Mark Aparna, Matharu Vineeta, Dowswell George, Smith Michael
Basildon and Thurrock University Hospital, Nethermayne, Basildon, Essex SS16 5NL, UK.
Int J Pediatr Otorhinolaryngol. 2013 Sep;77(9):1523-9. doi: 10.1016/j.ijporl.2013.06.024. Epub 2013 Jul 27.
Otitis media with effusion (OME) is a condition of uncertain aetiology seen in paediatric practice. It has important sequelae that can result in significant morbidity. Worldwide documentation of OME prevalence in older children is poor as OME is traditionally seen in children below the age of 6 years. Available research in Nepal reports a prevalence of OME in children between the ages of 3 and 8 years as high as 27%. This study aims to establish a reliable prevalence of OME in children between the ages of 9 and 16 years in order to inform public health policy and target limited resources.
This cross-sectional study was undertaken in Pokhara, Nepal. Two different school populations were examined, government and non-government. Children in these schools between 9 and 16 years underwent clinical assessment for OME with otoscopy and tympanometry. Demographic data were also collected to identify potential OME risk factors. For each school population the prevalence of unilateral, bilateral and all case OME was calculated as percentages with 95% confidence intervals.
A total of 494 children were recruited in this study (government=187, non-government=307). Fourteen were excluded due to impacted cerumen or other ENT pathology making it very difficult to conduct a clinical assessment. In the combined school populations the point prevalence of OME was 12.9%. The peak prevalence of OME was found in children aged 10 years (23.1%). A higher point prevalence of OME was found in the non-government school population than the government school (government=9.3%, non-government=15.0%). This difference was not statistically significant (χ(2)=3.209, df=1, p=0.073). Age was found to be significant predictor of OME.
Contrary to its established natural history OME has been found to be widespread in older children in Nepal. No significant predictors of OME were established and rates did not vary significantly between school types. Studies need to be conducted in a larger population to investigate this further. To fully assess disease burden of OME amongst children in Nepal, prevalence in children not regularly attending schools also needs investigation.
中耳积液（OME）是儿科临床中一种病因不明的病症。它具有重要的后遗症，可导致严重的发病情况。在全球范围内，关于大龄儿童OME患病率的记录较少，因为传统上OME多见于6岁以下儿童。尼泊尔现有的研究报告称，3至8岁儿童的OME患病率高达27%。本研究旨在确定9至16岁儿童OME的可靠患病率，以便为公共卫生政策提供信息并合理分配有限资源。
本横断面研究在尼泊尔博卡拉进行。对两类不同学校群体进行了检查，即政府学校和非政府学校。这些学校中9至16岁的儿童接受了耳镜检查和鼓室导抗图检查以评估OME。还收集了人口统计学数据以确定潜在的OME危险因素。对于每个学校群体，计算单侧、双侧及所有病例的OME患病率，并给出95%置信区间。
本研究共招募了494名儿童（政府学校=187名，非政府学校=307名）。由于耵聍栓塞或其他耳鼻喉科病理情况导致难以进行临床评估，14名儿童被排除。在合并的学校群体中，OME的点患病率为12.9%。OME患病率最高的是10岁儿童（23.1%）。非政府学校群体的OME点患病率高于政府学校（政府学校=9.3%，非政府学校=15.0%）。这种差异无统计学意义（χ(2)=3.209，自由度=1，p=0.073）。年龄被发现是OME的显著预测因素。
与已确定的自然病程相反，在尼泊尔大龄儿童中发现OME广泛存在。未确定OME的显著预测因素，且不同学校类型之间的患病率无显著差异。需要在更大规模人群中进行研究以进一步调查。为全面评估尼泊尔儿童中OME的疾病负担，还需要调查未经常上学儿童的患病率。
