Lertbussarakam Pariya, Pitathawatchai Pittayapon
Department of Otolaryngology, Hatyai Hospital, Songkhla, Thailand.
Department of Otolaryngology, Prince of Songkla University Faculty of Medicine, Songkhla, Thailand.
J Int Adv Otol. 2024 Nov 25;20(6):477-483. doi: 10.5152/iao.2024.231109.
When a universal newborn hearing screening program is not feasible, particularly in the early stages of its establishment when it requires a great deal of effort and resources, a smaller scale in screening, such as a specific geographical subset or targeted group, is suggested rather than doing nothing. This study aims to pilot a newborn hearing screening program at a hospital in a low- to middle-income country and determine its effectiveness and costs in the context of a lack of qualified audiologists.
All high-risk births at Hatyai Hospital were recruited for newborn hearing screening between January and December 2021. Newborns who failed 2 stages of transient evoked otoacoustic emissions screening were referred for diagnostic assessment and subsequent interventions. The program's effectiveness was assessed based on the standards of the American Academy of Pediatrics. All costs related to screening, diagnostic, and intervention stages were also evaluated.
Out of 883 newborns, 792 newborns were screened, resulting in a 95.1% screening coverage. The referral rate regarding the diagnostic stage was 3.9%. Also, 28.3% and 12.9% lost-to-follow-up rates were observed in the secondscreening and diagnostic assessment stages, respectively. Ten children were confirmed as having permanent hearing loss, with a prevalence of 1.3%. The total cost was US$13 611, and the cost (for the screening stage) per case screened was US$4.
The program was considered effective with 2 out of 3 benchmarks achieved.
当普遍的新生儿听力筛查项目不可行时，特别是在其建立的早期阶段，这需要大量的努力和资源，建议进行较小规模的筛查，例如特定的地理区域子集或目标群体，而不是不采取任何行动。本研究旨在在一个低收入至中等收入国家的一家医院试行新生儿听力筛查项目，并在缺乏合格听力学家的情况下确定其有效性和成本。
2021年1月至12月期间，合艾医院所有高危出生的婴儿均被纳入新生儿听力筛查。瞬态诱发耳声发射筛查2个阶段未通过的新生儿被转诊进行诊断评估及后续干预。该项目的有效性根据美国儿科学会的标准进行评估。还评估了与筛查、诊断和干预阶段相关的所有成本。
在883名新生儿中，792名新生儿接受了筛查，筛查覆盖率为95.1%。诊断阶段的转诊率为3.9%。此外，在第二次筛查和诊断评估阶段，失访率分别为28.3%和12.9%。10名儿童被确诊为永久性听力损失，患病率为1.3%。总成本为13611美元，每例筛查（筛查阶段）成本为4美元。
该项目被认为是有效的，实现了3个基准中的2个。
