Risk factors and hearing outcomes in infants and young children in KwaZulu-Natal, South Africa.

Abstract

Targeted new-born hearing screening, based on high risk factors is recommended in the absence of universal new-born hearing screening in resource-constrained settings. The relevance of risk factors listed in the guidelines of high-income countries and used bylow-middle income countriesremains relatively unknown. Risk factors consistent with the epidemiological profile, evolution of risks and disease burden in these countries need to be considered. This study aimed to profile the frequency of risk factors and their manifestation in hearing outcomesof youngchildren in the KwaZulu-Natal province of South Africa. A chart review ofN= 1433 patients' archival audiology records was conducted, conveniently sampled from a single tertiary hospital (n= 351), a provincial assessment and therapy centre (n= 649), a university clinic (n= 291), and two schools for the deaf (n= 142). Overall, 56% of the participants presented with either a conductive, sensorineural or a mixed hearing loss; 62% of the children had between 1 and 2 risk factors present (Mean [M] = 1.1; standard deviation [s.d.] = 0.98). Admission to neonatal intensive care unit, maternal infections, bacterial and viral infections and chemotherapy, from the Joint Committee on Infant Hearing list of high risk factors were significantly associated with hearing loss (p 0.05). Known non-JCIH risks, emerging risks and other statistically significant contextually relevant risk factors were also noted. Understanding the profile of high risk factors in a given context has implications forprevention, early hearing identification and intervention services.Contribution:Targeted new-born hearing screening needs to be based on risk factors that are contextually relevant. This study is one of the first profiling high risk factors for hearing loss in children in KZN, the province with the second highest population in South Africa.