Lasisi Akeem O, Olayemi Oladapo, Irabor Achiaka E
Department of Otorhinolaryngology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Eur Arch Otorhinolaryngol. 2008 Jul;265(7):765-8. doi: 10.1007/s00405-007-0544-1. Epub 2007 Nov 29.
The onset of early otitis media (EOM), in the first few months of life has been reported to predict later chronic otitis media (CSOM), although the prevalence rates are increasing little is known about specific risk factors. In this survey we examined the hypothesis that higher risk factors is associated with the development of OM within 1 year compared to later onset and early onset otitis media (OM) has potential for negative outcome of CSOM. This is a survey of the age at onset of otorrhoea and associated risk factors in children with CSOM, in five sites spread in two sub-urban cities in two states in Nigeria. Questionnaires were administered on the informants followed by examination of the children. EOM was seen in 136/189 (70%) with CSOM, the age range was 1-150 months, mean of 59.25 (SD = 44.55). Of the 85 CSOM subjects with hearing loss, EOM accounted for 49 (57.7%) while 36 (42.4%) was later onset, On multivariate analysis (OR = 0.276, CI = 0.133-0.572, P = 0.001) revealing EOM was significant in the development of hearing loss however there was no correlation with the frequency of attack of otorrhoea (OR = 1.025, CI = 0.88-1.19, P = 0.75). Low socioeconomic status seen in 110/136 EOM (P = 0.000), allergy (P = 0.030) and number of people >10 in household (OR = 4.13, CI = 1.81-9.39, P = 0.001) constituted the significant risk for EOM compared to later onset. Bottlefeeding, adenoiditis/adenoid hypertrophy, indoor cooking and upper respiratory infection were not found to have statistical significance in early onset OM compared to later onset OM. This study found correlation between EOM and hearing loss and identified allergy, low social status and chronic exposure to overcrowding through increased number of children in the household significant risk factors for future research focus. This may help in controlling the prevalence of hearing loss accompanying CSOM.
据报道，在生命的最初几个月出现的早期中耳炎（EOM）可预测日后的慢性化脓性中耳炎（CSOM），尽管其患病率在上升，但关于具体的风险因素却知之甚少。在本次调查中，我们检验了这样一个假设：与迟发性和早发性中耳炎相比，较高的风险因素与1年内中耳炎的发生有关，且早发性中耳炎（OM）有可能导致CSOM的负面结果。这是一项针对尼日利亚两个州的两个城郊城市中五个地点的CSOM患儿耳漏发病年龄及相关风险因素的调查。对 informant 进行问卷调查，随后对儿童进行检查。在189例CSOM患儿中有136例（70%）出现EOM，年龄范围为1 - 150个月，平均59.25个月（标准差 = 44.55）。在85例有听力损失的CSOM患儿中，EOM占49例（57.7%），迟发性占36例（42.4%）。多因素分析显示（比值比 = 0.276，可信区间 = 0.133 - 0.572，P = 0.001），EOM在听力损失的发生中具有显著意义，然而与耳漏发作频率无关（比值比 = 1.025，可信区间 = 0.88 - 1.19，P = 0.75）。与迟发性相比，110/136例EOM患儿存在社会经济地位低（P = 0.000）、过敏（P = 0.030）以及家庭人口数>10人（比值比 = 4.13，可信区间 = 1.81 - 9.39，P = 0.001）是EOM的显著风险因素。与迟发性中耳炎相比，奶瓶喂养、腺样体炎/腺样体肥大、室内烹饪和上呼吸道感染在早发性中耳炎中未发现具有统计学意义。本研究发现EOM与听力损失之间存在关联，并确定过敏、社会地位低以及因家庭中儿童数量增加导致长期处于拥挤环境是未来研究重点的重要风险因素。这可能有助于控制CSOM伴发的听力损失患病率。
