This integrated programme opens up new perspectives for hearing-impaired babies. The observation that 50% of babies with CHI have no risk factors from the classic AAP list may be partly explained by the non-inclusion of socio-demographic risk factors. Most of these risk factors can be linked to poverty. The socio-demographic factors of gender, birth order and birth length, initial feeding type, level of education and origin of the mother were found to be independent predictors of CHI. The diagnosis of hearing loss was confirmed in 77-82% of the babies referred. All children were referred to specialised centres and there was almost no loss to follow-up. The referral rate after two screenings was 2.7-7.2 per thousand of screened babies depending on the screener used. Socio-demographic factors were investigated to study any relationship with CHI. Positive results were referred for confirmation of the CHI diagnosis to specialised referral centres. In the period 1999-2008, the entire population of 628,337 newborns in Flanders was tested using an AABR hearing screener. It also discusses the results and the new insights into socio-demographic risk factors for CHI. This paper describes the special collaborative approach of the Flemish screening programme. Early treatment and rehabilitation is essential to prevent the delayed development of speech and language. Permanent congenital hearing impairment (CHI) occurs in approximately 1.4 per 1,000 newborns. This study is among the few to assess neonatal hearing screening programs over a life-time horizon and the first to predict the cost-effectiveness of multiple screening scenarios. Only the 2-stage OAE-aABR (maternity ward) protocol was below the willingness-to-pay threshold of €10,413 for Albania, as suggested by the World Health Organization, and was found to be cost-effective. Multi-staged screening decreased referral rates but may increase the number of missed cases due to false-negative test results and nonattendance. However, it also resulted in higher referral rates, which increased the total costs of diagnostics. Single-aABR screening led to more cases being detected compared to a two-stage screening program. Incremental cost-effectiveness ratios were €4181 and €78,077 per quality-adjusted life-year gained, respectively. The two best protocols for well infants were OAE followed by aABR (i.e., two-stage OAE-aABR) testing in the maternity ward and single-aABR testing. Cost-effectiveness was analyzed over a life-time horizon. We simulated multiple protocols using otoacoustic emissions (OAE) and automated auditory brainstem response (aABR), varying the test type, timing and number of stages. Parameter values were derived from a review of the literature and expert opinion. This study estimated the cost-effectiveness of various protocols in the preparation of implementation of neonatal hearing screening in Albania.Ī micro-simulation model was developed using input on demography, natural history of neonatal hearing impairment, screening characteristics and treatment. Universal neonatal hearing screening protocols vary in tests used, timing of testing and the number of stages of screening.
Natus algo 5 portable#
The stimulus output of two ALGO Portable and three ALGO 3i devices was recorded and analysed for stimulus level, spectral properties, and stimulus irregularities.ĪLGO 3i devices stimulate at a peak level 4.6 dB lower than ALGO Portable devices, have a different stimulus spectrum and show unexplained stimulus irregularities during 4% of the stimulation time.Ī number of technical differences were found between both device types which could explain the increase in referrals.Įarly detection of neonatal hearing impairment moderates the negative effects on speech and language development. In both countries, the percentage of children diagnosed with permanent hearing loss remained approximately the same.Ī technical comparison of both device types was carried out to identify possible causes for the increase in referrals. In the Netherlands, screening centers which used ALGO 3i devices also showed a significant increase in referrals. In Flanders, the refer rate has more than doubled with the switch to ALGO 3i devices. However, in both countries, ALGO 3i devices have a significantly higher rate of referrals than ALGO Portable devices. Since 2006 in Flanders and 2009 in the Netherlands, both programs have replaced the older ALGO Portable devices with the newer ALGO 3i devices. Neonatal hearing screening programs in Flanders and the Netherlands use Natus ALGO screening devices.
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