Newborn and Infant Hearing Screening for Early Detection of Hearing Loss in Nairobi, Kenya

Abstract

BACKGROUND Early detection of hearing loss and subsequent intervention leads to better speech, language and educational outcomes giving way to improved socioeconomic prospects in adult life. This can be achieved through establishing universal newborn hearing screening (UNHS) programs. The objectives of this study were to assess the feasibility of implementing a UNHS program and to also determine the prevalence of hearing loss in newborns in Nairobi, Kenya. MATERIALS AND METHODS A cross-sectional pilot study was conducted at the National Hospital and a sub-county hospital immunization clinic. A total of 9,963 babies aged 0-3 years, were enrolled in the hearing screening program through convenient sampling over nine months. A case history was administered followed by Distortion Product Oto-acoustic emissions (DPOAEs) and automated auditory brainstem response (AABR) hearing screening. RESULTS The screening coverage rate was 98.6% (9963/10,104). The referral rate for the initial screen was 3.6% (356/ 9,963), and the return rate for follow-up rescreening was 72% (258 babies out of 356) with a loss to follow-up rate of 28% (98/356). The referral rate of the second screen was 10% (26/258). All 26 babies referred from the second screen returned for diagnostic hearing evaluation and were confirmed to have hearing loss, yielding a prevalence of 3/1000. CONCLUSIONS Establishing universal newborn and infant hearing screening programs in Kenya is feasible and essential for early detection and intervention for hearing loss. Data management and efficient follow-up systems are an integral part of achieving diagnostic confirmation of hearing loss and early intervention.