Sensorineural hearing loss in infants with neonatal jaundice in Lagos: a community-based study.
OBJECTIVE
To establish the incidence and predictors of sensorineural hearing loss (SNHL) in infants with neonatal jaundice (NNJ) in an inner-city setting with predominantly non-hospital births.


METHODS
A community-based study in Lagos, Nigeria in which infants with SNHL attending well-child clinics for routine immunisation were detected by two-stage universal hearing screening with transient evoked oto-acoustic emissions and automated auditory brainstem response from July 2005 to December 2006. Predictors of SNHL among infants with a history of NNJ were determined with multivariate logistic regression based on adjusted odds ratio (OR) at 95% confidence intervals (CI).


RESULTS
Of the 3676 infants enrolled, 52.4% were not born in hospital and 71 (2.1%) were confirmed to have SNHL. Fourteen (6.0%) of the 234 infants with NNJ had SNHL. Bilateral hearing loss was moderate (41-70 dB) in three (21.4%), severe (71-90 dB) in eight (57.1%) and profound (>90 dB) in two (14.3%) infants. One infant (7.1%) had unilateral SNHL. Six (42.9%) of the infants with SNHL had a profile suggestive of auditory neuropathy/dyssynchrony. Christianity (OR 0.15, CI 0.03-0.93), multiparity (OR 7.33, CI 1.17-45.99), low social class (OR 6.04, CI 1.33-27.48), infant's age (OR 10.17, CI 1.91-54.05), multiple gestations (OR 10.55, CI 1.98-56.11) and exchange blood transfusion (OR 7.74, CI 1.66-36.2) were predictive of SNHL. This model has a sensitivity of 85.7%, a specificity of 83.6%, a negative predictive value of 98.9% but a positive predictive value of only 25.0% for identifying SNHL among infants with severe NNJ.


CONCLUSIONS
SNHL is prevalent among infants with NNJ and community-orientated early detection to curtail the associated long-term developmental consequences is feasible in resource-poor settings where facilities for clinical monitoring are limited. Hearing evaluation of infants treated for severe NNJ should be incorporated into the management and follow-up of these patients.
Olusanya
B O
BO
Maternal & Child Health Unit, Department of Community Health & Primary Care, College of Medicine, University of Lagos, Nigeria. boolusanya@aol.com
Somefun
A O
AO
D000328:Adult; D005260:Female; D005953:Glycogen Storage Disease Type I / Q000175:diagnosis / Q000453:epidemiology; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000150:complications* / Q000453:epidemiology; D008297:Male; D015997:Neonatal Screening; D009549:Nigeria / Q000453:epidemiology; D016017:Odds Ratio; D012044:Regression Analysis; D055815:Young Adult