Chronic suppurative otitis media and immunocompromised status in paediatric patients.

INTRODUCTION: The role of immunodeficiency in the development of chronic suppurative otitis media (CSOM), especially in paediatric populations, have yet to be fully elucidated. The purposesof this study is to investigate the association between immunocompromised status and CSOM among paediatric population in a tertiary hospital in Indonesia. MATERIALS AND METHODS: A cross-sectional study was performed by retrieving medical records of paediatric patients, with and without CSOM (age 0-18 years), visiting otorhinolaryngology (ENT-HNS) outpatient clinic in a tertiary hospital in Indonesia (2018-2020). We collected data on comorbidities causing immunosuppression such as HIV status, tuberculosis, and cancer. RESULTS: Among the 1018 included patients (50 immunocompromised children), HIV infection was the most common cause of immunodeficiency in the CSOM group (24 patients, 60%), and cancer in the non-CSOM group (10 patients, 100%). We found a significant association between immunocompromised hosts and CSOM (odds ratio 19.5 [95% confidence interval: 9.5-39.9], p<0.001). CONCLUSION: Immunocompromised children with HIV, tuberculosis, or cancer may be more vulnerable to CSOM. Further research is required to explore the association between other immunocompromised conditions and CSOM in paediatric populations.

Brain evoked response audiometry recording from the mastoid and earlobe electrodes in normal-hearing children.

BACKGROUND: Electrode placement plays an important role in Brain Evoked Response Audiometry (BERA) recording. It is important to measure wave latency and amplitude accurately in determining hearing level. Young children usually have limited mastoid area, and in certain condition, it is often difficult to place the vibrator and electrodes coinciding on the mastoid. Therefore, earlobe electrode is considered as an alternative placement. PURPOSE: The aim was to correlate the wave V latency and amplitude on the mastoid and earlobe electrodes in BERA recording. MATERIALS AND METHODS: Our study was a cross-sectional study conducted at Cipto Mangunkusumo Hospital, Jakarta, Indonesia, between November 2020 and November 2021. Our subjects were infants and young children with normal hearing who underwent BERA examination. Electrodes were used to record BERA, and the electrodes were placed over the earlobes and mastoid area. Clicks at 20, 40, and 60 dB and tone burst at 500 Hz were used as stimuli for both ears. RESULT: Fifty subjects (100 ears) were included in the study. Our statistical analysis showed that there was a strong correlation between wave V latencies from mastoid and earlobe electrode. Moderate correlation was also found in wave V amplitude between both electrodes. CONCLUSION: Our study has demonstrated that placing electrodes on the earlobe area is reliable, particularly in certain condition when placing the electrodes on the mastoid area is not possible.

A review of the burden of disease due to otitis media in the Asia-Pacific.

OBJECTIVE: The burden of disease due to otitis media (OM) in Asia Pacific countries was reviewed to increase awareness and raise understanding within the region. METHODS: Published literature and unpublished studies were reviewed. RESULTS: In school-age children, OM prevalence varied between 3.25% (Thailand) and 12.23% (Philippines) being highest (42%) in Aboriginal Australian children. OME prevalence at school age varied between 1.14% (Thailand) and 13.8% (Malaysia). Higher prevalence was reported in children with hearing impairment, HIV, pneumonia and rhinitis. CSOM prevalence was 5.4% in Indonesia (all ages), 15% in Aboriginal Australian children and 2-4% in Thailand, Philippines, Malaysia and Vietnam (WHO estimate). OM prevalence/incidence and service utilisation were highest in children 2-5 years of age. The disease burden was substantially higher in Pacific Island children living in New Zealand (25.4% with OME), and was highest in indigenous Australians (>90% with any OM). Streptococcus pneumoniae and Haemophilus influenzae dominated as primary causes of AOM in all studies. Few studies examined pneumococcal serotype distribution. Health-related cost estimates for OM, when available, were substantial. In developing countries, significant investment is needed to provide facilities for detection and treatment of ear disease in children, if long term hearing deficits and other sequelae are to be prevented. CONCLUSION: The available evidence suggests an important burden of disease and economic cost associated with OM in most Asia Pacific countries and a potential benefit of prevention through vaccination. Large, prospective community-based studies are needed to better define the prevalence of ear disease in children, and to predict and track pneumococcal conjugate vaccine impacts. AOM prevention through vaccination may also provide a means of reducing antibiotic use and controlling antibiotic-resistant disease in children. This review highlights the need for additional research, and provides a basis on which to build and develop regional guidelines for OM management.