Universal newborn hearing screening: the Belgian experience

Abstract Issue Worldwide 466 million people suffer from hearing loss (HL), of whom 34 million children. Early detection of HL in newborns through screening and subsequent intervention significantly improve their developmental and psychosocial outcome. The WHA adopted a resolution on prevention of de...

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Bibliographic Details
Published in:European journal of public health 2020-09, Vol.30 (Supplement_5)
Main Authors: Lerut, E, Van Overmeire, B, Scholtissen, S, Guérin, C, Pereira, T, De Schutter, I
Format: Article
Language:English
Subjects:
Age differences
Automation
Brain stem
Comparative analysis
Conductivity
Cost analysis
Cost effectiveness
Deafness
Hearing
Hearing loss
Intervention
Medical screening
Neonates
Newborn babies
Prevention
Program implementation
Public health
Referrals
Registration
Risk analysis
Risk factors
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Summary:Abstract Issue Worldwide 466 million people suffer from hearing loss (HL), of whom 34 million children. Early detection of HL in newborns through screening and subsequent intervention significantly improve their developmental and psychosocial outcome. The WHA adopted a resolution on prevention of deafness and HL (2017), urging the member states 'to develop, implement and monitor screening programs for early identification of ear diseases'. Population based newborn hearing screening (PNHS) by automated otoacoustic emission (AOAE) and/or automated auditory brainstem response (AABR) is considered good practice. Description of the Problem Flanders (FL): PNHS by AABR at the age of 2-3 weeks (pass/refer), repeated in case of 'refer'. At 2x 'refer', referral to a tertiary hearing center. French speaking community (FSC): newborns with risk factors for congenital HL are immediately referred to ENT. Others undergo AOAE at day 2-3 (pass/refer with retest in case of 'refer'). At 2x 'refer', referral to ENT for AABR. German speaking community: no data available. Results Coverage rate: FL (birth cohort 2014): 96-98%. FSC (birth cohort 2016): 94.9% of newborns without risk factors had a 1st test. 8.7% of newborns with risk factors didn't have any test. Detection rate/1000 tested newborns FL: 2.1 newborns with congenital HL. FSC: 2.33 newborns with HL (0.30 perceptive/0.36 permanently conductive/0.75 temporary conductive/0.1 conductive NOS/0.06 mixed type/0.77 NOS). Lessons Belgium has at least 2 quality PNHS programs. Due to program differences (different tests/age of testing/registration/financing) in depth comparative analysis on their performance, outcome and cost effectiveness is currently lacking (future perspective). Key messages PNHS is common in high income countries, but is not yet integrated worldwide. In the light of the 2017 WHA resolution Belgium might inspire regions and countries starting up PNHS. An in depth comparative analysis of the current Belgian PNHS programs is needed.
ISSN:1101-1262
1464-360X
DOI:10.1093/eurpub/ckaa166.941