Quality controlled neonatal hearing screening in children 0-3 months at post natal wards in Uganda: A multi-center study.

Introduction: Congenital and early-onset hearing loss in low- and middle-income countries constitutes the majority of global cases of permanent childhood hearing loss. Early detection through neonatal hearing screening programs is pivotal for timely intervention. However, such programs are infrequently implemented in low- and middle-income countries due to systemic challenges.

Objective: The primary goal was to evaluate the feasibility of establishing a comprehensive, quality-controlled newborn hearing screening (NHS) program in Uganda, following standards comparable to those in countries with well-established NHS systems.

Methods: This cross-sectional, multi-center study evaluated the performance of a quality-controlled neonatal hearing screening program in five public hospitals in Uganda. The study used a combined screening approach of Transient Evoked Otoacoustic Emissions and Automated Auditory Brainstem Responses. Data analyses were made by Microsoft Excel.

Results: This study analyzed data from 12,996 newborns. The findings revealed that newborn hearing screening coverage rates and referral rates across the five participating hospitals varied from 4.9 % to 23.2 % and 1.2 %-42.6 %, respectively. Notably, the loss to follow-up rates exhibited significant variation, spanning from 12.5 % to 90.7 % among the hospitals. Three children (0.23 per thousand) were identified with congenital hearing loss.

Conclusion: This study demonstrated both the feasibility and the necessity of implementing a quality controlled newborn hearing screening program in Uganda. Addressing challenges related to coverage rates, referral rates, and loss to follow-up rates is important in early detection and effective management of congenital hearing loss.