Bevilacqua Maria Cecilia, Alvarenga Kátia de Freitas, Costa Orozimbo Alves, Moret Adriane Lima Mortari
Department of Audiology and Speech Pathology at the School of Dentistry, University of São Paulo, Brazil.
Int J Pediatr Otorhinolaryngol. 2010 May;74(5):510-5. doi: 10.1016/j.ijporl.2010.02.009. Epub 2010 Mar 19.
The objective of the study is to investigate the results of the newborn hearing screening program carried out in a Public Hospital in Brazil, in the first 3 years regarding: (1) the prevalence of hearing impairment; (2) the influence of the universal hearing screening program on the age at which the diagnosis of hearing loss is defined; (3) the cost effectiveness of the program; (4) the outcomes, in terms of the age in which the hearing rehabilitation started.
A descriptive study of the first 3 years after starting the universal newborn hearing screening in a Public Hospital of Bauru, São Paulo state, Brazil. The screening method consists of a two-stage screening approach with transient otoacoustic emissions (TOAE), conducted by an audiologist. If the outcome in the second-stage screening is REFER, the infant is submitted to diagnostic follow-up testing and intervention at the Audiology and Speech Pathology Clinic at the University of São Paulo, campus of Bauru. The evaluation of the costs of the universal newborn hearing screening program per each screened newborn (around 4000/year) was done based on a proposal by the National Center for Hearing Assessment and Management, of the Utah State University, United States of America.
11,466 newborns were submitted to hearing screening, corresponding to 90.52% of the living newborns. The prevalence of sensorineural hearing loss was 0.96:1000. Of the 11 children with sensorineural hearing loss, eight children received hearing aids and five started the therapeutic process before the age of 1. Currently, four children between the ages of 11 months and 2 years old were submitted to cochlear implant surgery. The cost of hearing screening was US$7.00 and the annual cost of the universal newborn hearing screening program was US$26,940.47.
The hospital-based universal newborn hearing screening carried out through the Brazilian National Health System is viable, with promising results. However, in a country such as Brazil, which presents large socio-economic differences, the same type of analyses should be performed in several regions, so as to take into account specific aspects, to implement the newborn hearing screening along with the Public System.
本研究的目的是调查在巴西一家公立医院开展的新生儿听力筛查项目在最初3年的结果，涉及以下方面：（1）听力障碍的患病率；（2）普遍听力筛查项目对确定听力损失诊断年龄的影响；（3）该项目的成本效益；（4）就开始听力康复的年龄而言的结果。
对巴西圣保罗州鲍鲁市一家公立医院开展普遍新生儿听力筛查后的最初3年进行描述性研究。筛查方法包括由听力学家采用瞬态耳声发射（TOAE）进行的两阶段筛查方法。如果第二阶段筛查结果为转诊，婴儿将在圣保罗大学鲍鲁校区的听力学与言语病理学诊所接受诊断性后续测试和干预。根据美国犹他州立大学国家听力评估与管理中心的提议，对每个接受筛查的新生儿（每年约4000例）的普遍新生儿听力筛查项目成本进行了评估。
11466名新生儿接受了听力筛查，占活产新生儿的90.52%。感音神经性听力损失的患病率为0.96:1000。在11名感音神经性听力损失儿童中，8名儿童佩戴了助听器，5名在1岁前开始了治疗过程。目前，4名年龄在11个月至2岁之间的儿童接受了人工耳蜗植入手术。听力筛查的成本为7.00美元，普遍新生儿听力筛查项目的年度成本为26940.47美元。
通过巴西国家卫生系统开展的以医院为基础的普遍新生儿听力筛查是可行的，结果令人鼓舞。然而，在像巴西这样存在巨大社会经济差异的国家，应在多个地区进行相同类型的分析，以便考虑到具体情况，与公共系统一起实施新生儿听力筛查。
