Phanguphangu Mukovhe, Ross Andrew J
Department of Family Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban.
S Afr J Commun Disord. 2025 Jul 25;72(1):e1-e8. doi: 10.4102/sajcd.v72i1.1092.
In South Africa (SA), congenital hearing loss (HL) is identified at around 30 months of age, which is later than local standards of identification by 6 weeks, mainly because of limited access to infant and newborn hearing screening (INHS). Thus, there is a critical need to explore other models of providing early detection such as nurse-administered INHS.
This study aimed to determine the reliability of nurse-administered INHS.
This was a repeated-measures study where 50 infants scheduled to receive their 6-week immunisation were independently screened by two nurses and an audiologist using distortion product otoacoustic emissions (DPOAE). Data were analysed using Cohen's kappa, using Stata v18 for Macintosh.
Thirteen (n = 13, 26%) infants failed DPOAE screening tests, of which four were male and nine (n = 9) were female. All participants who failed the screening were referred to the hospital for further evaluation and intervention as needed. Further analysis revealed an almost perfect agreement between audiologist- and nurse-administered screening (k = 0.81, p 0.001).
Findings from this study demonstrate that nurses can consistently screen and identify babies with congenital HL using DPOAE screening tests. Furthermore, these findings pave the way for incorporating nurse-administered DPOAE screening into immunisation programmes, with the potential to increase access to INHS and reduce the age of identification of congenital HL to acceptable standards. Large-scale research is recommended to explore the implementation of this nurse-administered INHS in other contexts. Contribution: This study contributes to the growing body of evidence on INHS in SA.
在南非，先天性听力损失（HL）通常在30个月左右被确诊，这比当地6周的确诊标准要晚，主要原因是婴儿和新生儿听力筛查（INHS）的可及性有限。因此，迫切需要探索其他早期检测模式，如由护士进行的INHS。
本研究旨在确定由护士进行的INHS的可靠性。
这是一项重复测量研究，50名计划接受6周龄免疫接种的婴儿由两名护士和一名听力学家使用畸变产物耳声发射（DPOAE）进行独立筛查。使用Stata v18 for Macintosh软件，采用科恩kappa系数对数据进行分析。
13名（n = 13，26%）婴儿DPOAE筛查测试未通过，其中4名是男性，9名是女性。所有筛查未通过的参与者均被转诊至医院，以便根据需要进行进一步评估和干预。进一步分析显示，听力学家和护士进行的筛查之间几乎完全一致（k = 0.81，p < 0.001）。
本研究结果表明，护士可以使用DPOAE筛查测试持续筛查并识别患有先天性HL的婴儿。此外，这些发现为将护士进行的DPOAE筛查纳入免疫计划铺平了道路，有可能增加INHS的可及性，并将先天性HL的确诊年龄降低到可接受的标准。建议进行大规模研究，以探索在其他环境中实施这种由护士进行的INHS。贡献：本研究为南非关于INHS的越来越多的证据做出了贡献。
