A two-step aABR regime in neonatal hearing screening: an efficient alternative for remote and poor geographic areas

Birkena Qirjazi; Ervin Dyrmishi; Ervin Toci

doi:10.18203/issn.2454-5929.ijohns20260784

Authors

Birkena Qirjazi Department of ENT-Ophthalmology, Faculty of Medicine, University of Medicine of Tirana, Albania https://orcid.org/0000-0002-8734-5938
Ervin Dyrmishi Department of ENT-Head and Neck Division, Tirana University Hospital Center, Albania https://orcid.org/0009-0006-4441-3618
Ervin Toci ENT Division, Tirana University Hospital Center, Albania https://orcid.org/0000-0001-8740-059X

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20260784

Keywords:

aABR, ‘fail’ rates, Lost to follow up, Neonatal hearing screening, Screening algorithms, TEOAE

Abstract

Background: Neonatal hearing screening is a standard of care for the neonatal population. Nevertheless, lost to follow-up (LTFU) cases remain an issue for many new and mature programs. This study aims to evaluate the impact of hearing screening using an aABR algorithm in a neonatal population, with a particular focus on its effect on LTFU rates.

Methods: This retrospective study analyzed 2,072 infants selected from a total of 2,181 neonates born in the districts of Pogradec and Kukës, Albania, during 2018–2019. Two different newborn hearing screening algorithms were applied: a two-stage aABR protocol in Kukës and a three-stage TEOAE–TEOAE–aABR protocol in Pogradec. The “fail” rates and the proportion of infants LTFU were calculated and compared between the two screening approaches.

Results: LTFU rates were highest in Pogradec, where a traditional screening algorithm was used, increasing from 1.4% at the first test to 16.9% at the second. In Kukes, the corresponding rates were 0.7% and 15.5%. Fail rates ranged from 22.9% in Pogradec to 6.8% in Kukes. At both sites, fewer neonates failed the second screening than the first.

Conclusions: The algorithm based on two aABR stages appeared to produce a lower number of subjects who failed the first screening test and also a reduced number of LTFP cases. The ‘fail’ rates remained high in both sites, although lower in Kukes. Targeted strategies to reduce LTFU should be implemented to enhance the overall sensitivity and effectiveness of the hearing screening program.

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