‘Babies Born With Severe Jaundice Are More Likely To Be Deaf’ – Bola Olusanya, coordinator, Hearing International Nigeria
By FOLASHADE ADEBAYO
You have done extensive work on hearing impairment in Nigeria. What is your interest in hearing screening for babies?
My interest in newborn hearing screening originated from my work on the developmental profile of Nigerian school entrants 16 years ago as a postgraduate dissertation. Hearing impairment was identified in almost 14 per cent of children in mainstream schools and it was in the range of slight to moderate. And I did a follow-up study among children in the largest schools for the deaf in Lagos with astonishing results. Unfortunately, there were little or no audiological services to properly cater for these children. At that point I made up my mind to address the problem of hearing impairment in Nigeria. And as a child health physician I deeply recognised the impact of this condition on early child development.
Why is hearing loss a huge developmental problem in Nigeria?
Unlike blindness, hearing loss isolates the child completely. I have a 19-year-old just coming for help. He was detected as a baby but his parents could not afford hearing aids. An adult that cannot communicate is like a monster and most parents don’t like sign language. Now these children with severe hearing loss have been found to be among the delinquents in the society. They can commit crime, even kill. Now the problem is that many parents and even health care givers are not aware that babies should be screened for hearing loss before they are discharged after birth. When hearing loss is detected early, the baby can be helped but when it is getting to a year or more after birth, it is already late and such babies become affected for life. Some of them end up at the school for the deaf.
What are the predisposing factors for hearing loss?
What we have found from preliminary studies shows that jaundice is the number one causative factor of hearing loss among babies and it can be prevented or treated early. It is sad that even hospital workers are ignorant that children with jaundice ought to be investigated for hearing loss. In developed countries, jaundice is no longer a causative factor. Each time I make presentation abroad and I put jaundice as a causative factor, people ask me what we are doing about it in Nigeria. But, the truth is that jaundice is not recognised as an epidemic but it is. Also, babies born by Caesarean sections also are high-risk babies and ought to be screened for hearing loss before they are discharged. I say they are high-risk babies because majority of Caesarean sections in this environment are emergencies. The chances that the baby is already compromised before an emergency caesarean section is done are high. Ordinarily, such babies ought to be screened.
What are the basic diagnostic equipments needed for such screening and are they available in our hospitals?
Unfortunately they are not. And even where they are, the hospital staff may not be adequately trained to handle it. Both auditory brain stem response machine and the Otoacoustic Emissions machines cost about $50,000 (about N7.75 million). Imagine what would happen if we have these machines in all the teaching hospitals across the country. Many children would be able to live a productive life instead of being deaf and dumb for life. We can provide free training for doctors and nurses working in this area. When hearing loss has been established, hearing aids can be obtained for N200,000 per piece, but if government shows interest it can be bought in bulk for half the price.