A community based questionnaire study on the association between symptoms suggestive of otitis media with effusion, rhinitis and asthma in primary school children.

OBJECTIVES

To evaluate the association between symptoms suggestive of otitis media with effusion (OME), rhinitis and asthma in an unselected population of primary school children and investigate whether our previous observation of such an association in a secondary care setting was valid in the community.

METHODOLOGY

A specifically designed questionnaire was administered to 332 new entrant primary school children across 11 state and independent primary schools in the East Berkshire district between March and June 1996. It had six sections, to ascertain symptoms suggestive of OME, rhinitis, asthma, other atopic features, treatment for any of these, and a possible family history of atopy. Within the first three sections, each question was scored and weighted depending on the importance of each in establishing the possible diagnoses, with three scoring bands: '0' indicating the absence; '1-5' the possibility and '> or =6' a strong likelihood that the above conditions were present. The outcome measures were the number of children with or without symptoms suggestive of OME, rhinitis, asthma, and the correlation of these symptom scores with each other and OME with eczema, other atopic manifestations, family history of atopy and educational system.

RESULTS

Thirty two point eight percent, thirty six point six percent and twenty four percent had symptoms suggestive of OME, rhinitis and asthma, respectively with scores of either 1-5 or > or =6. There was a highly significant correlation between otological (OME) and nasal scores (p=0.00000), particularly obstructive nasal symptoms (p=0.00000) and > or =6 upper respiratory tract infections/year (p=0.00000); otological and chest scores suggestive of asthma (p=0.00001), and a family history of asthma (p=0.00178). No association was found between scores for OME and eczema, urticaria, food or drug allergies. No differences were noted between the sexes or educational systems.

CONCLUSION

The highly significant association between the symptom scores suggestive of OME and rhinitis in this unselected population, indicates the importance of enquiring about nasal symptoms in children with chronic OME, as appropriate treatment of rhinitis may improve the child's quality of life, reduce health care utilisation and possibly reduce the need for OME surgery.