Abstract
Establishing a newborn hearing screening programme in a low-income country with poor communication infrastructure has unique challenges. Data from 195 infants in three different patient populations in Malawi who underwent hearing screening using transient evoked otoacoustic emissions (TEOAE) testing were analysed to investigate the feasibility of a long-term screening programme. There were 65 infants in each group: infants from Group A were born in a private maternity unit, Group B attended a free community vaccination clinic, and Group C were receiving special care at a government hospital. 75% of infants requiring follow-up from the special-care baby unit were uncontactable following hospital discharge, and screening was discontinued there. Lost to follow-up rates after the first screen were lower from the private maternity unit (14%) and the community vaccination clinic (36%), and these screening programmes continue. A successful hearing screening programme requires extensive support services to manage infants requiring further testing and habilitation, this is not currently possible on a large scale in Malawi due to the small number of Audiology departments and trained staff.
Highlights
The estimated prevalence of disabling hearing loss in sub-Saharan African children is over three times that of high-income countries [1]
The World Health Assembly recently adopted a resolution on the prevention of deafness and hearing loss, which recommends the implementation of screening programmes for the early identification of high-risk groups, including infants [2]
A pilot project was carried out in three different patient populations in Lilongwe, Malawi, with the aim of determining whether a long-term screening programme was sustainable in a low-income country
Summary
The estimated prevalence of disabling hearing loss in sub-Saharan African children is over three times that of high-income countries [1]. Without early identification and access to appropriate support, hearing-impaired children in Malawi are at risk of failing to develop speech and language, and may not be able to access education. The World Health Assembly recently adopted a resolution on the prevention of deafness and hearing loss, which recommends the implementation of screening programmes for the early identification of high-risk groups, including infants [2]. Hearing screening offers the possibility of identifying infants with hearing loss in the first weeks of life and, if linked with early intervention services, has been found to improve speech and language outcomes [3]. A pilot project was carried out in three different patient populations in Lilongwe, Malawi, with the aim of determining whether a long-term screening programme was sustainable in a low-income country
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