Efficacy of a community-based infant hearing screening program in the Western Cape

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dc.contributor.advisor Swanepoel, De Wet en
dc.contributor.postgraduate Friderichs, Niki
dc.date.accessioned 2013-09-07T17:53:57Z
dc.date.available 2013-01-10 en
dc.date.available 2013-09-07T17:53:57Z
dc.date.created 2012-09-06 en
dc.date.issued 2013-01-10 en
dc.date.submitted 2012-12-03 en
dc.description Dissertation (MCommunication Pathology)--University of Pretoria, 2013. en
dc.description.abstract Apart from isolated programs in private and public health care sectors, South Africa has no existing systematic public infant hearing screening program at community level. As a result, early identification of hearing loss is certainly not being attained for the majority of infants in South Africa with far-reaching effects for individuals, families and society at large. Screening programs at primary health care immunization clinics have been proposed as an alternative to hospital-based programs in South Africa. The objective of this study was to evaluate the first systematic community-based infant hearing screening program in a developing South African community in the Western Cape. A combined descriptive and exploratory research methodology was followed incorporating aspects of a program evaluation design. The study was of a quantitative nature and the required data were collected by means of a questionnaire and OAE testing conducted by clinic nurses on subjects. A community-based universal infant hearing screening program initiated at eight primary health care clinics in the Cape Metropolitan area was evaluated over a 19-month research period. During this time 6227 infants who were candidates for screening attended their 6, 10 or 14-week immunization visit at the relevant clinic. Clinic nurses were trained as screening personnel. A two-stage distortion product otoacoustic emissions screening protocol was utilized. The target disorder for this study was bilateral permanent congenital and early onset hearing loss and infants referring the first screen were scheduled for a 4-week follow-up visit at the clinic. Diagnostic audiological and medical evaluations were scheduled at referral hospitals when indicated. The study evaluated the efficacy of the program based on coverage, referral and follow-up rates and diagnostic outcomes according to guidelines specified by the Health Professions Council of South Africa 2007 Position Statement. Overall coverage rate across the eight clinics was 32.4% with 2018 infants (aged 0- 14 weeks) screened. The mean age of the sample at first stage screen was 3.9 weeks of age and 13.5 weeks of age for first hospital visit. Overall first stage screen referral rate was 9.5% with 62 subjects (3%) referred for diagnostic services at hospital level after a follow-up screen. The average follow-up rate for rescreens at clinic level was 85.1% and for initial diagnostic assessments at hospital level it was 91.8%. Although minimal hearing loss was not the primary focus of the screening program the outcomes did include those subjects with fluctuating conductive hearing loss and permanent unilateral hearing loss. Prevalence rates were 4.5/1000 with significant hearing loss, including sensorineural (1.5/1000) and conductive (3/1000) losses, and 12.9/1000 for subjects with middle ear effusion.<p-> The community-based infant hearing screening program was valuable in attaining high follow-up return rates but reaching sufficient coverage may require dedicated screening personnel as opposed to existing nursing personnel. Furthermore, consideration of an alternative community-based platform such as midwife obstetric units may improve coverage and referral rates and prevalence of permanent congenital and early onset hearing loss. en
dc.description.availability Unrestricted en
dc.description.department Speech-Language Pathology and Audiology en
dc.identifier.citation Friderichs, N 2012, Efficacy of a community-based infant hearing screening program in the Western Cape, MCommunication dissertation, University of Pretoria, Pretoria, viewed yymmdd < http://hdl.handle.net/2263/30084 > en
dc.identifier.other F12/9/291/ag en
dc.identifier.upetdurl http://upetd.up.ac.za/thesis/available/etd-12032012-191105/ en
dc.identifier.uri http://hdl.handle.net/2263/30084
dc.language.iso en
dc.publisher University of Pretoria en_ZA
dc.rights © 2012 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. en
dc.subject Middle ear effusion en
dc.subject Pilot project en
dc.subject Follow-up rate en
dc.subject Referral rate en
dc.subject Coverage en
dc.subject Developing countries en
dc.subject Developed countries en
dc.subject Universal newborn hearing screening en
dc.subject Early hearing detection and intervention en
dc.subject Infant hearing loss en
dc.subject Immunization clinics en
dc.subject Otoacoustic emissions en
dc.subject UCTD en_US
dc.title Efficacy of a community-based infant hearing screening program in the Western Cape en
dc.type Dissertation en


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