Analysis of neonatal hearing screening program performed on an outpatient basis: Analysis of an outpatient hearing screening program.

OBJECTIVE: The aims of the present study were to analyze the coverage of an outpatient hearing screening program in a public hospital for healthy newborns, to describe the social and demographic profile of the mothers and to identify the prevalence of infants with severe or profound hearing losses. METHODS: The method was descriptive and retrospective. In 2002 and 2003, the newborn hearing screening program was initiated in the maternity ward. Due to many logistic problems, in 2004, we implemented screening on an outpatient basis. Thus, upon discharge from the hospital, the mothers received a printed schedule referring the baby to an outpatient clinic. A two-stage screening protocol was implemented. The screening results were presented from 2004 to 2013. RESULTS: The program was initiated on an outpatient basis in 2004. From 2004 to 2013, 14,882 infants were screened but the complete data for 14,205 cases were obtained. The adherence of the families was 32% in 2004 and increased to 85% in 2013. The mean age of the screened newborns was 48.66 days in 2005 and 24.53 days in 2013. The number of newborns who failed the test and were referred for diagnosis decreased from 12.3% in 2004 to 3% in 2013. The majority of the mothers were young, 69.77% of them aged up to 29 years old and 74.86% had completed basic education. Seventy infants showed hearing loss, totaling 0.49% or approximately 5 cases in 1000, with eight individuals diagnosed with severe or profound sensorineural hearing loss, totaling 0.06% or approximately six cases in 10,000. CONCLUSIONS: The newborn hearing screening program offered by a public hospital in Brazil, over the years, has increased the coverage from 32% to 85%, and so, can be performed on an outpatient basis as an alternative to overcome the operating limitations that might occur in hospital hearing screening. The mothers of the newborns were young and had complete basic education; the prevalence was similar to international studies as hearing loss is concerned.

Adesão a um programa de triagem auditiva neonatal / Adherence to a neonatal hearing screening program

A Triagem Auditiva Neonatal tem se efetivado mundialmente como meio para detecção precoce da surdez. Na Unicamp, desde 2002, os recém-nascidos na maternidade do Centro de Atenção Integral à Saúde da Mulher são agendados para a triagem auditiva no Centro de Estudos e Pesquisas em Reabilitação "Prof. Dr. Gabriel Porto". No entanto, nem todos vêm para a triagem e alguns abandonam o processo de avaliação antes do diagnóstico. O objetivo desta pesquisa foi caracterizar as taxas de adesão de lactentes ao Programa de Triagem Auditiva Neonatal. Tratou-se de pesquisa que utilizou dados contidos nos prontuários dos lactentes que efetuaram a triagem no período de fevereiro a novembro de 2007. Permaneceram no alojamento conjunto do CAISM 2107 lactentes e vieram para a triagem 1310. Dentre aqueles que não passaram na triagem (92 lactentes), realizaram o exame de PEATE-A 73 lactentes. A adesão na primeira etapa da triagem foi de 62,17 por cento, e na segunda, 79,34 por cento. As taxas de adesão são inferiores às preconizadas pelo Joint Comittee on Infant Hearing e encontradas em alguns países desenvolvidos. No entanto, aproximam-se de outras experiências brasileiras de programas de triagem auditiva neonatal. O acompanhamento sistemático às famílias dos lactentes que não passaram na primeira avaliação e a conscientização destas sobre a detecção precoce da perda auditiva e suas consequências podem ter contribuído para o aumento da taxa de adesão na segunda etapa da triagem.

Neonatal hearing screening programs have been developed worldwide. Since 2002, the newborns from the Center for Integral Assistance to Women's Health at UNICAMP have been referred to hearing screening at the Center for Studies and Research on Rehabilitation "Prof. Dr. Gabriel Porto". Nevertheless, not all newborns come to the screening and others drop out before the procedures are completed. The goal of this research was to characterize the newborns' adherence rates to the Neonatal Hearing Screening Program. A retrospective investigation was carried out, collecting data on the records of all cases screened from February to November of 2007. A total of 2107 infants were referred to hearing screening and 1310 actually came. Among those who failed the test (92 infants), 73 returned for the retest with the use of BAEP. The adherence rate in the first stage of the screening was 62.17% and, in the second, 79.34%. These rates are bellow the ones recommended by the JCIH as well as bellow those reached by hearing screening programs of some developed countries. However, they are similar to other Brazilian experiences of neonatal hearing screening programs. A close follow up of the families of those infants who failed the first stage of the screening, as well as the orientation given to them about early detection of hearing loss and its consequences, may have contributed to the increase in the adherence rate in the second stage of the screening.

Detecção de perdas auditivas em neonatos de um hospital público / Detection of hearing loss in neonates of a public hospital

OBJETIVO: Analisar os resultados obtidos na triagem auditiva neonatal realizada por meio de dois procedimentos, Emissões Otoacústicas Transientes e Potencial Evocado Auditivo de Tronco Encefálico - modo automático, em uma população de neonatos saudáveis de um hospital público, considerando-se o gênero masculino e feminino e o lado em que a falha ocorreu. MÉTODOS: Foram incluídos na pesquisa neonatos de alojamento conjunto, nascidos em um hospital público, e que realizaram triagem auditiva após a alta hospitalar. Utilizou-se para triagem as Emissões Otoacústicas Transientes (EOAT) com critério passa/falha e o reteste com o Potencial Evocado Auditivo de Tronco Encefálico-modo automático (PEATE-A). RESULTADOS: Foram testados 5106 neonatos, 51,3 por cento do sexo masculino e 48,7 por cento do sexo feminino. Falharam 628 (12,3 por cento) neonatos, 368 (58,6 por cento) do sexo masculino e 260 (41,4 por cento) do gênero feminino, sendo encaminhados para o PEATE-A. Destes, 223 (35,3 por cento) compareceram ao exame, 199 (89,2 por cento) passaram e 24 (10,8 por cento) falharam; 17 (70,9 por cento) do gênero masculino e sete (29,1 por cento) do gênero feminino. Houve diferença estatística significante entre falha auditiva por meio das emissões otoacústicas e sexo. Encontrou-se 10 por cento de neonatos que falharam nos dois procedimentos de triagem. CONCLUSÃO: Encontrou-se um número maior de falhas em crianças do gênero masculino no teste de emissões otoacústicas transientes. Não houve diferença entre neonatos do gênero masculino ou feminino quanto às falhas nas orelhas esquerda e direita.

PURPOSE: To analyze the results obtained in a neonatal hearing screening program that included two procedures, Transient Otoacoustic Emissions and Automated Brainstem Evoked Response Audiometry, in healthy neonates, born in a public hospital, regarding the variables gender (male or female) and ear that failed (left, right or bilateral). METHODS: Neonates born in a public maternity hospital, who stayed in shared rooms and attended hearing screening after discharge were included in the study. The screening included the Transient Otoacoustic Emissions with pass/fail criterium, and a retest for neonates who failed the first test with the Automated Brainstem Evoked Response Audiometry. RESULTS: A total of 5106 neonates were screened, 51.3 percent male and 48.7 percent female. Among them, 628 (12.3 percent) neonates failed the test, 368 (58.6 percent) male and 260 (41.4 percent) female. They were referred to the Brainstem Evoked Response Audiometry, and 223 (35.3 percent) came to the test. From these subjects, 199 (89.2 percent) passed and 24 (10.8 percent) failed the test: 17 (70.9 percent) male and seven (29.1 percent) female. Statistically significant difference was found between gender and fail in the Transient Otoacoustic Emissions. Ten percent of the neonates failed both screening procedures. CONCLUSION: It was found that a higher number of male neonates failed the Transient Otoacoustic Emissions screening. There was no difference between male and female neonates regarding the failled response in the right and left ears.

Improvement of return rates in a Neonatal Hearing Screening Program: the contribution of social work.

This paper aims to describe the implementation of a Neonatal Hearing Screening Program in a school hospital, focusing on the return rates among infants who failed the first screening. The population who goes to the school hospital for health services comes mainly from economically underprivileged groups. Even though our previous return rates were comparable to those reported elsewhere, we felt it was important to improve the methodology of the screening process in order to try and obtain better results. Our hypothesis was that scarce knowledge on early hearing loss detection and on the benefits of early intervention could be reasons for mothers to give less importance to the second screening. So, a strategy was developed around the idea of providing very detailed information to the mothers about the screening process since preliminary data, gathered with a different group of in-patients, had shown that mothers possessed little knowledge about neonatal hearing screening and the consequences of hearing loss for children's development. The no-return rates decreased considerably (from 39.8% to 25.8%). The findings of this research showed both the need of an adequate way of imparting information to the mothers of newborns about hearing screening in economically underprivileged populations, and the role of social work in this process. Without adequate knowledge on hearing screening and the consequences of hearing loss, a high percentage of newborns may not take advantage of free universal hearing screening programs.