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Long-term follow-up of chronic suppurative otitis media in a high-risk children cohort.

Abstract

OBJECTIVE

Chronic suppurative otitis media (CSOM) is the leading cause of mild to moderate hearing impairment in children worldwide and a major public health problem in many indigenous populations. There is a lack of basic epidemiological facts and knowledge on the development of CSOM, as the disease primarily affects developing countries where research capacities often are limited. The purpose of this study was to determine the long-term outcome of CSOM in a high-risk population and to identify risk factors.

METHODS

Follow-up study (2008) on a population-based cohort of 465 children in Greenland, initially examined (1996-8) between the ages 0 and 4 years. Follow-up was attempted among 307 children living in the two major towns. Binomial logistic regression analysis was made to identify risk factors for developing CSOM and for maintaining disease in to adolescence (odds ratios). Log linear binomial regression was used to estimate risk ratios and absolute risks.

RESULTS

At follow-up 236 participated (77% of those available). The prevalence of CSOM was 32/236 (14%) at age group 0-4 years and 21/236 (9%) at age group 11-15 years. Thirteen had disease debut after the initial study. Of those with CSOM in the initial study 24/32 (75%) healed spontaneously. Risk factors for the development of CSOM at any time in childhood was the mother's history of CSOM OR 2.55 (95% CI 1.14-5.70; p=0.02), and mothers with low levels of schooling OR 1.57 (1.03-2.40; p=0.04). Once CSOM had developed boys were more likely to have persistent disease OR 5.46 (95% CI 1.47-20.37; p=0.01). The absolute risk of CSOM if the mother had both a history of CSOM and low schooling was for boys 45.4% (95% CI 26.5-77.7) and for girls 30.7% (95% CI 17.8-53.10). The cumulative risk of CSOM was 19% at follow-up.

CONCLUSIONS

Even though a large number of CSOM cases seemed to heal spontaneously, the prevalence of untreated CSOM among school-age children in Greenland remained high as new cases were found at follow-up. Increased focus on prevention and identification of children at special risk could reduce the high prevalence of CSOM.

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  • Authors+Show Affiliations

    ,

    Department of Otolaryngology, Head & Neck Surgery, Rigshospitalet, University Hospital of Copenhagen, Denmark. ramon@dadlnet.dk

    , ,

    Source

    MeSH

    Adolescent
    Child
    Child, Preschool
    Chronic Disease
    Cohort Studies
    Educational Status
    Female
    Follow-Up Studies
    Greenland
    Humans
    Incidence
    Infant
    Inuits
    Male
    Otitis Media, Suppurative
    Prevalence
    Remission, Spontaneous
    Risk Factors

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    21592588

    Citation

    Jensen, Ramon Gordon, et al. "Long-term Follow-up of Chronic Suppurative Otitis Media in a High-risk Children Cohort." International Journal of Pediatric Otorhinolaryngology, vol. 75, no. 7, 2011, pp. 948-54.
    Jensen RG, Homøe P, Andersson M, et al. Long-term follow-up of chronic suppurative otitis media in a high-risk children cohort. Int J Pediatr Otorhinolaryngol. 2011;75(7):948-54.
    Jensen, R. G., Homøe, P., Andersson, M., & Koch, A. (2011). Long-term follow-up of chronic suppurative otitis media in a high-risk children cohort. International Journal of Pediatric Otorhinolaryngology, 75(7), pp. 948-54. doi:10.1016/j.ijporl.2011.04.017.
    Jensen RG, et al. Long-term Follow-up of Chronic Suppurative Otitis Media in a High-risk Children Cohort. Int J Pediatr Otorhinolaryngol. 2011;75(7):948-54. PubMed PMID: 21592588.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Long-term follow-up of chronic suppurative otitis media in a high-risk children cohort. AU - Jensen,Ramon Gordon, AU - Homøe,Preben, AU - Andersson,Mikael, AU - Koch,Anders, Y1 - 2011/05/17/ PY - 2011/01/31/received PY - 2011/04/20/revised PY - 2011/04/22/accepted PY - 2011/5/20/entrez PY - 2011/5/20/pubmed PY - 2011/10/5/medline SP - 948 EP - 54 JF - International journal of pediatric otorhinolaryngology JO - Int. J. Pediatr. Otorhinolaryngol. VL - 75 IS - 7 N2 - OBJECTIVE: Chronic suppurative otitis media (CSOM) is the leading cause of mild to moderate hearing impairment in children worldwide and a major public health problem in many indigenous populations. There is a lack of basic epidemiological facts and knowledge on the development of CSOM, as the disease primarily affects developing countries where research capacities often are limited. The purpose of this study was to determine the long-term outcome of CSOM in a high-risk population and to identify risk factors. METHODS: Follow-up study (2008) on a population-based cohort of 465 children in Greenland, initially examined (1996-8) between the ages 0 and 4 years. Follow-up was attempted among 307 children living in the two major towns. Binomial logistic regression analysis was made to identify risk factors for developing CSOM and for maintaining disease in to adolescence (odds ratios). Log linear binomial regression was used to estimate risk ratios and absolute risks. RESULTS: At follow-up 236 participated (77% of those available). The prevalence of CSOM was 32/236 (14%) at age group 0-4 years and 21/236 (9%) at age group 11-15 years. Thirteen had disease debut after the initial study. Of those with CSOM in the initial study 24/32 (75%) healed spontaneously. Risk factors for the development of CSOM at any time in childhood was the mother's history of CSOM OR 2.55 (95% CI 1.14-5.70; p=0.02), and mothers with low levels of schooling OR 1.57 (1.03-2.40; p=0.04). Once CSOM had developed boys were more likely to have persistent disease OR 5.46 (95% CI 1.47-20.37; p=0.01). The absolute risk of CSOM if the mother had both a history of CSOM and low schooling was for boys 45.4% (95% CI 26.5-77.7) and for girls 30.7% (95% CI 17.8-53.10). The cumulative risk of CSOM was 19% at follow-up. CONCLUSIONS: Even though a large number of CSOM cases seemed to heal spontaneously, the prevalence of untreated CSOM among school-age children in Greenland remained high as new cases were found at follow-up. Increased focus on prevention and identification of children at special risk could reduce the high prevalence of CSOM. SN - 1872-8464 UR - https://www.unboundmedicine.com/medline/citation/21592588/Long_term_follow_up_of_chronic_suppurative_otitis_media_in_a_high_risk_children_cohort_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-5876(11)00228-X DB - PRIME DP - Unbound Medicine ER -