Störbeck Claudine, Young Alys
Centre for Deaf Studies, University of the Witwatersrand, Wozani Building, Education Campus, 27 St Andrew's Road, Parktown, Johannesburg, South Africa.
School of Nursing, Midwifery and Social Work, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, UK.
BMC Pediatr. 2016 Mar 22;16:45. doi: 10.1186/s12887-016-0574-1.
Identification of deafness before 3 months of age substantially improves the socio-linguistic and cognitive development of deaf children. Existing studies demonstrating the feasibility of newborn hearing screening in South Africa have used small samples unrepresentative of general population characteristics. This study establishes the characteristics of the largest data set of deaf infants and their families in South Africa on which there is baseline and longitudinal data (n = 532); explores its representativeness in terms of socio-demographic features and reports on access to and quality of newborn hearing screening within the sample. It examines specifically the relationship between age of maternal suspicion of childhood deafness and age of identification of deafness by cohort characteristics.
Secondary analysis, using descriptive and inferential statistics, of a pre-existing longitudinal data set (n = 532) of deaf infants under 6 years of age, and their families, collected as routine monitoring of the HI HOPES (HH) early intervention programme.
The HH cohort is representative in terms of racial profile and private/public health care use but displays slightly higher level of maternal education and slightly lower socio-economic status than national comparators. 102 out of 532 infants had undergone newborn hearing screening, resulting in 29 true positives, 15 of whom would have met the criteria for targeted screening. Later onset deafness does not account for the 73 false negatives. The median age of maternal suspicion (n = 247) of infant deafness was 18 months; the median age of identification of 28 months. Age of identification was unrelated to private/public health care status. The median delay between age of suspicion and age of identification was significantly longer in the public sector (7 m; IQR 0-15 m) compared to the private sector (2 m; IQR 0-8.5 m) (p = 0.035). Age of suspicion was unrelated to level of maternal education. Earlier age of suspicion did not predict earlier identification.
Targeted screening as timely response to maternal suspicion offers a viable means to reduce substantially the age of identification of deafness in South Africa until implementation of newborn hearing screening on a population-wide basis can be justified.
在3个月龄前识别出耳聋可显著改善聋儿的社会语言和认知发展。南非现有研究虽已证明新生儿听力筛查具有可行性，但所使用的样本量较小，无法代表总体人群特征。本研究建立了南非最大的聋儿及其家庭数据集（n = 532），该数据集包含基线数据和纵向数据；探讨了其在社会人口学特征方面的代表性，并报告了样本中新生儿听力筛查的可及性和质量。具体研究了母亲怀疑儿童耳聋的年龄与按队列特征确定耳聋的年龄之间的关系。
对一个现有的纵向数据集（n = 532）进行二次分析，该数据集来自6岁以下聋儿及其家庭，是作为对HI HOPES（HH）早期干预项目的常规监测收集的，分析使用描述性和推断性统计方法。
HH队列在种族分布和私立/公立医疗保健使用方面具有代表性，但与全国比较对象相比，其母亲受教育水平略高，社会经济地位略低。532名婴儿中有102名接受了新生儿听力筛查，其中29例为真阳性，其中15例符合靶向筛查标准。迟发性耳聋并不能解释那73例假阴性。母亲怀疑婴儿耳聋的中位年龄（n = 247）为18个月；确诊的中位年龄为28个月。确诊年龄与私立/公立医疗保健状况无关。与私立部门（2个月；四分位距0 - 8.5个月）相比，公立部门中怀疑年龄与确诊年龄之间的中位延迟显著更长（7个月；四分位距0 - 15个月）（p = 0.035）。怀疑年龄与母亲受教育水平无关。较早的怀疑年龄并不能预测较早的确诊。
作为对母亲怀疑的及时回应，靶向筛查是一种可行的方法，可在南非大规模实施新生儿听力筛查具有合理性之前，大幅降低耳聋确诊年龄。
