2023 Early Hearing Detection & Intervention Conference

March 5-7, 2023 • Cincinnati, OH

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10/24/2016  |   12:45 PM - 1:45 PM   |  Infant Hearing Screening in Rural Nicaragua: Initial Results and Cost Effectiveness   |  BGPOP Building 4A/B/C

Infant Hearing Screening in Rural Nicaragua: Initial Results and Cost Effectiveness

The benefits of universal screening of newborns have been well demonstrated in developed countries in higher outcome scores in social and gross development and quality of life. We report on the incidence and risk factors for congenital hearing loss in a remote region of Nicaragua and perform cost analysis of screening programs in this setting. A proportionally distributed cross-sectional survey was conducted using Otoacoustic Emissions to screen infants (< 6 months) in Jinotega, Nicaragua in 8 municipalities with varying socioeconomic status and birth settings including NICU, institutional, and home births. Data on 15 risk factors were analyzed. Cost analysis for 4 screening strategies were conducted based on disability adjusted life years (DALY). Targeted screening included high risk infants. Cost effectiveness was determined using the WHO standard of cost effectiveness ratio/gross domestic product per capita.

  • Describe the factors that determine cost effectiveness of infant hearing screening in rural low -resource setting
  • List 3 risk factors of hearing loss in rural Nicaragua
  • Describe the method of deriving cost effectiveness using DALY's

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Presenters/Authors

James Saunders (), Dartmouth Hitchcock Medical Center, james.saunders@hitchcock.org;
Dr. James E. Saunders is a Professor of Otology / Neurotology at Dartmouth Hitchcock Medical Center. He completed an M.D. at University of Oklahoma, Residency Training and a Research Fellowship in Otolaryngology at Duke University Medical Center, and a Research and Clinical Fellowship at the House Ear Institute in Los Angeles. Dr. Saunders has many projects related to the etiology, prevention and treatment of hearing loss in the developing world including collaborations with the WHO and the Global Burden of Disease Project. He is past Coordinator for International Affairs and Chairman of the Humanitarian Efforts Committee for the AAO-HNSF. In 1999, he co-founded Mayflower Medical Outreach, an organization that supports and trains otolaryngologists and audiologists in Nicaragua. He currently serves as the co-chair for the Coalition for Global Hearing Health, an international multidisciplinary organization devoted to education and advocacy for hearing health services in low resource areas.


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Lye-Yeng Wong (), Geisel School of Medicine at Dartmouth, Lye.Yeng.Wong.MED@dartmouth.edu;
Third year medical student. BS in Neuroscience from University of Texas at Dallas.


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