Gell F M, White E M, Newell K, Mackenzie I, Smith A, Thompson S, Hatcher J
Acción Rural Fe y Alegria, Sucre, Bolivia.
Bull World Health Organ. 1992;70(5):645-55.
Routine screening for hearing impairment in childhood is now widespread in industrial countries, although there is considerable controversy over the most efficient techniques and procedures. In most developing countries, however, routine screening programmes for hearing impairment do not currently exist. The problems involved in implementing screening programmes in developing and industrial countries are very different, and in selecting screening procedures for a particular population the following factors have to be taken into consideration: the environmental test conditions; the availability of resources for equipment and the training of testers; the local attitudes towards disability; the level of hearing impairment that may cause handicaps; and the major types of pathology causing hearing impairment. We suggest that in developing countries children should be screened at school entry using a simple field audiometer and that the external ear be inspected for the presence of a discharge. There is an urgent need to develop reliable and simple screening procedures for infants and young children; where possible, all children should be screened for severe or significant hearing impairment before the age of 2 years. No screening should, however, be implemented until appropriate follow-up services are available.
目前，在工业化国家，儿童听力障碍的常规筛查已很普遍，尽管在最有效的技术和程序方面存在相当大的争议。然而，在大多数发展中国家，目前尚无针对听力障碍的常规筛查项目。在发展中国家和工业化国家实施筛查项目所涉及的问题截然不同，在为特定人群选择筛查程序时，必须考虑以下因素：环境测试条件；设备资源的可用性以及测试人员的培训情况；当地对残疾的态度；可能导致残疾的听力障碍程度；以及导致听力障碍的主要病理类型。我们建议，在发展中国家，应在儿童入学时使用简单的便携式听力计进行筛查，并检查外耳是否有分泌物。迫切需要为婴幼儿开发可靠且简单的筛查程序；在可能的情况下，所有儿童都应在2岁之前接受严重或显著听力障碍的筛查。然而，在没有适当的后续服务之前，不应实施任何筛查。
