Risk factors for hearing impairment in neonates in South Africa: scoping the context for newborn hearing screening planning.

Abstract

The current study aimed to describe the medical case history factors in a group of neonates admitted to high care and Kangaroo Mother Care wards at two hospitals in Gauteng, South Africa and to explore the relationship between specific case history factors and audiological outcomes. This study was part of a bigger study titled " Early detection of hearing loss: exploring risk-based hearing screening within a developing country context " where all case history data were recorded from participant medical files at the time of an initial hearing screening, through the use of a case history form that was developed for this study. Results were analysed using descriptive statistics. The relationship between case history factors and audiological outcomes was analysed using the Fisher's exact test. Findings revealed that, of all the case history data, preterm birth (95.7%), exposure to ototoxic medication (87.7%), neonatal jaundice (NNJ) (80.6%) and birthweight below 1500 g (66.7%) were the most frequently occurring case history factors in this South African sample. No statistically significant association was found between these frequently occurring case history factors and the repeat hearing screening outcomes in this sample. Risk factors for hearing impairment cannot be viewed in isolation; but should be considered in relation to their interaction with multiple other risk factors. Contextually understanding the profile of high risk has implications for medical intervention, as well as for the field of Audiology where planning for early identification and intervention services for hearing impairment is vital. Such contextually relevant evidence allows for a snap shot of how this population presents, what their needs and requirements are, and their possible future requirements; hence raising important planning implications for the department of health and for targeted newborn hearing screening as well as early childhood intervention within the South African context.