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Prevalence of paediatric chronic suppurative otitis media and hearing impairment in rural Malawi: A cross-sectional survey.
PLoS One. 2017; 12(12):e0188950.Plos

Abstract

OBJECTIVE

To estimate the prevalence of World Health Organization-defined chronic suppurative otitis media (CSOM) and mild hearing impairment in a population representative sample of school-entry age children in rural Malawi. A secondary objective was to explore factors associated with CSOM in this population.

METHODS

We performed a community-based cross-sectional study of children aged 4-6 years in Chikhwawa District, Southern Malawi, utilising a village-level cluster design. Participants underwent a structured clinical assessment, including video-otoscopy and screening audiometry. Diagnoses were made remotely by two otolaryngologists who independently reviewed clinical data and images collected in the field. Hearing impairment was classified as failure to hear a pure tone of 25dB or greater at 1, 2 or 4kHz.

RESULTS

We recruited 281 children across 10 clusters. The prevalence estimates of CSOM, unilateral hearing impairment and bilateral hearing impairment were 5.4% (95%CI 2.2-8.6), 24.5% (95%CI 16.3-30.0), and 12.5% (95%CI 6.2-16.9) respectively. Middle ear disease was seen in 46.9% of children with hearing impairment. A trend towards increased risk of CSOM was observed with sleeping in a house with >2 other children.

INTERPRETATION

We found a high burden of middle ear disease and preventable hearing impairment in our sample of school-entry age children in rural Malawi. There are important public health implications of these findings as CSOM and hearing impairment can affect educational outcomes, and may impact subsequent development. The identification and management of middle ear disease and hearing impairment represent major unmet needs in this population.

Authors+Show Affiliations

Liverpool School of Tropical Medicine, Liverpool, United Kingdom.College of Medicine, Blantyre, Malawi.Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom.Malawi-Liverpool-Wellcome Trust Clinical Research Program, Blantyre, Malawi.Malawi-Liverpool-Wellcome Trust Clinical Research Program, Blantyre, Malawi.University Hospitals Leicester NHS Foundation Trust, Leicester, United Kingdom.Independent Scholar, Sheffield, United Kingdom.Liverpool School of Tropical Medicine, Liverpool, United Kingdom.

Pub Type(s)

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

Language

eng

PubMed ID

29267304

Citation

Hunt, Luke, et al. "Prevalence of Paediatric Chronic Suppurative Otitis Media and Hearing Impairment in Rural Malawi: a Cross-sectional Survey." PloS One, vol. 12, no. 12, 2017, pp. e0188950.
Hunt L, Mulwafu W, Knott V, et al. Prevalence of paediatric chronic suppurative otitis media and hearing impairment in rural Malawi: A cross-sectional survey. PLoS One. 2017;12(12):e0188950.
Hunt, L., Mulwafu, W., Knott, V., Ndamala, C. B., Naunje, A. W., Dewhurst, S., Hall, A., & Mortimer, K. (2017). Prevalence of paediatric chronic suppurative otitis media and hearing impairment in rural Malawi: A cross-sectional survey. PloS One, 12(12), e0188950. https://doi.org/10.1371/journal.pone.0188950
Hunt L, et al. Prevalence of Paediatric Chronic Suppurative Otitis Media and Hearing Impairment in Rural Malawi: a Cross-sectional Survey. PLoS One. 2017;12(12):e0188950. PubMed PMID: 29267304.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of paediatric chronic suppurative otitis media and hearing impairment in rural Malawi: A cross-sectional survey. AU - Hunt,Luke, AU - Mulwafu,Wakisa, AU - Knott,Victoria, AU - Ndamala,Chifundo B, AU - Naunje,Andrew W, AU - Dewhurst,Sam, AU - Hall,Andrew, AU - Mortimer,Kevin, Y1 - 2017/12/21/ PY - 2017/03/21/received PY - 2017/11/16/accepted PY - 2017/12/22/entrez PY - 2017/12/22/pubmed PY - 2018/1/18/medline SP - e0188950 EP - e0188950 JF - PloS one JO - PLoS One VL - 12 IS - 12 N2 - OBJECTIVE: To estimate the prevalence of World Health Organization-defined chronic suppurative otitis media (CSOM) and mild hearing impairment in a population representative sample of school-entry age children in rural Malawi. A secondary objective was to explore factors associated with CSOM in this population. METHODS: We performed a community-based cross-sectional study of children aged 4-6 years in Chikhwawa District, Southern Malawi, utilising a village-level cluster design. Participants underwent a structured clinical assessment, including video-otoscopy and screening audiometry. Diagnoses were made remotely by two otolaryngologists who independently reviewed clinical data and images collected in the field. Hearing impairment was classified as failure to hear a pure tone of 25dB or greater at 1, 2 or 4kHz. RESULTS: We recruited 281 children across 10 clusters. The prevalence estimates of CSOM, unilateral hearing impairment and bilateral hearing impairment were 5.4% (95%CI 2.2-8.6), 24.5% (95%CI 16.3-30.0), and 12.5% (95%CI 6.2-16.9) respectively. Middle ear disease was seen in 46.9% of children with hearing impairment. A trend towards increased risk of CSOM was observed with sleeping in a house with >2 other children. INTERPRETATION: We found a high burden of middle ear disease and preventable hearing impairment in our sample of school-entry age children in rural Malawi. There are important public health implications of these findings as CSOM and hearing impairment can affect educational outcomes, and may impact subsequent development. The identification and management of middle ear disease and hearing impairment represent major unmet needs in this population. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/29267304/Prevalence_of_paediatric_chronic_suppurative_otitis_media_and_hearing_impairment_in_rural_Malawi:_A_cross_sectional_survey_ L2 - https://dx.plos.org/10.1371/journal.pone.0188950 DB - PRIME DP - Unbound Medicine ER -