Stablishing national program for ear health and prevention of hearing loss
This program is currently integrated in Iran PHC system focused on three major target population:
1. Early hearing detection and intervention (EHDI) services in neonatal population (below 28 days old)
2. Hearing detection and intervention services in 3-6 years old children (pre-school)
3. Age-related hearing loss (adults above 65 years old) detection and intervention
Integratig the national program for ear health and prevention of hearing loss in primary health cre (PHC)
Iranian ear and hearing health system was established by the department and research center of ENT– Head and Neck (WHOCC) at deputy of center for non-communicable disease control and prevention, ministry of health and medical education (MoH) with collaboration of state welfare organization (SWO) in the country. Then, the national committee on ear health and prevention of hearing loss was established by the MoH (Iran).
Implementing newborn hearing screening program from 2005 up to now with coverage rate of 63 % in the country
(Firoozbakht M, Mahmoudian S, Alaeddini F, Esmaeilzadeh M, Rafiei M, Firouzbakht A, Rahimi F, Farhadi M. Community-based newborn hearing screening programme for early detection of permanent hearing loss in Iran: an eight-year cross-sectional study from 2005 to 2012. J Med Screen. 2014 Mar;21(1):10-7. doi: 10.1177/0969141314522992. Epub 2014 Feb 12.)
Educating skilled human resources for ear health and prevention of hearing loss
There are three levels of health care in the PHC system of Iran including primary, secondary and tertiary care (1st, 2nd and 3rd levels). Primary care consisting immunization, health education, treatment of the mother, nutrition, supplementation, avoidance, counseling, identification of carriers, detection of at-risk groups, avoidance, reduction in noise and early detection by screening all or high-risk groups and treatment is considered.
In the 2nd level of health care for ear and hearing, the audiological diagnostic procedures are considered to identification of degree and type of hearing impairments.
3rd level of hearing health care is related to surgery, hearing aids, special education, rehabilitation, social integration / accessibility as appropriate case follow-up.
Determining major causes of deafness and hearing impairment
Major causes for hearing impairments were related to causes such as hereditary (mainly GJB2 mutations) and non-hereditary genetic factors and infectious diseases (CMV, maternal rubella and other infections during pregnancy), low birth weight, birth asphyxia, use of ototoxic drugs (aminoglycosides and diuretics) and severe jaundice in the neonatal period.
Role of GJB2 mutation (Connexin Cx26) in Iranian young deaf population is more prominent than previous study that can be a result of higher consanguine marriage in population. But our result shows that there is only 25% non-syndromic hearing loss due to high frequency of consanguine marriage in Iranian population.
1. Falah, et al., Profile of Iranian GJB2 Mutations in Young Population with Novel Mutation. Iranian Journal of Basic Medical Sciences, 2011, 14(3), 213-218
2. Najmabadi, et al. "GJB2 mutations: passage through Iran." American Journal of Medical Genetics Part A 133.2 (2005): 132-137.