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The Latin American and the Caribbean Newborn Hearing Screening Survey: Process and Results

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Title: The Latin American and the Caribbean Newborn Hearing Screening Survey: Process and Results


1
The Latin American and the Caribbean Newborn
Hearing Screening Survey Process and Results
  • Barbara Gerner de Garcia
  • Gallaudet Research Institute
  • First Wednesday Research Seminar
  • March 5, 2008

2
Researchers
  • This is a collaborative project conducted by
    Gallaudet University and the U.S. Centers for
    Disease Control and Prevention (CDC) Early
    Hearing Detection and Intervention (EHDI)
    Diversity Committee.
  • Barbara Gerner de García, Gallaudet University,
    Co-Principal Investigator
  • Susan Chacon, New Mexico Dept. of Health,
    Co-Principal Investigator
  • Claudia Gaffney, CDC collaborator
  • Marcus Gaffney, CDC collaborator

3
Purpose of presentation
  • To provide information on the current state of
    newborn screening in various Latin American and
    Caribbean countries, implications of the findings
    from the research conducted, and the challenges
    and rewards of cross-cultural and cross-national
    research.

4
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5
Demographics
  • There are approximately 4 million births per year
    in the U.S.
  • Since 2000, the number of infants screened in the
    U.S. has increased from 38 to 95 (Joint
    Commission on Infant Hearing, 2007).
  • There are approximately 11 million births per
    year, in Latin America, although it is estimated
    that close to 2 million of the 11 million annual
    births in the region remain unregistered (Unicef,
    2006).

6
From Audiology, 2000
  • With a total population of 400 million and
    vastly varying health conditions across Latin
    America, it is hard to get a clear picture of the
    prevalence of hearing loss and its consequences
    in this part of the world.
  • Because of limited economic resources in many
    Latin American countries, prevention and
    treatment of hearing loss is not a priority.
  • The conditions for carrying out comprehensive
    screening programs in Latin America are
    difficult. Some regions are hard to reach, and
    the health system may be undeveloped.

7
From Audiology, 2000
  • Fewer than 30 of DHH children in schools for the
    deaf in Argentina use hearing aids, because of
    the expense.
  • Fewer than 30 of Brazilian children with hearing
    loss are diagnosed by the age of two years.
  • It is estimated that over 15 of Chilean
    children, ages 4 to 14, have from hearing
    disorders, many related to otitis media with
    effusion.
  • In Costa Rica, 1.5 children in 1000 are born with
    hearing loss.
  • Sources Audiology, 2000 39(5) 212-20

8
UHS in Latin America
  • Universal Hearing Screening (UHS) is being done
    is only a few countries Chile, Brazil.
  • Brazil has 200 infant hearing screening programs,
    but they cover only 3 percent of hospitals in the
    country.
  • Other countries screen high risk infants e.g.
    Panama.
  • Despite the dedication and efforts of
    professionals in Latin America , relatively
    little information is available about recent
    progress towards establishing newborn hearing
    screening programs in this region.

9
Objectives of the survey
  • Provide stakeholders in the U.S. with resources
    and knowledge that they can use when addressing
    and responding to the needs of Latin American
    children with hearing loss and their families.
  • Increase knowledge and understanding of Newborn
    Hearing Screening (NHS) programs in Latin
    American and Caribbean countries.
  • Highlight barriers to identifying and providing
    services to children with hearing loss in Latin
    American and Caribbean countries.

10
Methods and Procedures
  • An extensive literature review was performed to
    find current information about the status of NHS
    in Latin American and Caribbean countries
  • This included reviewing articles and other
    resources related to NHS in Latin American and
    Caribbean countries.
  • Key contacts in each country were identified
    through this review.
  • We developed a 12 question, two page survey.

11
Methods and Procedures
  • A Spanish language survey was developed and
    reviewed before dissemination by three
    practitioners in Latin America.
  • Their feedback was used to revise the survey.
    Survey requested information about NHS
    procedures, the availability of early
    intervention services, and key challenges to
    identifying and providing services to infants
    with hearing loss.
  • The survey was sent via email to contacts in 20
    Latin American and Caribbean countries,
    including
  • Cuba, Dominican Republic, Puerto Rico, Costa
    Rica, El Salvador, Guatemala, Honduras,
    Nicaragua, Panama, Argentina, Bolivia, Brazil,
    Chile, Colombia, Ecuador, Paraguay, Peru,
    Uruguay, Venezuela, Mexico.

12
Results
  • Six countries responded to the survey
  • Puerto Rico
  • Costa Rica
  • Guatemala
  • Chile
  • Uruguay
  • Mexico

13
Barriers to NHS
  • Respondents reported barriers to NHS including
  • Lack of funding (e.g., government)
  • Lack of awareness about the effects of hearing
    loss in children.
  • Physicians have limited knowledge about infant
    hearing loss and available hearing tests.
  • Lack of equipment
  • Lack of qualified personnel

14
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15
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17
Conclusions
  • In spite of considerable barriers several NHS
    programs have been implemented in Latin America
    and the Caribbean.
  • In some cases these programs are only located in
    a hospital or serve a certain region of a
    country.
  • These programs are making notable progress in
    identifying children with hearing loss and
    offering appropriate services.
  • A number of barriers and challenges remain to
    establishing new NHS programs and expanding
    existing programs in Latin American and Caribbean
    countries.

18
Next steps
  • Convene a teleconference with respondents to
    discuss responses to the survey and foster
    increased communication between countries.
  • Summarize and release findings from this project.
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