Factors Associated with Hearing and Visual Impairments in High-Risk Neonates: A Cross-Sectional Study in Cameroon

Abstract

Background: Early detection of hearing and visual impairments in high-risk neonates is essential to prevent developmental delays, yet data from resource-limited settings like Cameroon are limited. High-risk neonates were defined as those with prematurity (Methods: A hospital-based cross-sectional study was conducted from January 3 to April 5, 2024, at the neonatology units of Buea and Limbe Regional Hospitals. High-risk neonates were defined as those with prematurity, low birth weight, or perinatal complications, were screened using transient evoked otoacoustic emissions (TEOAE) for hearing and red reflex testing (RRT) for vision. Data on sociodemographic, perinatal, and clinical variables (e.g., APGAR score, duration of oxygen therapy measured in days as a continuous variable from medical records, serving as a proxy for illness severity) were collected via structured interviews and medical records, with validation through cross-checking. Logistic regression identified risk factors for hearing impairment; visual impairment was analysed descriptively due to low event counts. Results: Of 260 screened neonates, 22 (8.5%, 95% CI: 5.9% - 12.6%) failed the TEOAE test, indicating possible hearing impairment, and 3 (1.2%, 95% CI: 0.5% - 3.4%) had an absent red reflex, suggesting potential visual impairment. Six (n = 6) of 11 neonates who attended follow-up confirmed positive for hearing impairment via auditory brainstem response (ABR) testing. Duration of oxygen therapy was the only factor associated with hearing impairment (aOR = 1.58, 95% CI: 1.26 - 1.98, p Conclusion: Possible hearing (8.5%) and visual (1.2%) impairments are notable in high-risk neonates in Cameroon. Prolonged oxygen therapy should prompt targeted screening of hearing impairment in high-risk neonates. Larger studies are needed to assess visual impairment and confirm risk factors like maternal rubella.