title: Evaluation of universal newborn hearing screening in South African primary care.
abstract: BACKGROUND
  Universal Newborn Hearing Screening (UNHC) is the gold standard toward early hearing detection and intervention, hence the importance of its deliberation within the South African context.
  
  
  OBJECTIVE
  To determine the feasibility of screening in low-risk neonates, using Otoacoustic Emissions (OAEs), within the Midwife Obstetric Unit (MOU) three-day assessment clinic at a Community Health Centre (CHC), at various test times following birth.
  
  
  METHODS
  Within a quantitative, prospective design, 272 neonates were included. Case history interviews, otoscopic examinations and Distortion Product OAEs (DPOAEs) screening were conducted at two sessions (within six hours and approximately three days after birth). Data were analysed via descriptive statistics.
  
  
  RESULTS
  Based on current staffing profile and practice, efficient and comprehensive screening is not successful within hours of birth, but is more so at the MOU three-day assessment clinic. Significantly higher numbers of infants were screened at session 2, with significantly less false-positive results. At session 1, only 38.1% of the neonates were screened, as opposed to more than 100% at session 2. Session 1 yielded an 82.1% rate of false positive findings, a rate that not only has important implications for the emotional well-being of the parents; but also for resource-stricken environments where expenditure has to be accounted for carefully.
  
  
  CONCLUSIONS
  Current findings highlight the importance of studying methodologies to ensure effective reach for hearing screening within the South African context. These findings argue for UNHS initiatives to include the MOU three-day assessment to ensure that a higher number of neonates are reached and confounding variables such as vernix have been eliminated.
authors.affiliation: Faculty of Humanities, Department of Audiology, University of the Witwatersrand,. katijah.khoza@wits.ac.za.
authors.forename: Katijah
authors.initials: K
authors.lastname: Khoza-Shangase
authors.forename: Shannon
authors.initials: S
authors.lastname: Harbinson
mesh_terms: D005189:False Positive Reactions; D005240:Feasibility Studies; D005260:Female; D006311:Hearing Disorders / Q000175:diagnosis*; D006320:Hearing Tests / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000379:methods*; D017084:Otoacoustic Emissions, Spontaneous; D011320:Primary Health Care / Q000379:methods*; D011446:Prospective Studies; D013019:South Africa; D013997:Time Factors