Age of detection of congenital hearing loss in South Africa: A systematic review

Background: Newborn hearing screening is the most important step towards early intervention of congenital or early-onset hearing loss (HL) and has the potential to optimise patient outcomes. Yet, literature on the age of identification of this HL in South Africa (SA) is sparse. Aim: To determine the age of identification of congenital HL from published studies in SA. Setting: The study was conducted in SA. Methods: This was a systematic review conducted during April 2024 - June 2024 across the following databases: PubMed, EBSCO, Web of Science and Scopus. A random effects (RE) model meta-analysis was conducted using STATA version 18. Statistical tests conducted include meta-summary statistics and RE meta-analysis. Results: Ten studies, with a total of 1501 children, were included in this review. The computed Q-test of homogeneity was 5870.97 and the pooled mean age of identification was 30 months (95% confidence intervals [CI]: 19.3-41.3). Conclusion: These findings show that congenital or early-onset HL in SA is identified later than the national and international standards, that is, < 1 month of age. These findings are important for future research, priority setting and implementation of strategies to reduce the burden and impact of HL. Future research investigating the barriers to early detection of HL in SA is recommended. Furthermore, the implementation of evidence-based interventions to lower the age of identification of congenital HL to enable its early detection and intervention in this age group is recommended. Contribution: This study highlights the need to strengthen preventative programmes for paediatric HL in SA.