Meyer, Miriam ElsaSwanepoel, De WetLe Roux, TalitaVan der Linde, Michael J. (Mike)2012-06-062012-06-062012-05Miriam Elsa Meyer, De Wet Swanepoel, Talita le Roux & Mike van der Linde, Early detection of infant hearing loss in the private health care sector of South Africa, International Journal of Pediatric Otorhinolaryngology, vol. 76, no. 5, pp. 698-703 (2012), doi: 10.1016/j.ijporl.2012.02.0230165-5876 (print)1872-8464 online)10.1016/j.ijporl.2012.02.023http://hdl.handle.net/2263/19125OBJECTIVE : A national survey of early hearing detection services was undertaken to describe the demographics, protocols and performance of early hearing detection, referral, follow-up and data management practices in the private health care sector of South Africa. METHODS : All private hospitals with obstetric units (n = 166) in South Africa were surveyed telephonically. This data was incorporated with data collected from self-administered questionnaires subsequently distributed nationally to audiology private practices providing hearing screening at the respective hospitals reporting hearing screening services (n = 87). Data was analyzed descriptively to yield national percentages and frequency distributions and possible statistical associations between variables were explored. RESULTS : Newborn hearing screening was available in 53% of private health care obstetric units in South Africa of which only 14% provided universal screening. Most (81%) of the healthy baby screening programs used only otoacoustic emission screening. Auditory brainstem response screening was employed by 24% of neonatal intensive care unit screening programs with only 16% repeating auditory brainstem response screening during the follow-up screen. Consequently 84% of neonatal intensive care unit hearing screening programs will not identify auditory neuropathy. A referral rate of less than 5% for diagnostic assessments was reported by 80% of universal programs. Follow-up return rates were reported to exceed 70% by only 28% of programs. Using multiple methods of reminding parents did not significantly increase reported follow-up return rates. Data management was mainly paper based with only 10% of programs using an electronic database primarily to manage screening data. CONCLUSIONS : A shortage of programs and suboptimal and variable protocols for early hearing detection, follow-up and data management in existing programs mean the majority of babies with hearing loss in the South African private health care sector will not be identified early. Newborn hearing screening must be integrated with hospital-based birthing services, ideally with centralized data management and quality control.en© 2012 Elsevier Ireland Ltd. All rights reserved. Notice : this is the author’s version of a work that was accepted for publication in International Journal of Pediatric Otorhinolaryngology.Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in International Journal of Pediatric Otorhinolaryngology, vol.76, no. 5, 2012, doi : 10.1016/j.ijporl.2012.02.023Newborn hearing screeningInfant hearing lossAuditory brainstem responseAuditory neuropathyFollow-up programPrivate health care sector of South AfricaHearing impaired infants -- South AfricaDeaf infants -- South AfricaMedical screening -- South AfricaNewborn infants -- Medical examinations -- South AfricaHearing disorders in infants -- Diagnosis -- South AfricaOtoacoustic emissionsPostprint Article