Referral and Lost to System Rates of Two Newborn Hearing Screening Programs in Saudi Arabia.

Ahmad A Alanazi

doi:10.3390/ijns6030050

Abstract

Congenital hearing loss has been commonly reported as a significant health problem. Lost to system (LTS) is a major challenge facing newborn hearing screening (NHS) programs. This retrospective cross-sectional descriptive study aimed to determine the referral and LTS rates after the two-stage NHS based on transient evoked otoacoustic emissions (TEOAEs) in two main hospitals in Riyadh, Saudi Arabia (SA). NHS was performed on newborns before hospital discharge. Newborns were only rescreened if NHS initially revealed a fail/refer outcome in one or both ears. Those who failed the first and second screenings or had risk factors were referred for auditory brainstem response (ABR) testing to confirm or exclude hearing loss. In total, 20,171 newborns (40,342 ears; 52% males; 48% females) were screened, of whom 19,498 (96.66%) passed the initial screening, while 673 (3.34%) failed. Of the 673 newborns, 235 (34.92%) were LTS, and 438 (65.08%) were rescreened, of whom 269 (61.42%) failed and were referred for a comprehensive audiological assessment to confirm the existence of hearing loss. The referral rate after the initial two-stage screening was equal to 1.33%. The lack of awareness of the importance of NHS among parents seems to be the major cause behind the LTS rate. The stakeholders have to work efficiently to reduce the LTS rate.

Highlights

34 million children around the world have hearing loss [1]
The number of newborns who were in the regular nursery, the number of unilateral or bilateral failed cases, the auditory brainstem response (ABR) results of those who failed the two-stage screening, and the Lost to system (LTS) rate after the second stage could not be verified according to the liImnti.tJe
Identification of hearing loss via newborn hearing screening (NHS) programs paves the way to early confirmation and intervention

Summary

Introduction

Congenital sensorineural hearing loss affects approximately 2–6 per 1000 newborns in low-, middle-, and highincome countries [2,3]. At least 90% of newborns with hearing loss live in less developed countries [4]. The prevalence of any type and severity of disability among Saudi citizens is 3.3% [5]. According to the General Authority for Statistics in Saudi Arabia (SA), 1.4% of all citizens have mild, moderate or severe hearing difficulties [6]. Previous Saudi studies showed different prevalences of hearing loss ranging from 1.75% to 7.12% [8,9]. The General Authority for Statistics in SA reported that 21.3% of disabilities among Saudi citizens are caused by congenital malformations [6]. Syndromic and non-syndromic hereditary hearing loss have been found in many families [10]

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