The burden and management of infants with life-long and irreversible hearing impairment in Nigeria.

If left untreated or treated late and inappropriately, sensorineural hearing impairment has several adverse, irreversible and life-long health, psycho-social and economic consequences for the affected infants and their families. This seminar paper sets out to describe the burden, current practices and management options for sensorineural or permanent hearing impairment in early infancy for primary care physicians in Nigeria against the backdrop of their role as primary or first contact for all health consultations. Available studies suggest that up to 2.7% or 162,000 of the 6 million infants born annually may have permanent hearing impairment. The underlying aetiological factors may not be determined in the majority of the infants thus limiting the effectiveness of any primary prevention initiatives. However, the affected infants can be detected accurately with objective screening technologies such as otoacoustic emissions and auditory brainstem response in hospital or community settings. The ethical and scientific rationale for this intervention has been well established. Barring the challenge of parental follow-up default which is not insurmountable, affected infants and their families can be supported to establish appropriate auditory-based communication, avoid potentially harmful traditional therapies and child neglect commonly associated with childhood hearing impairment. Primary care providers in private and public practice have a crucial role in guiding parents to seek timely and appropriate services from ear care providers and child development specialists to ensure optimal child growth and developmental outcomes. On-going parental commitment to and active participation in the selected intervention programmes are essential to satisfactory long-term outcomes.