Development of an effective public health screening program to assess hearing disabilities among newborns in Shanghai: a prospective cohort study.

BACKGROUND An effective, systematic program of screening, diagnosis and intervention against hearing loss in infants could help them avoid developmental impediments and could help society stem preventable healthcare burdens. We assessed the feasibility and outcomes of a new public health universal newborn hearing screening program (UNHSP) for neonates born in Shanghai. METHODS From March 2002 to June 2007, we conducted a two-stage hearing loss screening program for neonates born at all 105 delivery hospitals in Shanghai. Institutional participants in the program followed standardized testing criteria and procedures. The first stage of screening occurred in the hospital during the third day post-birth; positive infants underwent a second-stage outpatient screening on Day 42. Positive infants were examined at clinical diagnosis centres, and interventions were conducted at rehabilitation centres. In 2003, a random sample of parents were interviewed about the program, and their level of stress over learning their child screened positive were recorded and analyzed. FINDINGS Overall, our program screened 72.98% of eligible infants and provided effective interventions within six months to 86.31% of those with hearing oss. During the 5-year study, first-stage screenings assessed 90.85% of 616,880 eligible infants and found 12.16% positive. Day 42 screenings had a 65.68% participation rate and a positive rate of 14.75%. Of these, 0.146% were deemed permanently hearing impaired within three months of birth. Parental satisfaction measures exceeded 90%. INTERPRETATION A government-sponsored public health program to screen, diagnose, treat and provide interventions for all newborns with permanently hearing impairment can be effectively implemented and can achieve outcomes that surpass comparable clinical initiatives.