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.