A Survey on the Global Status of Newborn and Infant Hearing Screening

Objective: Assess the global status of newborn/infant hearing screening (NIHS) and its effectiveness in early detection and intervention of permanent childhood hearing loss (PCHL). Design: Individuals potentially involved with NIHS in 196 countries/territories (in the following text referred to as countries) received a questionnaire about coverage, strategies, and outcomes of country-specific NIHS programs. Study Sample: Questionnaires from 158 countries were returned. Results: Thirty-eight percent of the world's population were reported to have no/minimal screening, 33% reported screening more than above 85% of the babies (hereafter referred to as universal newborn hearing screening [UNHS]). Mean living standard of countries with UNHS was 10 times higher than in countries with NIHS coverage that was less than 10%. Average age at diagnosis of PCHL was 4.6 months for screened children and 34.9 months for non-screened children. Average age at start of intervention was 6.9 months for screened children and 35.2 months for non-screened children. Methods used for screening included otoacoustic emissions (OAE) in 57% of countries, automated auditory brainstem response (AABR) in 11%, and two-step OAE-AABR in 30%. On average, 4.5% of the infants failed the screening and 17.2% of those children were reported as lost-to-follow-up. The prevalence of PCHL identified in NIHS programs ranged from 0.3-15.0 per 1,000 infants with a median of 1.70. Conclusions: Newborns with PCHL are more likely to benefit from early identification and intervention in countries where NIHS is done. There is a need to invest in NIHS programs, including data collection, in low-income countries.