Half a billion people, or 6.8% of the global population, have disabling hearing loss, according to a new report published in Lancet.
Despite advances in screening and treatment, many children between birth and 5 years of age are not receiving the benefits of early hearing detection and intervention, according to a 2007 report by the Joint Committee on Infant Hearing [PDF]. Although 98% of all newborns are screened for hearing loss in the United States, this is not the case in developing countries. Without proper screening and treatment, children are at risk for delayed acquisition of spoken language and lower literacy than their normally hearing peers—potentially compromising their educational attainment.
In an effort to address this issue, Debara L. Tucci, MD, has been working with colleagues in Nairobi, Kenya, to develop a newborn hearing screening program. “We have screened thousands of children at Kenyatta National Hospital at the University of Nairobi, and we have hearing aids ready to fit them, if they need it,” she said.
The first step toward establishing a hearing program in a developing country is to develop the infrastructure. “I work with an excellent audiologist, Serah Ndegwa, as well as two otolaryngologists—Professor Isaac Macharia and John Ayugi, MD—who are very committed to providing hearing health care in Kenya,” Dr. Tucci said. In addition, she and Ndegwa have trained nurses to conduct the newborn screening tests. MED-EL sponsored the one-year pilot program, and Natus has contributed the screening and auditory brainstem response (ABR) diagnostic equipment and associated supplies used for the program, Dr. Tucci added.
“One of the difficulties with screening newborns in developing countries has been that the majority of births have been at home. Since these countries often have large rural populations, screening newborns is logistically difficult. But in Kenya, more and more births are taking place in the hospital, increasing the impact of a hospital-based newborn hearing screening program. We also work with immunization clinics, which are the first point of care for many children,” Dr. Tucci noted.
The one-year pilot study is almost complete, so Dr. Tucci is now starting to work with colleagues in Kenya to identify newborns who are potential candidates for cochlear implantation. But there is still infrastructure work to be done. In addition to a lack of audiologists, there is a scarcity of speech therapists to work with the children after implantation. The few audiologists and speech pathologists working in Kenya today were all trained outside of the country, but efforts are underway to develop educational programs in Kenya through partnerships with professionals from outside the country.