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Costs and performance of early hearing detection programmes in Lagos, Nigeria

Olusanya, BO; Emokpae, A; Renner, JK; Wirz, SL; (2009) Costs and performance of early hearing detection programmes in Lagos, Nigeria. T ROY SOC TROP MED H , 103 (2) 179 - 186. 10.1016/j.trstmh.2008.07.001.

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Abstract

In line with global progress towards early detection of permanent congenital and early-onset hearing toss (PCEHL), the costs and performance of hospital-based and community-based infant hearing screening models were evaluated in Lagos, Nigeria. The protocol consisted of two-stage screening with transient-evoked otoacoustic emissions and automated auditory brainstem response followed by diagnostic evaluation for all infants referred after the second-stage screening. The main outcome measures were referral rates at screening, cost per baby screened, cost per case detected and yield for PCEHL. First-stage referrals were 32.2% for universal and 31.7% for targeted screening in the hospital, compared with 14.3% and 15.2%, respectively for the community-based programme. Second-stage referrals ranged from 3.3% under hospital-based universal screening to 4.9% under community-based targeted screening. The highest yields of 27.4 and 22.5 per 1000 were recorded under community-based targeted and universal screening, respectively. Screening cost per child was lowest (US$7.62) under community-based universal screening and highest (US$73.24) under hospital-based targeted screening. Similarly, cost per child detected with PCEHL was lowest (US$602.49) for community-based universal screening and highest (US$4631.33) for hospital-based targeted screening. Community-based universal screening of infants during routine immunisation clinics appears to be the most cost-effective model for early detection of PCEHL in low-income countries. (C) 2008 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

Type:Article
Title:Costs and performance of early hearing detection programmes in Lagos, Nigeria
DOI:10.1016/j.trstmh.2008.07.001
Keywords:Neonatal screening, Early diagnosis, Hearing loss, Screening tests, Cost-effectiveness, Immunisation, BRAIN-STEM RESPONSE, DEVELOPING-COUNTRIES, IMPAIRMENT, CHILDREN, AFRICA
UCL classification:UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Child Health

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