the global status of newborn and infant hearing screening · katrin neumann 1, harald a. euler1,...
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Katrin Neumann1, Harald A. Euler1, Mario Knauth1, Karl White2
Ruhr Universität Bochum
The global status of newborn and infant hearing
screening
1Dept. of Phoniatrics & Pediatric Audiology, Hearing &
Cochlear Implant Center Ruhr Valley, Clinic of
Otolaryngology, University of Bochum, Germany
2National Center for Hearing Assessment and
Management, Utah State University, Logan (UT), USA
Presented at the 6th Annual Coalition for Global Hearing Health Conference , Washington D.C., October 09-
10, 2015
Current Action for Improving the Early Identification and
Intervention of Infant Hearing Loss – a Global Survey
• Disabling hearing impairment has profound impact on interpersonal
communication, psychosocial well-being, quality of life & economic independence
• WHO estimates: number of people with such impairment increased from 42
million in 1985 to 360 million in 2011
• This includes 7.5 million children less than 5 years of age.
• In 1995, a “roadmap” for curtailing the burden by disabling hearing impairment
was outlined in a resolution of the World Health Assembly
• Demands: Preparation of national plans for the prevention and control of major
causes of avoidable hearing loss, and for early detection in babies, toddlers, and
children…
Current Action for Improving the Early Identification and
Intervention of Infant Hearing Loss – a Global Survey
• Principle of this roadmap remains valid and relevant, some updating is
required to reflect the current status & epidemiologic changes
Olusanya, Neumann, Saunders. The global burden of disabling hearing impairment: a call
to action. Bull World Health Organ. 2014 May 1;92(5):367-73.
• One predisposition: assess the current status of early identification and
further services for diagnostics and intervention
• Method: survey on the global status of newborn and infant hearing
screening (NIHS)
• 2 questionnaires developed, tested, and submitted to potential
representatives of NIHS of as many countries as possible
Survey supported by the following intern. societies:
• Coalition for Global Hearing Health
• International Society of Audiology
• Hearing International
• Audiology Committee der International Association of Logopedics and Phoniatrics (IALP)
• International Working Group on Childhood Hearing
First presentation at the World Health Summit,
Berlin, Oct. 2014
At current: data clarification, completion, search
for contacts to missing countries
Planning: handover of the data to Shelly Chadha
for WHO report 2015
publication
EUROPE
Country Participant
Albania Birkena Quirjazi
Andorra Josef Estrada
Armenia Artur Shukuryan, Armine Martirosyan
Austria Viktor Weichbold
Azerbaijan Ramil M. Hashimli
Belarus Marina Pessozkaya
Belgium Luc Stappaerts
Bosnia and Herzegovina Sanja Spiric
Bulgaria Petar Rouev
Croatia Borut Marn
Cyprus Chryssoula Thodi
Czech Republic Zeleník Karol, Havlíková Eva
Denmark Therese Ovesen
Estonia Liina Luth, Katrin Kruustük
Finland Riina Niemensivu
France Thai-van Hung, Stéphane Roman
Georgia Zurab Kevanishvili
Germany Katrin Neumann
Greece Thomas Nikolopoulos
Hungary Beke Zsolt
Iceland Ingibjörg Hinriksdóttir
Ireland Ann O'Connor
ItalyGabriella Tognola, Ferdinando
Grandori, Luciano Bubbico
Kosovo Borut Marn
Latvia Sandra Kušķe
Country Participant
Lithuania Ingrida Uloziene
Luxembourg Panosetti Eugene
Macedonia Borut Marn
Liechtenstein Wolfgang Maneng
Malta Helen Grech
Moldova Anghelina Chiaburu
Monaco Michèle Berlioz
Montenegro Borut Marn
Netherlands Anneke Meuwese
NorwaySiri Wennberg, Nina
Jakhelln Laugen
Poland Witold Szyfter
PortugalJorge Humberto
Martins
Romania Madalina Georgescu
Russia George Tavartkiladze
Serbia Branka Mikic
Slovakia Gabriela Pavlovcinova
Slovenia Majda Spindler
Spain Faustino Nuñez-Batalla
Sweden Kajsa-Mia Holgers
Switzerland Dorothe Veraguth
Transnistrien Anghelina Chiaburu
Ukraine Dmytro Zabolotny
United KingdomRyan Siobhan, Jane
Hibbert√
AFRICA
BotswanaEsther Palai, Moalosi
Mmapetla
Burkina Faso Tesni, Sian
Cameroon Jean Valentin Fokouo Fogha
Ethiopia Donna Carkeet
Egypt Somaia Tawfik
Gambia Lucy Carter
Ghana Ronald Adjekum
Kenya Zachary Wanjohi
Lesotho DeWet Swanepol
Libya Fadi Afara
Madagascar Theodore
Malawi Peter and Rebecca Bartlett
Nigeria Akeem O. Lasisi
Rwanda Kaitesi Batamuliza Mukara
Sierra Leone Monica Tomlin
South Africa DeWet Swanepol
Tanzania Lucy Carter
Tunisia Mona Zouari, Seif Melliti
Uganda Josephine Likichoru
Zambia Alfred Mwamba
ASIA
Bahrain Samia AlDosari
Bangladesh Susan Emmett
Bhutan Saba Battelino
Cambodia Ned Carter
China XingKuan Bu
India Arun Agarwal
Indonesia Ronny Suwento
Iran Said Mahmoudian
Iraq Salah AlHayani
Israel Daphne Roth
Japan Kunihiro Fukushima
Jordan Mohammad al Masri
Kazakhstan Aizhan Galiyeva
Korea, North Glyn Vaughan
Korea, South Seung Ha Oh
Kuwait Aseel Almuqbel
Malaysia Rafidah Mazlan
Mongolia Palamdorj Ganchimeg
Nepal Susan Emmett
Oman Mazin Al-Khabori
Pakistan Nadeem Mukhtar
Palestine Sister Lucia Corradin
PhilippinesRosario R. Ricalde,
Charlotte Chiong
Qatar Khalid Abdul Hadi
Saudi Arabia Ahmad Alsehli
Syria Samer Sakka Ameni
Tajikistan Jamol Kholmatov
Thailand Suchitra Prasansuk
Timor-Leste Dimity Dornan
Turkey Ferda Akdaş
Turkmenistan Vladimir Primako
United Arab Emirates Wassem Al-Nayef
Uzbekistan Amonov Shavkat
Vietnam Nhu Tuan Nguyen
CENTRAL & SOUTH AMERICA
Antigua and Barbuda George M. Roberts
Argentina Gladys Fernández de Soto
Barbados Joseph Marquis Dowell
Bolivia Alvaro Calvo, Rene Zabala
Brazil Doris Lewis, Monica Chapchap
Chile Mariela Torrente Avendaño
Colombia Juan Garcia Gomez
Costa Rica Juan José Madriz
Dominican Republic Donna Carkeet
Ecuador Mario Mora
El Salvador Richard Wagner
Guatemala Patricia Castellanos de Muñoz
Haiti Donna Carkeet
Jamaica Aye Thwin
Nicaragua Karen Mojica
Panama Stella Rowley
Paraguay Terry Liu
Puerto Rico Soami Santiago de Snyder
Peru Susana Stiglich Watson
Trinidad and Tobago Solaiman Juman
Saint Kitts and Nevis George M. Roberts
Uruguay Rogerlio and Gabriel Charlone Granucci
Venezuela Jacqueline Alvarado Medina
AUSTRALIA & OCEANIA
Australia Greg Leigh
Fiji Philip Newall
Kiribati Jean Johnson
Marshall Islands Karl White
Micronesia Jean Johnson
Nauru Jean Johnson
New Zealand Moira McLeod
Palau Berry Moon Watson
Papua New Guinea Sian Tesni
Samoa Marie Bentin Toalepaialii
Solomon Islands Jean Johnson
Tonga Jean Johnson
Tuvalu Jean Johnson
Vanuatu Jean Johnson
143 countries replied!
√
Missing Countries
AFRICA
Algeria
Angola
Benin
Burkina Faso
Burundi
Cape Verde
Central African Republic
Chad
Comoros
Congo (Brazzaville)
Congo (Kinshasa)
Côte d'Ivoire
Djibouti
Equatorial Guinea
Eritrea
Gabon
Guinea
Guinea-Bissau
Liberia
Mali
Mauritania
CENTRAL & SOUTH AMERICA
Bahamas, The
Belize
Cuba
Dominica
Grenada
Guyana
Honduras
Saint Lucia
Saint Vincent and the Grenadines
Suriname
ASIA
Afghanistan
Brunei
Burma
Kyrgyzstan
Laos
Lebanon
Maldives
Myanmar
Singapore
Sri Lanka
Mauritius
Morocco
Mozambique
Niger
Sao Tome and Principe
Senegal
Seychelles
Somalia
South Sudan
Sudan
Swaziland
Togo
53 countries missed!
Who can help?
� Information provided � No reply
� Information announced � No contact address
Global Newborn and Infant Hearing Screening SurveyReturns of Questionnaires and Replies
>90 % of world population response provided or announced
144 of 198 independent countries
Global Newborn and Infant Hearing Screening SurveyTargeting of Newborn and Infant Hearing Screening
� Exclusively universal � Prevailing targeted
� Prevailing universal � Prevailing sporadic
� Prevailing later � Mixed universal / targeted / later than neonate
� Exclusively targeted � No screening
� No data
� Completely national � Prevailing local / hospital-based / pilot / sporadic
� Prevailing national � No screening
� Prevailing regional / federal � No data
Global Newborn and Infant Hearing Screening SurveyDistribution of Newborn and Infant Hearing Screening
Global Newborn and Infant Hearing Screening SurveyPrevailing Screening Methods
� Prevailing OAE � Prevailing questionnaires / others
� Prevailing AABR � No screening
� Prevailing two step OAE-AABR � No data
Coverage of Hearing Screening: Age of Diagnosis and Therapy Onset
Targets of screening Age at diagnosis
(mos.)
Age range
(mos.)
Age at therapy
onset (mos.)
Age range
(mos.)
Universal neonatal
hearing screening
5.6 0.1 - 20.5 7.5 1.4 – 24.0
No screening 21.8 1.0 – 48.0 25.0 0.3 – 72.0
Stevens G, Flaxman S, Brunskill E, Mascarenhas M, Mathers CD, Finucane M, Global Burden of Disease
Hearing Loss Expert Group: Acuin J, Alberti P, Beria J, Bevilacqua MC, Bu X, Davis A, Gigante LP, Hoffman H,
Joseph A, Al-Khabori M, Ku YA, Mackenzie I, Morata T, Neumann K, Newton V, Olusanya B, Pascolini D,
Parving A, Saunders J, Smith A, Tavartkiladze G (2013) Global and regional hearing impairment prevalence:
an analysis of 42 studies in 29 countries. Eur J Public Health. 2013 Feb;23(1):146-52.
Region-dependent Prevalences of Hearing Loss
Global Newborn and Infant Hearing Screening SurveyPrevalence of Infant Hearing Loss According to the Survey
� 0-1/1000 � 3-4/1000 � No data
� 1-2/1000 � 4-5/1000
� 2-3/1000 � >5/1000
*Stevens et al. 2011
Questionnaire II: Prevalences of Infant Hearing Loss Related to Severity
and Kind of Hearing Loss: Replies of 44 countries from all continents
*Stevens et al. 2011
Summary of the Results
• More than the half of the replying 143 countries have implemented newborn or
infant hearing screening programs on a regional or national level.
• The effectiveness of NIHS is higher if there is a national program and the screening
is mandated.
• There is a lack of such programs in low income countries.
• Region-dependent prevalences of permanent infant hearing loss ranged from >1 to
15 per 1000.
Conclusion:
Hearing loss is still underestimated in the Global Burden of Disease project of the
WHO which evaluates the disabling impact of specific diseases.
Fortunately, many countries have implemented a newborn or infant hearing
screening basing on objective methods which makes sense and is feasible.