Prevalence of obstructive sleep apnoea and validation of OSA-5 questionnaire among children 2-7 years with severe adenotonsillar hypertrophy in Mulago Hospital

Abstract

Background Adenotonsillar hypertrophy (ATH) is the commonest cause of obstructive sleep apnoea (OSA) in children. The gold standard for the diagnosis of OSA is polysomnography, however, it is expensive, time consuming and not readily available in Uganda. The Obstructive Sleep Apnoea 5 (OSA 5) Questionnaire is a simple questionnaire that performs well as a triage screening tool to identify those children at risk of OSA among large numbers of referrals for sleep disordered breathing (SDB). We found the prevalence of OSA and validated the OSA-5 Questionnaire in children with severe ATH in Mulago Hospital in Kampala, Uganda. Objective To determine the prevalence of obstructive sleep apnoea and to validate the OSA-5 questionnaire among children aged 2-7 years with severe ATH. Methods This was a cross sectional study. We enrolled 104 participants 2 to 7 years with severe ATH. They were subjected to OSA-5 questionnaire and then underwent overnight polysomnography (PSG) using the ambulatory Alice PDX sleep system on the ward. We then determined the prevalence of OSA among these children and the validity of OSA-5 questionnaire in detecting OSA in children with severe ATH by determining its specificity and sensitivity. Results The majority (54.8%) of the participants were female with a male to female ratio of 0.82 to 1. The youngest participant was 2 years old while the oldest was 7 years with a mean age of 4.6 years. The mean BMI was 15.9. The prevalence of OSA was found to be 88.5% (95% CI of 82.2-94.7) and the OSA-5 Questionnaire was found to have a sensitivity, specificity, positive predictive value and negative predictive value of 100%. Conclusion The prevalence of OSA is high among patients aged 2-7 years with severe ATH in Mulago Hospital. The OSA 5 questionnaire is a simpler and highly specific and sensitive tool that can be adopted for screening of OSA in children with severe ATH.