A systematic review and meta-analysis of screening and diagnostic accuracy for hearing loss among under-five children in South-Asian region

• DOI: https://doi.org/10.1108/IJHRH-01-2021-0018
• Published date: 13 September 2021
• Date: 13 September 2021
• Pages: 305-317
• Subject Matter: Health & social care,Vulnerable groups,Inequalities & diverse/minority groups,Sociology,Race & ethnic studies,Minorities,Multiculturalism,Racial identity,Work,economy & organizations
• Author: Ramesh Athe,Rinshu Dwivedi,Krushna Chandra Sahoo,Debdutta Bhattacharya,Shalu Jain,Sanghamitra Pati

A systematic review and meta-analysis

of screening and diagnostic accuracy

for hearing loss among under-five

children in South-Asian region

Ramesh Athe, Rinshu Dwivedi, Krushna Chandra Sahoo, Debdutta Bhattacharya,

Shalu Jain and Sanghamitra Pati

Abstract

Purpose –Congenital hearing disabilities among children are associated with lifetime

discrepancies in the attainment ofspeech, poor academic-performance, socio-individual isolation

and emotional-maladjustments. The present study aims to combine evidence from randomized,

controlled trials to assess the accuracy of hearing-screening proceduresand relative diagnostic-

tests concomitant with partial/permanent hearing loss (HL) among neonatal and under-five

children.

Design/methodology/approach –The steps in this process were conductedaccording to the PRISMA

(Preferred-Reporting-Items-for-Systematic-reviews-and-Meta-Analysis) guidelines. The PubMed,

ProQuest, Science-Direct, Cochrane-Library and secondary reference databases were searched.

Analyses were carried out by usingfixed/random-effects-models for calculatingthe summary estimates

on hearing-screening and test-procedure. Meta-regression-analysis is performed to explore the

influenceof confounders on the net-pooled effect.

Findings –A total of 1,656 articles were identified,and 1,575 were excluded as they were not relevant to

the purpose of the study.Further, out of 81 studies, 67 were excluded with reasonsand 14 were included

in the final analysis. Three independent reviewers have assessed the titles/abstracts for their potential

relevance. The resultsfrom meta-analysis indicate that hearing-screeningwas significantly higher in the

intervention group(n8,102; OR 0.52, 95% CI 0.34, 0.79; p<0.00001), as depicted via forest plot. Meta-

regression analysis indicates a positive relationship between the age and effect size (regression-

coefficient0.638, 95% CI 0.005, 0.731; p<0.05).

Research limitations/implications –The evidencefrom the present study can be used as reference for

identifyingthe associated risk indicators, improved hearing-screeningand reduction of hearing disability

among under-fivechildren.

Practical implications –The results of this reviewwill be used for implementation of a new-born hearing

screening, diagnosticaccuracy and understanding the risk indicatorsfor HL among under-five children

in the South-Asian region. The evidence will be helpful for strategic directions for improved hearing

screeningand reduction of hearing disability amongunder-five children.

Social implications –By understanding the underlying dynamics of hearing-screening procedures,

hearing-impairmentscan be identified at an early stage and required treatment can be provided to the

children.

Originality/value –The findings of this study indicatethat early detection, screening and diagnosis of

the HL among the children, especially among the infants and new-born (0–2years of age), will be of

utmost importance in reducing the prevalence of HL, especially among the South-Asian region. This

study can be used as a reference for other future studies in the area of hearing-screening, diagnostic

accuracyand associated risk indicators amongchildren.

Keywords Children, Hearing loss, Systematic review, Meta-Analysis, South Asia region

Paper type Literature review

(Informationabout the

authorscan be found at the

end of this article.)

Received 27 January 2021

Revised 20 April 2021

16 May 2021

19 July 2021

Accepted 18 August 2021

DOI 10.1108/IJHRH-01-2021-0018 VOL. 15 NO. 3 2022, pp. 305-317, ©Emerald Publishing Limited, ISSN 2056-4902 jINTERNATIONAL JOURNALOF HUMAN RIGHTS IN HEALTHCARE jPAGE 305