The prevalence of otitis media with effusion among 4-6 year old nursery school children in Kawempe devision, Kampala district.

Abstract

Hearing impairment is one of the commonest causes of disability in the world. Hearing impairment occurring in a child may lead to delayed speech and language development, poor intellectual ability and abnormal psychosocial skills. The commonest causes of hearing impairment in children are the various forms of otitis media. Otitis media with effusion (OME), a type of inflammation of the middle ear in which a collection of fluid is present in the middle ear, is the commonest cause of hearing impairment in pre-school children in the developed countries. Although it is believed to be worldwide, little research on this condition has been carroed out in developing countires and virtually none in Uganda. A cross sectional descriptive study of OME was carried out in one of the divisions of kampala city/ district. The main objectives were to determine the prevalence of OME and the prevalence and severity of hearing impairment associated with OME among 4-6 year old nursery school children. A total of 575 pupils were selected using a multi-stage random sampling procedure designed to stratify for different socio-economic classes. The disgnosis of OME was based on otoscopy and tympanometry. Pure tone audiometry was performed on diagnosed cases of OME to determine the prevalence of hearing impairment among children with OME as well as the severity of such hearing impairment when present. The prevalence of OME was found was found to be 14.1%. Female children were significant more likely to have OME than male children (OR= 0.585, CI=0.363-0.942, P= value= 0.026). More of the 6 years old (15.1%) had OME compared to the 5 year olds (13.7%) and the 4 year olds (14.0%). However, these differences were not statistically significant (p= value 0.822) Socio-economic status was not significant associated with OME (P. value = 0.145). Hearing impairment was detected in 78.7% of the OME cases and most of the hearing impairment (97%) was of the mild degree while the remaining 3% was of the moderate degree. There were no cases of severe or profound hearing impairment associated with OME. CONCLUSIONS: It was concluded that the prevalence of OME in kawempe division, kampala, Uganda is nearly as high as that in developed counries. It was also concluded that the prevalence of OME in kawempe division, kampala, Uganda is higher than in other African countries. It was further concluded that there is a high prevalence of mild hearing impairment among children with OME RECOMMENDATIONS: It is recommended that school children be routinely screened regularly in order to detect middle ear problems early since a significant portion of them (at least 14%) have OME or other ear problems such as suppurative otitis media, wax and undiagnosed foreign bodies in the ears. It is recommended that teachers of children with OME be sensitized to give special attention to such pupils in their classes since the majority of them have associated hearing impairment. It is also recommended that further research should be planned to investigate the possible risk factors for this prevalence of OME.