Revista CEFAC
https://revistacefac.org.br/article/doi/10.1590/1982-0216/20262862326
Revista CEFAC
Artigos Originais

Childhood hearing loss: Audiological profile, risk indicators, and care trajectory in public health services (2012-2024)

Perda auditiva na infância: perfil audiológico, indicadores de risco e trajetória assistencial em serviços públicos de saúde (2012-2024)

Allan Dayner Silva Lopes; Antônio Pereira de Carvalho Filho; Karinna Veríssimo Meira Taveira; Hannalice Gottschalck Cavalcanti

http://dx.doi.org/10.1590/1982-0216/20262862326 Revista CEFAC, vol.28, n6, e2326, 2026
PDF English
PDF Português
SciELO
Downloads: 0
Views: 6

Abstract

Purpose: to characterize the epidemiological profile and care trajectory of children with confirmed hearing loss or undergoing audiological monitoring who received care within the public health network of Maceió, AL, Brazil, between 2012 and 2024.

Methods: an observational, retrospective, cross-sectional, document-based study conducted at the five Specialized Rehabilitation Centers in the municipality. A total of 3,495 medical records of children aged 0 to 12 years were analyzed, including cases with confirmed hearing loss and cases undergoing audiological monitoring. Descriptive statistics and Chi-square and Kruskal-Wallis tests were used (p < 0.05).

Results: neonatal hearing screening coverage was 80.9%. The median age at diagnosis was 1.0 year (IQR: 0.3-3.0), and the median age at intervention onset was also 1.0 year (IQR: 0.5-3.0). Only 34.6% of children initiated intervention by six months of age. Bilateral sensorineural hearing loss predominated, and risk indicators for hearing loss were identified in 42.0% of the sample.

Conclusion: despite the high coverage of neonatal hearing screening, delays in diagnostic confirmation and auditory intervention persist, highlighting weaknesses in the pediatric hearing care pathway within the analyzed public health network.

Keywords

Hearing Loss; Neonatal Screening; Epidemiology; Early Diagnosis; Child Health; Health Services

Resumo

Objetivo: caracterizar o perfil epidemiológico e a trajetória assistencial de crianças com perda auditiva confirmada ou sob monitoramento auditivo atendidas na rede pública de saúde de Maceió (AL), entre 2012 e 2024.

Métodos: estudo observacional, retrospectivo e transversal, de base documental, realizado nos cinco Centros Especializados de Reabilitação do município. Foram analisados 3.495 prontuários de crianças de 0 a 12 anos, incluindo casos com perda auditiva confirmada e casos sob monitoramento auditivo. Utilizaram-se estatísticas descritivas e os testes do qui-quadrado e de Kruskal-Wallis (p<0,05).

Resultados: a cobertura da triagem auditiva neonatal foi de 80,9%. A idade mediana ao diagnóstico foi de 1,0 ano (IIQ: 0,3-3,0) e ao início da intervenção também de 1,0 ano (IIQ: 0,5-3,0). Apenas 34,6% das crianças iniciaram intervenção até seis meses. Predominou a perda auditiva sensorioneural bilateral, e indicadores de risco foram identificados em 42,0% da amostra.

Conclusão: apesar da elevada cobertura da triagem auditiva neonatal, persistem atrasos na confirmação diagnóstica e na intervenção auditiva, evidenciando fragilidades na trajetória assistencial da saúde auditiva infantil na rede pública analisada.

Palavras-chave

Perda Auditiva; Triagem Neonatal; Epidemiologia; Diagnóstico Precoce; Saúde da Criança; Serviços de Saúde

Referências

1. Almomani F, Al-momani MO, Garadat S, Alqudah S, Kassab M, Hamadneh S et al. Cognitive functioning in deaf children using cochlear implants. BMC Pediatr. 2021;21(1):71. https://doi.org/10.1186/s12887-021-02534-1 PMID: 33568086.

2. Lamminmäki S, Cormier K, Davidson H, Grigsby J, Sharma A. Auditory cortex maturation and language development in children with hearing loss and additional disabilities. Children. 2023;10(11):1813. https://doi.org/10.3390/children10111813 PMID: 38002904.

3. Yoshinaga-Itano C, Manchaiah V, Hunnicutt C. Outcomes of universal newborn screening programs: Systematic review. JCM. 2021;10(13):2784. https://doi.org/10.3390/jcm10132784 PMID: 34202909.

4. Joint Committee on Infant Hearing. Year 2007 Position Statement: Principles and guidelines for early hearing detection and intervention programs. Pediatrics. 2007;120(10):898-921. https://doi.org/10.1542/peds.2007-2333 PMID: 17908777.

5. Feng Y, Hu S, Zhao S, Chen M. Recent advances in genetic etiology of non-syndromic deafness in children. Front Neurosci. 2023;17(1282663). https://doi.org/10.3389/fnins.2023.1282663 PMID: 37928735.

6. Pan K, Shang Z, Liu J, Wen Y, Luo J, Zou D et al. Newborn concurrent hearing and genetic screening for hearing impairment: A systematic review and meta-analysis. Exp Ther Med. 2024;28(3):365. https://doi.org/10.3892/etm.2024.12654 PMID: 39091413.

7. World Health Organization [webpage on the Internet]. World report on hearing. World Health Organization; 2021. [accessed on March 8, 2026]. Available at: https://www.who.int/publications/i/item/9789240020481

8. Besen E, Paiva KM, Cigana LB, Machado MJ, Samelli AG, Haas P. Prevalence of congenital infections in newborns and universal neonatal hearing screening in Santa Catarina, Brazil. Audiology Research. 2023;13(1):107-15. https://doi.org/10.3390/audiolres13010011 PMID: 36825949.

9. Wen C, Zhao X, Li Y, Yu Y, Cheng X, Li X et al. A systematic review of newborn and childhood hearing screening around the world: Comparison and quality assessment of guidelines. BMC Pediatrics. 2022;22(1). https://doi.org/10.1186/s12887-022-03234-0 PMID: 35351033.

10. Ferrari AJ, Santomauro DF, Aali A, Abate YH, Abbafati C, Abbastabar H et al. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: A systematic analysis for the Global Burden of Disease Study 2021. The Lancet. 2024;403(10440):2133-61. https://doi.org/10.1016/S0140-6736(24)00757-8 PMID: 38642570.

11. Duarte JL, Silva KD, Carlino FC, Souza MVDA, Vieira GDSP, Carregosa AM et al. Children's Hearing Health Panorama in the Unified Health System in the state of Sergipe. CoDAS. 2024;36(1):e20210197. https://doi.org/10.1590/2317-1782/20232021197en PMID: 38126548.

12. Alhazmi W. Risk factors associated with hearing impairment in infants and children: A systematic review. Cureus. 2023;15(6):e40464. https://doi.org/10.7759/cureus.40464 PMID: 37456446.

13. Galvão MB, Lewis DR. Hearing assessment after referral in universal newborn hearing screening. Audiol., Commun. Res. 2023;28:e2657. https://doi.org/10.1590/2317-6431-2022-2657en PMID: 37324874.

14. Botasso KC, Lima MCMP, Correa CRS. Analysis of an outpatient child hearing health program: From screening to referral for rehabilitation. CoDAS. 2022;34(4):e20200403. https://doi.org/10.1590/2317-1782/20212020403 PMID: 35137893.

15. Dutra MRP, Cavalcanti HG, Ferreira MÂF. Access to pediatric hearing healthcare in Rio Grande do Norte, Brazil. ABCS Health Sci. 2023;48:e023205-e023205. https://doi.org/10.7322/abcshs.2021063.1798

16. Dias LR, Tomasi YT, Boing AF. The newborn screening tests in Brazil: Regional and socioeconomic prevalence and inequalities in 2013 and 2019. Jornal de Pediatria. 2024;100(3):296-304. https://doi.org/10.1016/j.jped.2023.11.008 PMID: 38169234.

17. Lucena MHMDSL, Cavalcanti HG. Maternal and child predictors associated with loss to follow-up in the newborn hearing screening program: A cohort study in maternity hospitals in northeastern Brazil. CoDAS. 2023;35(6):e20220114. https://doi.org/10.1590/2317-1782/20232022114 PMID: 37703112.

18. Brasil. Ministério da Saúde. Conselho Nacional de Saúde. Resolução no 466, de 12 de dezembro de 2012 2013.

19. Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):3449. https://doi.org/10.1016/j.jclinepi.2007.11.008 PMID: 18313558.

20. IBM C. IBM SPSS Statistics for Windows, Version 29.0. Armonk (NY): IBM Corp.; 2022.

21. Joint Committee on Infant Hearing (JCIH). Year 2019 Position Statement: Principles and guidelines for early hearing detection and intervention programs. J Early Hear Detect Interv. 2019;4(2):1-44. https://doi.org/10.15142/FPTK-B748

22. Diego Gimenes Lopes J, Disconzi Dallegrave C, Hellmann Delfino N, Lauxen R, Marcelino T, Eduardo Monteiro Zappelini C. Epidemiological profile of neonates in hearing screening at a maternity of a tertiary hospital in the state of Santa Catarina, Brazil. Int Arch Otorhinolaryngol. 2023;27(3):e412-22. https://doi.org/10.1055/s-0043-1770918

23. De Souza CFM, Tonon T, Silva TO, Bachega TASS. Newborn screening in Brazil: Realities and challenges. J Community Genet. 2025;16(3):431-8. https://doi.org/10.1007/s12687-024-00762-3 PMID: 39792349.

24. Zaqqout RF, Hamad BA. Risk factors for hearing impairment in infants and toddlers in the Gaza governorates: A case-control study. The Lancet. 2022;399(supply 1):S41. https://doi.org/10.1016/S0140-6736(22)01176-X

25. Li Y, Yang X, Wang C, Cheng X, Qi B, En H et al. Analysis of audiological outcomes of children referred from a universal newborn hearing screening program over 9 years in Beijing, China. Sci Rep. 2023;13:22630. https://doi.org/10.1038/s41598-023-50171-8 PMID: 38114581.

26. Thornton SK, Hoare DJ, Yates AM, Willis KR, Scutt P, Kitterick PT et al. UK and US risk factors for hearing loss in neonatal intensive care unit infants. PLoSOne. 2024;19(1):e0291847. https://doi.org/10.1371/journal.pone.0291847 PMID: 39047012.

27. Choe G, Park S-K, Kim BJ. Hearing loss in neonates and infants. Clin Exp Pediatr. 2023;66(8):369-76. https://doi.org/10.3345/cep.2022.01011 PMID: 36634668.

28. Frezza S, Tiberi E, Corsello M, Priolo F, Cota F, Catenazzi P et al. Hearing loss and risk factors in very low birth weight infants. JCM. 2023;12(24):7583. https://doi.org/10.3390/jcm12247583 PMID: 38137652.

29. Aguiar LB, Cunha BKSD, Bezerra M, Brito MEFD, Arrais N, Moore DR et al. Occurrence of risk for hearing loss in infants with congenital syphilis: A cross-sectional study using automatic auditory brainstem response. Rev. CEFAC. 2025;27(2):e5224. https://doi.org/10.1590/1982-0216/20252725224

30. Galvão MB, Fichino SN, Lewis DR. Infants Hearing Assessment process after referring newborn hearing screening. Distúrb. Comun. 2021;33(3):416-27. https://doi.org/10.23925/2176-2724.2021v33i3p416-427

31. Lopes AA, Friche AADL, Lemos SMA, Bicalho L, Silva AMM, Santos TSD et al. Prevalence of hearing loss and health vulnerability in children aged 25 to 36 months: An analysis of spatial distribution. CoDAS. 2023;35:e20210189. https://doi.org/10.1590/2317-1782/20232021189en PMID: 38055408.

32. Dutra MRP, Cavalcanti HG, Ferreira MÂF. Neonatal hearing screening programs: Quality indicators and access to health services. Rev Bras Saude Mater Infant. 2022;22(3):593-9. https://doi.org/10.1590/1806-9304202200030009

33. Mallmann MB, Tomasi YT, Boing AF. Neonatal screening tests in Brazil: Prevalence rates and regional and socioeconomic inequalities. Jornal de Pediatria (Portuguese version) 2020;96(4):487-94. https://doi.org/10.1016/j.jpedp.2019.05.007

34. Korver AM, Smith RJ, Van Camp G, Schleiss MR, Bitner-Glindzicz MA, Lustig LR et al. Congenital hearing loss. Nat Rev Dis Primers. 2017 Jan 12;3:16094. https://doi.org/10.1038/nrdp.2016.94 PMID: 28079113; PMCID: PMC5675031.

35. Mackey AR, Persson A, Uhlén I. Pre-school hearing screening is necessary to detect childhood hearing loss after the newborn period: A study exploring risk factors, additional disabilities, and referral pathways. Int J Audiol. 2025;64(2):80-8. https://doi.org/10.1080/14992027.2024.2368571 PMID: 38913507.

36. Zhu Q-W, Li M-T, Zhuang X, Chen K, Xu W-Q, Jiang Y-H et al. Assessment of hearing screening combined with limited and expanded genetic screening for newborns in Nantong, China. JAMA Netw Open. 2021;4(8):e2125544. https://doi.org/10.1001/jamanetworkopen.2021.25544 PMID: 34533568.

37. Paul A, Bense F, Boithias Guerot C, De La Rubia S, Lebeaux C, Papon J-F. Leading risk factors for congenital deafness in the context of universal neonatal screening: Our observations in a four-year retrospective study. IJNS. 2024;10(1):11. https://doi.org/10.3390/ijns10010011 PMID: 38390975.
 

Submetido em:
12/04/2026

Revisado em:
08/07/2026

Aceito em:
28/09/2026

6af70a34a95395633a6b0f92 cefac Articles
1982-0216 (Eletrônico) 1516-1846 (Impresso)
Revista CEFAC ©2026 Todos os direitos reservados sobre o conteúdo deste website. Os artigos seguem suas próprias licenças.

Revista CEFAC

Share this page
Page Sections