Tanon-Anoh M J, Sanogo-Gone D, Kouassi K B
ENT - Cervical and Facial Surgery Unit, Yopougon's Teaching Hospital, 21 BP 622 Abidjan 21, Côte d'Ivoire.
Int J Pediatr Otorhinolaryngol. 2010 Feb;74(2):188-91. doi: 10.1016/j.ijporl.2009.11.008. Epub 2009 Dec 5.
To investigate the feasibility of neonatal hearing impairment in newborn babies in Abidjan, Côte d'Ivoire.
It is a cross-sectional study in which all infants aged from 3 to 28 days, attending for Bacille Calmette-Guerin (BCG) immunization in primary care centers or hospitalized in neonatal intensive care units (NICU), between July 2007 and March 2008, were included. Screening followed a two-stage strategy with transient evoked otoacoustic emissions (TEOAE). Infants referred after the second-stage screening were scheduled for diagnostic evaluation by diagnostic auditory brainstem response (ABR). The variables analyzed were: screening coverage, referral rates; return rates for second-stage screening and diagnostic evaluation, incidence of permanent hearing loss and age at diagnosis.
1306 newborns, of a total of 1495, were successfully screened, giving a screening coverage of 87.4%. The average age was 4.5 days (S.D.: 2.7), with 5.85 days (S.D.: 3.17) for the immunization group and 3.20 days (S.D.: 0.40) for the neonatal unit group. In total, 286 out of the 1306 infants (21.9%) were referred after the first-stage screening; out of which 193 (67.5%) return for the second stage. After the second-stage screening, 48 (16.8%) were scheduled for diagnostic evaluation (45 from NICU and 3 from primary care centers). The overall referral rate for diagnostic evaluation was 3.7% (48/1306). Only 18.75% of those referred (9/48) returned for evaluation, and seven of them (77.8%) were confirmed with hearing loss (2 from immunization group and 5 from neonatal unit group). The prevalence of permanent hearing loss in this screened population was 5.96 per 1000 (7/1174 babies who completed the screening) [95% I.C.: 5.62-6.30 per 1000]. The mean age at diagnosis was 22 weeks (S.D.: 8.3). The reasons for non-completed screening were, according to 62 mothers: no financial means, absence of hearing loss, fear of spouse reactions, lack of information about this test and deafness.
The incidence of permanent and early hearing impairment identified by this screening program was about 6 per 1000. Routine hearing screening of infants for the early detection of hearing loss is necessary in Côte d'Ivoire. It is possible to implement such a hearing screening, targeting all newborns, in primary health care centers and neonatal intensive care units.
调查科特迪瓦阿比让新生儿听力障碍的可行性。
这是一项横断面研究，纳入了2007年7月至2008年3月期间在初级保健中心接受卡介苗（BCG）免疫接种或在新生儿重症监护病房（NICU）住院的所有3至28天的婴儿。筛查采用两阶段策略，即瞬态诱发耳声发射（TEOAE）。第二阶段筛查后转诊的婴儿安排进行诊断性听性脑干反应（ABR）评估。分析的变量包括：筛查覆盖率、转诊率；第二阶段筛查和诊断评估的返回率、永久性听力损失的发生率及诊断时的年龄。
在总共1495名新生儿中，1306名成功接受筛查，筛查覆盖率为87.4%。平均年龄为4.5天（标准差：2.7），免疫接种组为5.85天（标准差：3.17），新生儿病房组为3.20天（标准差：0.40）。在1306名婴儿中，共有286名（21.9%）在第一阶段筛查后被转诊；其中193名（67.5%）返回进行第二阶段筛查。第二阶段筛查后，48名（16.8%）被安排进行诊断评估（45名来自NICU，3名来自初级保健中心）。诊断评估的总体转诊率为3.7%（48/1306）。只有18.75%的转诊者（9/48）返回进行评估，其中7名（77.8%）被确诊为听力损失（2名来自免疫接种组，5名来自新生儿病房组）。在这个筛查人群中，永久性听力损失的患病率为每1000人中有5.96人（7/1174名完成筛查的婴儿）[95%置信区间：每1000人中有5.62 - 6.30人]。诊断时的平均年龄为22周（标准差：8.3）。根据62位母亲的说法，未完成筛查的原因包括：没有经济能力、没有听力损失、担心配偶反应、缺乏关于这项检查和耳聋的信息。
该筛查项目确定的永久性和早期听力障碍的发生率约为每1000人中有6人。在科特迪瓦，对婴儿进行常规听力筛查以早期发现听力损失是必要的。在初级卫生保健中心和新生儿重症监护病房针对所有新生儿实施这样的听力筛查是可行的。
