Low cost calibrated mechanical noisemaker for hearing screening of neonates in resource constrained settings
- Title
- Low cost calibrated mechanical noisemaker for hearing screening of neonates in resource constrained settings
- Creator
- Ramesh A.; Jagdish C.; Nagapoorinima M.; Suman Rao P.N.; Ramakrishnan A.G.; Thomas G.C.; Dominic M.; Swarnarekha A.
- Description
- Background & objectives: There is a need to develop an affordable and reliable tool for hearing screening of neonates in resource constrained, medically underserved areas of developing nations. This study valuates a strategy of health worker based screening of neonates using a low cost mechanical calibrated noisemaker followed up with parental monitoring of age appropriate auditory milestones for detecting severe-profound hearing impairment in infants by 6 months of age. Methods: A trained health worker under the supervision of a qualified audiologist screened 425 neonates of whom 20 had confirmed severe-profound hearing impairment. Mechanical calibrated noisemakers of 50, 60, 70 and 80 dB (A) were used to elicit the behavioural responses. The parents of screened neonates were instructed to monitor the normal language and auditory milestones till 6 months of age. This strategy was validated against the reference standard consisting of a battery of tests - namely, auditory brain stem response (ABR), otoacoustic emissions (OAE) and behavioural assessment at 2 years of age. Bayesian prevalence weighted measures of screening were calculated. Results: The sensitivity and specificity was high with least false positive referrals for 70 and 80 dB (A) noisemakers. All the noisemakers had 100 per cent negative predictive value. 70 and 80 dB (A) noisemakers had high positive likelihood ratios of 19 and 34, respectively. The probability differences for pre- and post- test positive was 43 and 58 for 70 and 80 dB (A) noisemakers, respectively. Interpretation & conclusions: In a controlled setting, health workers with primary education can be trained to use a mechanical calibrated noisemaker made of locally available material to reliably screen for severe-profound hearing loss in neonates. The monitoring of auditory responses could be done by informed parents. Multi-centre field trials of this strategy need to be carried out to examine the feasibility of community health care workers using it in resource constrained settings of developing nations to implement an effective national neonatal hearing screening programme.
- Source
- Indian Journal of Medical Research, Vol-135, No. 2, pp. 170-176.
- Date
- 2012-01-01
- Subject
- Auditory response; Neonatal hearing screening; Noisemakers; Sensitivity; Specificity
- Coverage
- Ramesh A., Divisions of Otolaryngology, St. John's Medical College and Hospital, India; Jagdish C., Divisions of Otolaryngology, St. John's Medical College and Hospital, India; Nagapoorinima M., Divisions of Audiology, St. John's Medical College and Hospital, India; Suman Rao P.N., Divisions of Neonatology, St. John's Medical College and Hospital, India; Ramakrishnan A.G., Medical Intelligence and Language Engineering Laboratory, Indian Institute of Science, India; Thomas G.C., Department of Physics, Christ University, Bangalore, India; Dominic M., Divisions of Community Medicine, St. John's Medical College and Hospital, India; Swarnarekha A., Divisions of Otolaryngology, St. John's Medical College and Hospital, India
- Rights
- Restricted Access
- Relation
- ISSN: 9715916; PubMed ID: 22446858; CODEN: IMIRE
- Format
- Online
- Language
- English
- Type
- Article
Collection
Citation
Ramesh A.; Jagdish C.; Nagapoorinima M.; Suman Rao P.N.; Ramakrishnan A.G.; Thomas G.C.; Dominic M.; Swarnarekha A., “Low cost calibrated mechanical noisemaker for hearing screening of neonates in resource constrained settings,” CHRIST (Deemed To Be University) Institutional Repository, accessed February 25, 2025, https://archives.christuniversity.in/items/show/17333.