastern provinces (93.1%) than in western provinces (79.4%). In 2016, the detection rate of hearing impairment across the country was 0.23% (95% CI 0.15–0.25%), and it varied from 0.17% in western provinces to 0.22% in central provinces and 0.28% in eastern provinces. The lowest rate was 0.02% in Heilongjiang Province and the highest rate was 0.63% in Hainan Province.ConclusionsNational UNHS coverage increased substantially from 2008 to 2016, although provinces and regions still showed differences. The detection rate of infant hearing impairment in China is comparable to that in other countries. A national individual-level information system is urgently needed in China to facilitate the integration of screening, diagnosis and treatment of infant hearing impairment, which may also lead to a more accurate estimate of the detection rate.

Highlights

Newborn hearing screening (NHS) can reduce the economic and social burden of hearing impairment
According to the Regulation of Neonatal Disease Screening promulgated by National Health Commission of China (NHCC) in 2009 [15], all the medical institutions providing NHS or hearing impairment diagnosis should be licensed by the provincial health administrative department
The licensed NHS institutions are responsible for the primary screening and secondary screening of newborns who were referred in the primary screening, and the referral of newborns who were referred in the secondary screening

Summary

Introduction

Newborn hearing screening (NHS) can reduce the economic and social burden of hearing impairment. Newborn hearing screening (NHS) can effectively enable the diagnosis of hearing impairment and intervention during the first 6 months, ensuring better outcomes for children [1, 4, 5]. Such screening may reduce special education costs by up to 37%, saving children from the need for up to 12 years of special classes for deaf children [6]. NHS lags behind in many developing countries [11], reflecting a lack of financing for equipment; a lack of audiologists and newborn health workers, especially in rural areas; families’ concern over costs, which leads them to refuse NHS for their infants or refuse followup when indicated; and the discharge of neonates in less than 24 h, which prevents timely NHS [11]

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Results

Discussion

Conclusion