Implementation of neonatal hearing screening in the Rhône-Alpes region. Status report for 2016 and the first half of 2017
Introduction: Neonatal hearing screening (NHS) was launched as a public health program in 2015 in the Rhône-Alpes region, with the goal of detecting unilateral and bilateral hearing loss. Following an initial test (T1) and a retest (T2) in the maternity ward, the diagnostic phase was centralized in a limited number of centers. A preliminary delayed test (T3) was offered before the infant reached 1 month of age. The objectives of the study were to evaluate the implementation of the program and the impact of T3. Materials and Methods: This retrospective observational study relied on data routinely submitted to the regional agency responsible for neonatal screening by maternity wards and expert centers. Results: All maternity wards and neonatal units in the Rhône-Alpes region offered the newborn screening program; 47 out of 51 maternity wards used the recommended techniques. Coverage reached 99.7% among legally eligible newborns (excluding the 0.2% of parental refusals). A T2 test was required for 10.2% of children, and this was followed by a T3 test for 31.3% of abnormal T2 results; 88.6% of T3 tests were reported as normal. Finally, 2.2% of newborns were referred to a diagnostic center for inconclusive unilateral or bilateral test results. The 6-month outcomes for 2016 showed an overall deafness rate of 1.7‰ (4.7‰ among referred newborns) and a bilateral deafness rate of 1.2‰. Among children with abnormal retests, 7.7% were lost to follow-up. In the network making extensive use of the T3, 0.6% of children were referred to a diagnostic center—that is, 4 children referred for every 1 deaf child—versus 17 (p<0.001) for the rest of the region in 2016. Conclusion: In Rhône-Alpes, national and regional newborn hearing screening (NHS) coverage targets are significantly exceeded. Limiting the number of children lost to follow-up remains essential. Repeating an automated test around 2–4 weeks of age improves screening and significantly reduces referrals to specialist centers without increasing the number of children lost to follow-up. The DNS is a complex process (pathway, stakeholders, assessment). The network’s plans are to compare experiences and solicit feedback from parents.
Author(s): Bouillot Lorène, Vercherat Maurice, Durand Catherine
Publishing year: 2018
Pages: 556-562
Weekly Epidemiological Bulletin, 2018, n° 27, p. 556-562
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