Otitis media with effusion and its associated factors among patients with cerebral palsy aged 2 to 18 years at Mulago and Kawempe National Referral Hospitals

Abstract

Introduction : Otitis media with effusion (OME) is the presence of fluid within the middle ear cavity which causes a conductive hearing loss. Children with cerebral Palsy (CP) are prone to OME and subsequent hearing loss which negatively impacts their speech and language abilities. It is therefore important to have early assessment and timely intervention to improve quality of life. This was a cross-sectional study among patients with CP between 2 to 18 years at Mulago and Kawempe National Referral Hospitals (NRHs). Data on sociodemographic and clinical characteristics was collected using a semi-strucured questionnaire. Diagnosis of OME was made on presence of a type B tympanogram. Prevalence of OME was reported as a frequency and Poisson regression analysis was used to calculate prevalence ratios for factors associated with OME.Results: One hundred and fifty one patients with CP were recruited for this study with a median age of 3.9 (IQR 2.5-6.9), 64.2% (97/151) males and 78.8% (119/151) had non-ambulatory CP. Children who were breastfed for more than 6 months were 74.8% (113/151). Passive smoking exposure and indoor charcoal stove smoke exposure were 15.2% (23/151) and 40.4% (61/151) respectively. Allergic rhinitis was reported in 40.4% (61/151) and 69.5% (105/151) had nasal regurgitation of feeds. The prevalence of OME was 43.7% (66/151). Children who were breastfed for more than 6 months (p value =0.025) were less likely to have OME while presence of allergic rhinitis (p value = 0.016) and nasal regurgtation of feeds (p value = 0.035) increased the odds of having OME. Age, sex, type of CP, indoor charcoal stove smoke exposure and passive smoking had no association with OME.Conclusions: The prevalence of OME among patients with CP was high (43.7%). Treatment for nasal regurgitation of feeds and allergic rhinitis should be initiated early to minimize the risk of OME among these patients. Mothers of children with CP who can breastfeed should be encouraged to continue breastfeeding beyond 6 months as this is protective against OME.