Newborn screening for hearing and sight, Cameroon

Abstract

Objective: To evaluate a combined hearing and eye screening model for newborns attending immunization clinics in Cameroon. Methods: We analysed data from a screening project that took place between November 2021 and February 2024, which assessed both the hearing and eyes of newborns using otoacoustic emission and fundal reflex tests, respectively. We then evaluated sensitivity, specificity and predictive values of screening conducted by trained auxiliary staff versus specialists. Findings: We screened 1807 newborns, of which 54% (976) were female. The median age at screening was 13 days. Eight percent of newborns (141/1807) did not pass the otoacoustic emission test; screeners scheduled these newborns for a second-line otoacoustic emission test within three months. Only 28% (39/141) returned for the repeat otoacoustic emission test. Of the returning babies, 33% (13/39) still did not pass, and screeners referred them for an auditory brainstem response threshold test. Screeners detected an absent fundal reflex in 2% (27) of babies. Compared to specialists, trained auxiliary staff showed 82% sensitivity and 99% specificity in hearing screening; predictive values were 90% (positive) and 99% (negative). For eye screening, sensitivity was 67% and specificity 99%, with predictive values of 86% (positive) and 98% (negative). Conclusion: Combined screening performed by trained auxiliary staff in immunization clinics offers a promising approach to screening newborns' hearing and eyes, enabling broader population coverage with fewer resources. Combined screening conducted at immunization clinics includes both hospital- and community-born babies and is therefore suitable for countries with a high number of out-of-hospital births.