Neonatal screening for hearing impairment—The Oman experience

SummaryBackgroundOman introduced universal hearing screening at a national level in 2002 after piloting it in limited regions. Authors present their experiences.MethodsThe screening had three phases. In Phase I, trained health staff of the delivery suits screened newborns by transient evoked otoacoustic emissions (TEOAE) test. In Phase II, otologists examined ears and repeated hearing tests after 6 weeks. Those who failed the repeat test were referred to a tertiary unit for the Phase III. Audiometrists tested their hearing by an Automated Auditory Brainstem Response (AABR). The rates of hearing disabled, false positive, yield and cost of screening were estimated.ResultsThe coverage of Phase I was 66.6% (21,387/32,125) and it had significant regional variation. Two thousand two hundred and eighty-seven (10.7%) newborns were suspected with hearing impairment. We detected 262 (1.2%) children with hearing impairment. In Phase II, 55 (0.26%) neonates failed the test. In Phase III, 36 neonates were tested with ABR. Eleven were lost to follow up and eight children were advised to undergo further investigations. Ten children were found normal and 26 had hearing impairment. Six neonates had sensory-neuronal hearing loss, 17 children had otitis media with effusion and three children had atresia of the middle ear. The yield of hearing screening was 1.2/1000. The cost of screening was US$ 7.1/newborn.ConclusionUniversal hearing screening in Oman was useful but had teething problems. Proper planning, advocacy to the health staff and parents, commitment of the staff and care of the equipment are important. Such screening should be complimented with a defaulter retrieval and rehabilitation facilities for the hearing disabled.