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      Frequency of otitis media with effusion among children aged 1–5 years presenting to immunization center of tertiary care hospitals, Rawalpindi

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          Abstract

          Objective

          We conducted this study to assess the etiopathogenic relation of otitis media with effusion (OME) in a group of children aged 1–5 years among the local population of Rawalpindi.

          Methods

          This was a cross‐sectional retrospective study. Study was conducted among the children presenting to the immunization center of three tertiary care hospitals of Rawalpindi. Otitis media was assessed by clinical examination and tympanometry from August 2019 to January 2020. Multi‐factor regression analysis was then applied to recognize the statistical significance and association of various risk factors to OME.

          Results

          Out of 400 children enrolled in this study, 108 (27.0%) had OME, out of which 65 (60.2%) were males and 30 (27.8%) were of age group 2–3 years. Multivariable regression analysis of risk factors associated with OME showed it was strongly associated with snoring ( P < 0.001), last year symptoms (attack of ear aches with hearing loss [ P = 0.002]), drugs (URTI antibiotics [ P = 0.026], All 3 drugs [ P = 0.013]).

          Conclusions

          We found out that OME is a common disease which if not identified or treated timely can lead to other hard to cure health problems. Control of its etiopathogenic factors can play a major role in its prevention.

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          Most cited references20

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          Burden of Disease Caused by Otitis Media: Systematic Review and Global Estimates

          Lorenzo Monasta, Luca Ronfani, Federico Marchetti … (2012)
          Background Otitis media (OM) is a leading cause of health care visits and drugs prescription. Its complications and sequelae are important causes of preventable hearing loss, particularly in developing countries. Within the Global Burden of Diseases, Injuries, and Risk Factors Study, for the year 2005 we estimated the incidence of acute OM, chronic suppurative OM, and related hearing loss and mortality for all ages and the 21 WHO regional areas. Methods We identified risk factors, complications and sequelae of OM. We carried out an extensive literature review (Medline, Embase, Lilacs and Wholis) which lead to the selection of 114 papers comprising relevant data. Data were available from 15 of the 21 WHO regions. To estimate incidence and prevalence for all countries we adopted a two stage approach based on risk factors formulas and regression modelling. Results Acute OM incidence rate is 10.85% i.e. 709million cases each year with 51% of these occurring in under-fives. Chronic suppurative OM incidence rate is 4.76‰ i.e. 31million cases, with 22.6% of cases occurring annually in under-fives. OM-related hearing impairment has a prevalence of 30.82 per ten-thousand. Each year 21thousand people die due to complications of OM. Conclusions Our study is the first attempt to systematically review the available information and provide global estimates for OM and related conditions. The overall burden deriving from AOM, CSOM and their sequelae is considerable, particularly in the first five years of life and in the poorest countries. The findings call for incorporating OM-focused action within preventive and case management strategies, with emphasis on the more affected.
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            Otitis media

            Anne G. M. Schilder, Tasnee Chonmaitree, Allan W Cripps … (2016)
            Otitis media (OM) or middle ear inflammation is a spectrum of diseases, including acute otitis media (AOM), otitis media with effusion (OME; ‘glue ear’) and chronic suppurative otitis media (CSOM). OM is among the most common diseases in young children worldwide. Although OM may resolve spontaneously without complications, it can be associated with hearing loss and life-long sequelae. In developing countries, CSOM is a leading cause of hearing loss. OM can be of bacterial or viral origin; during ‘colds’, viruses can ascend through the Eustachian tube to the middle ear and pave the way for bacterial otopathogens that reside in the nasopharynx. Diagnosis depends on typical signs and symptoms, such as acute ear pain and bulging of the tympanic membrane (eardrum) for AOM and hearing loss for OME; diagnostic modalities include (pneumatic) otoscopy, tympanometry and audiometry. Symptomatic management of ear pain and fever is the mainstay of AOM treatment, reserving antibiotics for children with severe, persistent or recurrent infections. Management of OME largely consists of watchful waiting, with ventilation (tympanostomy) tubes primarily for children with chronic effusions and hearing loss, developmental delays or learning difficulties. The role of hearing aids to alleviate symptoms of hearing loss in the management of OME needs further study. Insertion of ventilation tubes and adenoidectomy are common operations for recurrent AOM to prevent recurrences, but their effectiveness is still debated. Despite reports of a decline in the incidence of OM over the past decade, attributed to the implementation of clinical guidelines that promote accurate diagnosis and judicious use of antibiotics and to pneumococcal conjugate vaccination, OM continues to be a leading cause for medical consultation, antibiotic prescription and surgery in high-income countries. Supplementary information The online version of this article (doi:10.1038/nrdp.2016.63) contains supplementary material, which is available to authorized users.
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              Clinical Practice Guideline

              Richard Rosenfeld, Jennifer Shin, Seth R Schwartz … (2016)
              This update of a 2004 guideline codeveloped by the American Academy of Otolaryngology-Head and Neck Surgery Foundation, the American Academy of Pediatrics, and the American Academy of Family Physicians, provides evidence-based recommendations to manage otitis media with effusion (OME), defined as the presence of fluid in the middle ear without signs or symptoms of acute ear infection. Changes from the prior guideline include consumer advocates added to the update group, evidence from 4 new clinical practice guidelines, 20 new systematic reviews, and 49 randomized control trials, enhanced emphasis on patient education and shared decision making, a new algorithm to clarify action statement relationships, and new and expanded recommendations for the diagnosis and management of OME.
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                Author and article information

                Contributors
                Nida Riaz: nidariaz100@hotmail.com
                Journal
                Journal ID (nlm-ta): World J Otorhinolaryngol Head Neck Surg
                Journal ID (iso-abbrev): World J Otorhinolaryngol Head Neck Surg
                Journal ID (doi): 10.1002/(ISSN)2589-1081
                Journal ID (publisher-id): WJO2
                Title: World Journal of Otorhinolaryngology - Head and Neck Surgery
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Print): 2095-8811
                ISSN (Electronic): 2589-1081
                Publication date (Electronic): 16 May 2022
                Publication date Collection: December 2022
                Volume: 8
                Issue: 4 ( doiID: 10.1002/wjo2.v8.4 )
                Pages: 315-320
                Affiliations
                [ 1 ] Department of Otorhinolaryngology and Head and Neck Surgery Holy Family Hospital Rawalpindi Pakistan
                [ 2 ] Department of Otorhinolaryngology and Head and Neck Surgery HBS Medical College Islamabad Pakistan
                [ 3 ] Rawalpindi Medical University Rawalpindi Pakistan
                Author notes
                [*] [* ] Correspondence Nida Riaz, Department of Otorhinolaryngology and Head and Neck Surgery, Holy Family Hospital, Rawalpindi 43600, Pakistan.

                Email: nidariaz100@ 123456hotmail.com

                Article
                Publisher ID: WJO245
                DOI: 10.1016/j.wjorl.2021.03.002
                PMC ID: 9714043
                SO-VID: 5a886642-e351-4f59-962a-4b741c2ad720
                Copyright © © 2022 The Authors. World Journal of Otorhinolaryngology ‐ Head and Neck Surgery published by John Wiley & Sons, Ltd on behalf of Chinese Medical Association.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                Date received : 13 January 2021
                Date accepted : 28 March 2021
                Page count
                Figures: 0, Tables: 2, Pages: 6, Words: 3891
                Funding
                Funded by: None
                Categories
                Subject: Research Paper
                Subject: Research Papers
                Custom metadata
                source-schema-version-number 2.0
                cover-date December 2022
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.1 mode:remove_FC converted:01.12.2022

                Keywords: etiology,low resource country,otitis media with effusion,prevelance,tympanometry
                Data availability:
                Keywords: etiology, low resource country, otitis media with effusion, prevelance, tympanometry

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