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

Questionnaire I

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

NORTH AMERICA

Canada Martyn Hyde

Mexico Pedro Berruecos

United States Karl White

√

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

(Stevens et al. 2011)

Region-dependent Prevalences of Hearing Loss

(Stevens et al. 2011)

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.

Thanks to all the contributors

Thanks to the supporting societies

and

Thank you for your attention