Epidemiology of otitis media in a local tropical African population.

BACKGROUND: Otitis media is one of the most common childhood infections. There are however very few community based studies on the prevalence of this disease in Nigeria children. OBJECTIVES: To establish the community prevalence of otitis media: and to identify associated environmental and the host risk factors in Nigerian children. SETTING: A semi urban community of Ife Central Local Government area of Osun State, Southwestern part of Nigeria. MATERIAL AND METHODS: Thirty enumeration areas within the study location were randomly picked and their boundaries were defined with the assistance of the National Population Commission (NPC) Officials. Households were used as sampling units within the area. Children aged 1 day old-12 years in each selected household were identified. A questionnaire was administered to the mother/guardian of each child. Otoscopic examination, in addition to the general physical examination was carried out on each child. The data were analyzed using simple descriptive statistics, correlation and multivariate regression technique. RESULT: 600 children aged 0-12 years were investigated. There were 299 males and 301 females. The prevalence of otitis media was found to be 14.7%. This comprises of acute otitis media (AOM) in 11.8%, chronic suppurative otitis media (CSOM) in 2.5%, while Otitis media with effusion (OME) was diagnosed in less than 1%. The peak age of incidence was found to be in the age group 1-4 years 55 (9.2%), while the least age of occurrence was found to be in the age group less than 1 year 10 (1.7%). There was no statistical association between the duration of breastfeeding practice and occurrence of otitis media among the subject (P>0.05). There was no statistical association between the occurrence of otitis media and immunization (p>0.05). However there were 3 children who had otitis media associated with measles infection. A highly significant association was shown between exposure to household cooking fuel (wood smoke) and the occurrence of otitis media (P<0.05). Mother's educational status, number of children sleeping in the same room greater than four was found to demonstrate a strong association with the occurrence of Otitis media (p<0.05). CONCLUSION: Otitis media is prevalent among Nigeria children and it is found to occur more in children of mothers with lower educational status and in number of children greater than 4 sleeping in the same room. A strong association was found between exposure to wood smoke in the living environment and the occurrence of otitis media.

Acute Otitis media, malaria and pyrexia in the under five age group.

BACKGROUND: Acute Otitis media is one of the most common childhood infections. It is responsible for every third visit to a pediatrician in a developed world. However, in Nigeria there is scanty knowledge about the incidence of Acute Otitis Media (AOM). OBJECTIVE: This study aimed at determining the incidence of AOM among under five year old children presenting with pyrexia, and to compare the incidence of AOM as a cause of pyrexia with the incidence of malaria in pyrexic children. DESIGN: It is a cohort study of 200 children of between the ages of 2 weeks and five years with a rectal temperature of 38 degrees C and above, seen over a period of 3 months. SETTING: The study was conducted at the Obafemi Awolowo University Teaching Hospital (OAUTHC) Comprehensive Health Centre, Eleiyele, and the children emergency room of the OAUTHC, Ile-Ife. PATIENTS AND METHODS: A questionnaire to collect information on the demographic data was administered to each mother/guardian of the patient. Otoscopic examination using a battery-operated hand held otoscope and magnifying lenses were done in addition to general systemic physical examination. Thin and thick blood smears were made for malaria parasite. The dried slides were examined under the microscope using the X 100 objective. Sixteen of the patients' slides were lost after processing. RESULTS: Out of the 200 patients that were studied, 58 (29%) had AOM. The highest incidence was recorded in the age group 12-24 months while the least age of occurrence was found to be the age group 4-5 years. Malaria parasitemia was found in 81 (43.5%) while 21 (25.9%) of those with parasitemia also had AOM. But 76 (36%) of the study population had neither AOM nor malaria parasitemia. CONCLUSION: Acute Otitis media was found in 29% of under five years old presenting with pyrexia. It was found to be highest in the first and second year of life, and was found to be least in the 5th year of life. Malaria was found in 81 (43.5%) of the children, and 21 (10.5%) of the children had malaria with a co-existing AOM.