Prevalence et facteurs favorisants des otomycoses traitees en milieu hospitalier a Abidjan (Cote d'Ivoire)

RESUMEN

Otomycosis is fre q u e n t ly encountered in tropical and subtropical zones. In Ivory Coast diagnosis of this disease is often based solely on the clinical symptoms. The objectives of this study were to determine the prevalence; predisposing factors; and etiologic agents associated with otomycosis at the Treichville University Hospital Center in Abidjan; Ivory Coast. M y c o l ogical examinations we re perfo rmed on specimens obtained from 115 patients presenting with external otitis at the d'Oto-Rhino-Laryngology Department. Fungi-positive cultures were obtained in 49 patients for an overall otomycosis prevalence of 42.6 (95Confidence Interval (CI); 34.4-52.2). Univa ri ate analysis showed that the predisposing fa c t o rs for otomycosis we re frequent swimming in natural or artificial pools (Relative Risk (RR) 3.7; CI 1.7-8.1); daily ear cleaning (RR 3.5; CI 1.8-6.8) and excessive use of eardrops containing antibiotics and corticoids (RR = 9.3; IC95= 4.3-20.1). The most common etiologic agents were Aspergillus fl avus (20.4); Candida albicans (16.3); Candida parapsilosis (14.3); and A s p e rgillus niger (12.2). A combination of two agents was found in five cases. These data show that otomycosis is endemic in Ivo ry Coast. Manage m e n t of otomycosis must include mycological examination for diagnosis as well as changing behavior patterns leading to infection