Infantix, the system developed by CNEURO for the detection of hearing and vision disorders

For the first time in the context of neonatal screening, a system allows recording of visual evoked potentials, providing an objective assessment of the visual pathway in a few minutes. This same system is aimed at the objective detection of hearing disorders through the recording and analysis of automatic brainstem auditory evoked potentials and otoacoustic emissions. Its features also make it possible to differentiate between transient and permanent conductive losses due to neural damage.

This is Infantix, a screening system for one-month-old infants, developed by the Cuban Neuroscience Center (CNEURO) with the purpose of early detection of hearing and vision disorders in newborns. It was registered since 2019 by the Cuban regulatory authority, the Center for the State Control of Medicines, Equipment and Medical Devices (Cecmed), to carry out hearing tests, and for visual analysis in 2020.

Extending it progressively to the country’s maternities is the aspiration of CNEURO, engineer Ernesto Velarde Reyes, head of the Electronics department of that scientific institution and head of the project, told Cubadebate in the context of the BioHabana 2022 congress.

“We plan to introduce around twenty teams and we are in the process of doing a general validation, that is, with a larger population of children (around 300) in the Ramón González Coro Gynecobstetric Hospital, in the capital, where the tests were already being carried out. previous tests. The equipment is registered and its safety and effectiveness verified, but validating it with a larger pediatric population will allow us to measure its specificity and sensitivity in greater depth, parameters that are taken into account in the automatic screening tests to have real references of what it is capable of make the system”, commented the interviewee.

He said that for this they are working closely with the Ministry of Public Health, and its care programs for people with visual and hearing disabilities.

Why is research important?

The incidence of hearing loss at birth is greater than 0.6% in the world, said Velarde Reyes. In Cuba, he specified, it could be around 1%.

“We are talking about a large number of boys and girls. For example, if 110,000 infants were born, this means that more than 700 could do so with hearing loss. It is essential to detect them in time, because after six months of age the areas related to language begin to be established in the cerebral cortex”, he pointed out.

If the child does not receive attention, that is, is not intervened with a hearing aid or a cochlear implant before six months, that child already falls behind, does not learn to speak in time and ends up needing to attend special education, he said.

“We seek to be able to detect them before the month of birth, diagnose it before three months and start treating them before six. If we follow this scheme, according to studies that have been done with large populations of hearing-impaired infants, that boy or girl at five years of age meets the same neurodevelopmental milestones as a child who was never hearing-impaired, and they can be incorporated into general education”, Velarde Reyes highlighted.

The objective with Infantix is ​​to achieve a universal screening of all children in the country before they leave the maternity ward. “In countries with few resources, attention to children at risk is prioritized, but it has been shown that 50% of hearing-impaired children never had risk factors, which implies that there will be children who will not be diagnosed in a timely manner,” he specified.

He emphasized that the idea is to investigate all minors in Cuba and for this, sovereign technology that we can produce in the country like this system is needed.

The validation would also be an advantage to publish the studies, endorse them institutionally and be able to export the equipment to other countries that need it, he said.

This type of test is carried out today in the country’s maternity hospitals, mostly with imported otoacoustic emission equipment. But, none of these technologies in the world has incorporated visual research among its functions; so the Infantix already represents a substantial advantage.

The team has a system designed to couple different modules, depending on the test and the signal records and, according to the specialist, they plan to continue incorporating modules that allow diagnosing a greater number of ailments.

A cardiovascular research module, he mentioned, would make it possible to determine if there are alterations in the function of the cardiovascular system in babies.

For otoacoustic emission tests, Infantix has a module consisting of an attachment that has microphones and speakers, taking into account that the clinical analysis consists of the device emitting a sound and collecting its echo. This bounce provides information about the functioning of the child’s middle and inner ear, which the Infantix analyzes to issue a result.

In relation to a visual evoked potential, the patient receives a visual stimulus, for example a flash, and the screening system evaluates the brain’s response to that stimulation.

Through this type of investigation it is possible to detect major problems of the visual pathway such as congenital cataracts or neuropathies of the visual nerve.

Infantix, he said in an interview, is a fruit of Cuban science that can contribute to the normal development of more and more boys and girls in Cuba.