PREVALENCE OF OTITIS MEDIA WITH EFFUSION IN NIGERIAN CHILDREN AGED 2 TO 7 YEARS

Abstract

BACKGROUND: Otitis media with effusion (OME) is a common cause of hearing difficulty in
children of school age in the developed world. It was thought to be rare in black Africans as there
have been only few reports on the prevalence of this condition.
OBJECTIVES: The aim of this study was to determine the point prevalence of OME in Nigerian
children aged 2 to 7 years and its risk factors.
METHODS: This study was a descriptive cross-sectional study for point prevalence of OME of
196 pupils from 3 nursery and primary schools in Ilorin selected by using multistage sampling
technique. Standardized semi-structured questionnaires were served to the consenting parents of
subjects recruited into the study. A physical examination of the ear, nose and throat was carried
out on all subjects and tympanometric tests conducted after otoscopy confirmed the patency of the
external auditory canal and an intact tympanic membrane. The data was analysed using Statistical
Product and Service Solutions (SPSS) version 16 computer software package. Quantitative data
were summarized using frequency distribution tables and percentages. The test for statistical
association was done using Chi-square method, while p - value was set at < 0.05.
RESULT: There were 91 (46.40%) males and 105 (53.60%) females, (male: female ratio 1:1.2)
Age range was 2-7years, with a mean age and standard deviation of 3.29 + 1.729. Thirty-seven
(18.9%) subjects had type B tympanogram diagnostic of OME. A significant association existed
between OME and age group 2 - 4 years (P = 0.005), low socio-economic class (P = 0.008),
family history of asthma/atopy (P = 0.026), abnormally increasing the volume of television set
while sitting close to it (P = 0.002), past history of ear discharge/AOM (P = 0.003), recurrent
URTI (P = 0.002) and catarrh (P = 0.021). There was no statistically significant relationship
between OME and gender (P = 0.245), overcrowding (P = 0.114), indoor air pollution (P = 0.342),
passive smoking (P = 0.144), snoring (P = 0.630), speech/language defect (P = 0.413) and
tonsillar hypertrophy (P = 0.481). Using Multivariate regression analysis to eliminate confounding
variables, only those in age group of 2 - 4 years, a past history of ear discharge/AOM and
recurrent URTI, remained as independent predictors/risk factors for OME.

CONCLUSION: The prevalence rate of OME was 18.9% in this study. OME is therefore not
uncommon in Nigerian children. Environmental, epidemiologic and familial factors play an
important role in the pathogenesis of OME thus; parents, guardians and other caregivers should be
made to be aware of these highly modifiable risk factors so that the development of OME can be
prevented. Screening for OME as part of the routine pre-school entrance medical examination and
health education to women of child bearing age on the preventable risk factors for OME was
advocated.