Implementation of Newborn Hearing Screening in Albania

Andrea M.L. Bussé, Birkena Qirjazi, Allison R. Mackey, Jan Kik, André Goedegebure, Hans L.J. Hoeve, Ervin Toçi, Enver Roshi, Gwen Carr, Martijn S. Toll, Huibert J. Simonsz*

*Corresponding author for this work

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Newborn hearing screening (NHS) was implemented in Albania in four maternity hospitals in 2018 and 2019. Implementation outcome, screening outcome, and screening quality measures were evaluated. Infants were first screened by midwives and nurses before discharge from the maternity hospital and returned for follow-up screening. Acceptability, appropriateness, feasibility, adoption, fidelity, coverage, attendance, and stepwise and final-referral rates were assessed by onsite observations, interviews, questionnaires, and a screening database. A post hoc analysis was performed to identify reasons for loss to follow up (LTFU) in a multivariate logistic regression. In total, 22,818 infants were born, of which 96.6% were screened. For the second screening step, 33.6% of infants were LTFU, 40.4% for the third, and 35.8% for diagnostic assessment. Twenty-two (0.1%) were diagnosed with hearing loss of ≥40 dB, six unilateral. NHS was appropriate and feasible: most infants are born in maternity hospitals, hence nurses and midwives could perform screening, and screening rooms and logistic support were supplied. Adoption among screeners was good. Referral rates decreased steadily, reflecting increasing skill. Occasionally, screening was repeated during a screening step, contrary to the protocol. NHS in Albania was implemented successfully, though LTFU was high. It is important to have effective data tracking and supervision throughout the screening.

Original languageEnglish
Article number28
JournalInternational Journal of Neonatal Screening
Issue number2
Publication statusPublished - Jun 2023

Bibliographical note

Funding Information:
This project was supported by the European Union’s Horizon 2020 research and innovation programme [grant agreement No 733352]. This study sponsor had no role in the study design or the collection, analysis, and interpretation of the data or the writing of the report or in the decision to submit the article for publication.

Publisher Copyright: © 2023 by the authors.


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