A Modified Model for Universal Neonatal Hearing Screening in Remote Areas

BACKGROUND: This study evaluated a practical strategy for conducting universal neonatal hearing screening (UNHS) to increase the coverage rate in remote areas. METHODS: Between July 2012 and Jan 2021, 1,040 newborns were screened for hearing loss in south Hualien. The automated auditory brain stem response (AABR) was performed as a two-stage test. Under the supervision of the Hualien Health Bureau, all new mothers were notified by local hospitals or birth clinics to send their baby to the Yuli Tzu Chi Hospital (YLTCH) in southern Hualien at a fixed time to undergo an AABR test. A qualified audiologist from the Hualien Tzu Chi Hospital (HTCH) traveled to the YLTCH to perform AABR tests twice per month. The babies with a two-stage test result of ＂referral＂ were sent to the HTCH for definitive diagnoses and treatment. RESULTS: From July 2012 to January 2021, 1,255 babies were born in the southern Hualien area. First-stage screening was performed on 1,040 children at the YLTCH with a coverage rate of 82.8% (1,040/1,255). The mean screening age was 28±15 (3-90) days. There were 4 babies (0.38%) who had a ＂referral＂ result in at least one ear in the two-stage screening test; these babies were sent to the Hualien Tzu Chi Medical Center for definitive diagnoses. One infant had bilateral profound hearing loss, one had unilateral microtia with mixed type hearing loss, one had bilateral mild hearing loss, and one had cleft palate syndrome with otitis media. CONCLUSIONS: The modified UNHS model that integrates local hospitals, obstetric clinics, medical centers, and the government showed good results in a remote area that lacks sufficient medical resources.