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Balanço de 20 anos do rastreio auditivo neonatal universal : recomendações com base na experiência
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A incidência de perda auditiva bilateral significativa é estimada em 1 a 3 por 1000 recémnascidos (RN) saudáveis e em 20 a 40 por 1000 RN de risco, sendo muito superior à de outras patologias que são alvo de rastreio precoce sistemático. A intervenção precoce influencia decisivamente o prognóstico do desenvolvimento linguístico, cognitivo e social e por este motivo, recomenda-se o rastreio auditivo neonatal universal (RANU) para identificar todas as crianças com perda auditiva antes dos três meses de idade e iniciar a intervenção adequada até aos seis meses. Pretende-se fazer um balanço global dos 20 anos do RANU, desde a sua implementação até aos dias de hoje, retratando a surdez infantil, sua etiologia, e a importância da introdução do rastreio e da intervenção precoce. Além de fazer o levantamento da situação atual do rastreio, procura-se dar uma visão crítica e focar nas recomendações para o futuro, com base na experiência adquirida. A implementação do RANU teve um grande impacto e evolução, contudo é necessário refletir continuamente sobre as limitações existentes. Apela-se a esforços no sentido de elevar o RANU para uma escala de organização nacional e governamental, colmatar limitações legislativas, atualizar as normas de orientação e recomendações em vigor, promover protocolos e estratégias que possibilitem uniformizar estudos, economizar recursos humanos e materiais, melhorar as taxas de follow-up, obter diagnósticos e intervenções precoces. Assim, garantindo programas de RANU com qualidade, eficiência e impacto na vida das crianças com perda auditiva.
The incidence of significant bilateral hearing loss is estimated at 1 to 3 per 1000 healthy newborns at 20 to 40 per 1000 newborns at risk, being much higher than other pathologies targeted for a systematic early screening. Early intervention in these children will decisively influence the prognosis of linguistic, cognitive and social development and for this reason, the Universal Newborn Hearing Screening (UNHS) is currently recommended to identify all children with hearing loss before the age of three months and start adequate intervention up to six months of age. The goal is to make a global and worldwide assessment of the 20 years of the UNHS, since its implementation to the present day, portraying infant deafness, its etiology and consequences in the life of the deaf child, as well as highlighting the importance of introducing early screening and intervention. In addition to surveying the current screening procedure, the thesis seeks to give a critical view and focus on recommendations based on experience for the future. The implementation of the UNHS had a great impact and evolution, however it is necessary to continuously reflect on the existing limitations. Efforts are called for to elevate the UNHS to a national and governmental scale of organization, to overcome legislative limitations, to update the current guidelines and recommendations, to promote protocols and strategies that make it possible to standardize studies, spare human and material resources, improve follow-up rates and obtain early diagnoses and interventions. Thus, ensuring UNHS programs with quality, efficiency and impact on the lives of children with hearing loss.
The incidence of significant bilateral hearing loss is estimated at 1 to 3 per 1000 healthy newborns at 20 to 40 per 1000 newborns at risk, being much higher than other pathologies targeted for a systematic early screening. Early intervention in these children will decisively influence the prognosis of linguistic, cognitive and social development and for this reason, the Universal Newborn Hearing Screening (UNHS) is currently recommended to identify all children with hearing loss before the age of three months and start adequate intervention up to six months of age. The goal is to make a global and worldwide assessment of the 20 years of the UNHS, since its implementation to the present day, portraying infant deafness, its etiology and consequences in the life of the deaf child, as well as highlighting the importance of introducing early screening and intervention. In addition to surveying the current screening procedure, the thesis seeks to give a critical view and focus on recommendations based on experience for the future. The implementation of the UNHS had a great impact and evolution, however it is necessary to continuously reflect on the existing limitations. Efforts are called for to elevate the UNHS to a national and governmental scale of organization, to overcome legislative limitations, to update the current guidelines and recommendations, to promote protocols and strategies that make it possible to standardize studies, spare human and material resources, improve follow-up rates and obtain early diagnoses and interventions. Thus, ensuring UNHS programs with quality, efficiency and impact on the lives of children with hearing loss.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2021
Palavras-chave
Surdez infantil Rastreio auditivo neonatal universal (RANU) Intervenção precoce Pediatria