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
(No Transcript)
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
(No Transcript)
15
(No Transcript)
16
(No Transcript)
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.