Loss to follow-up in a newborn hearing screening program in Saudi Arabia

Noura Alothman; Munira Alotaibi; Ghadeer Alshawairkh; Maryam Almutairi; Rawan Aldosari; Razan Alblowi; Amal Alqhtany

doi:10.1016/j.ijporl.2023.111688

Loss to follow-up in a newborn hearing screening program in Saudi Arabia

Int J Pediatr Otorhinolaryngol. 2023 Sep:172:111688. doi: 10.1016/j.ijporl.2023.111688. Epub 2023 Jul 24.

Authors

Noura Alothman¹, Munira Alotaibi², Ghadeer Alshawairkh², Maryam Almutairi², Rawan Aldosari², Razan Alblowi², Amal Alqhtany³

Affiliations

¹ Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, PO Box 84428, Riyadh, 11671, Saudi Arabia. Electronic address: nialothman@pnu.edu.sa.
² Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, PO Box 84428, Riyadh, 11671, Saudi Arabia.
³ Department of Rehabilitation Services, King Abdullah bin Abdulaziz University Hospital (KAAUH), PO Box 84428, Riyadh, 11671, Saudi Arabia.

PMID: 37517140
DOI: 10.1016/j.ijporl.2023.111688

Abstract

Objectives: Newborn hearing screening (NHS) program was officially initiated in Saudi Arabia in 2016. Although the rate of follow-up default is considered one of the major challenges to the NHS program, no studies have investigated the NHS rate of follow-up default and its reasons in Saudi Arabia. This study aimed to investigate the rate of follow-up default in a hospital-based NHS program and the possible reasons for it.

Methods: All newborns who were delivered at a tertiary hospital-based NHS program between June 2020 and February 2022 were retrospectively included. The number of live births, newborns who passed NHS, newborns who referred NHS, and newborns who did not complete the appropriate screening or diagnostic stages were reviewed. In a prospective study, parents of all newborns who defaulted the follow-up on screening or diagnosis were telephonically interviewed about the reasons for their follow-up default.

Results: In total, 2312 newborns were screened. Screening coverage of 96% and referral rate of 0.6% were found, which align well with the international benchmark. The follow-up default was 18%, which was higher than the benchmark. Parents of all newborns who defaulted the follow-up (n = 424) were also included. The most frequent reasons for follow-up default were related to the parents' unawareness of the recommended follow-up screening (39.5%) and their perception that follow-up was not necessary (24.7%). Coronavirus disease 2019 was also reported by 15.8% of the parents as a reason for follow-up default.

Conclusion: Lack of knowledge regarding recommendations made for follow-up and the importance of NHS were the most common reasons for default. Reducing follow-up defaults is essential for successful NHS programs, which can be achieved by implementing a tracking system to remind and encourage parents. Further studies are needed to evaluate the national NHS and investigate the reasons for follow-up defaults from different demographic regions in Saudi Arabia.

Keywords: Coverage; Early hearing detection and intervention; Follow-up default; Newborn hearing screening; Referral rate; Saudi Arabia.

MeSH terms

COVID-19*
Hearing
Hearing Tests
Humans
Infant, Newborn
Neonatal Screening*
Prospective Studies
Retrospective Studies
Saudi Arabia / epidemiology