Al-Quaiz A J
Department of Family & Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
J Family Community Med. 2001 May;8(2):17-24.
To describe correlates of various modes of presentation and identify some surrogates of poor outcome of children less than 5 years with Acute Otitis Media (AOM).
This is a cross-sectional survey conducted at 11 primary health care centers in Riyadh city over 3 month period. A total of 140 children, each less than 5 years of age and presenting with a new episode of AOM were enrolled. Twenty-eight family physicians participated in the study. Each physician made the diagnosis of AOM based on history and clinical examination of the tympanic membranes (TM) using an otosocope. Poor outcome was defined as children presenting with otorrhea.
The majority of children presented with fever (62%), URTI (58%) and earache (54%). Presence of URTI, irritability, or sleeplessness were positively associated with redness and dullness of TM (p<0.05). Thumb sucking reduced the risk of bulging (OR = 0.29, 95% CI: 0.07-0.94). Children of illiterate fathers were more likely to present with otorrhea (X(2) = 4.66, p< 0.05). Bottle feeding increased the risk of otorrhea by two fold (OR = 2.26, 95% CI:1.01-5.05).
Children with AOM presenting as URTI, irritability or sleeplessness will showed redness and dullness of the TM as clinical signs of the disease. Thumb sucking was found to be protective from bulging of the TM. Having an illiterate father and being bottle fed were found to be surrogates of otorrhea .
描述小于5岁急性中耳炎（AOM）患儿不同表现方式的相关因素，并确定一些不良预后的替代指标。
这是一项在利雅得市11个初级卫生保健中心进行的为期3个月的横断面调查。共纳入140名小于5岁且首次发作AOM的儿童。28名家庭医生参与了该研究。每位医生根据病史和使用耳镜对鼓膜（TM）的临床检查做出AOM诊断。不良预后定义为患儿出现耳漏。
大多数患儿表现为发热（62%）、上呼吸道感染（URTI，58%）和耳痛（54%）。存在URTI、烦躁或失眠与TM发红和浑浊呈正相关（p<0.05）。吮拇指可降低鼓膜膨出的风险（OR = 0.29，95%CI：0.07 - 0.94）。父亲为文盲的儿童更易出现耳漏（X(2)=4.66，p<0.05）。奶瓶喂养使耳漏风险增加两倍（OR = 2.26，95%CI：1.01 - 5.05）。
表现为URTI、烦躁或失眠的AOM患儿会出现TM发红和浑浊，这是该疾病的临床体征。发现吮拇指可预防TM膨出。父亲为文盲和奶瓶喂养被发现是耳漏的替代指标。
