Mtamo Ruth, Vallario Jenna, Kumar Ambuj, Casanova Jesse, Toman Julia
African Bible College, Area 47, Lilongwe P.O. Box 1028, Malawi.
Department of Internal Medicine, Morsani College of Medicine, Tampa, FL 33612, USA.
Audiol Res. 2024 May 30;14(3):493-504. doi: 10.3390/audiolres14030041.
Outer and middle ear pathologies are known to disproportionately affect low-income countries but data is limited. We aim to quantify the prevalence rate of patients presenting with middle/outer ear pathologies at ABC Hearing Clinic and Training Centre in Lilongwe, Malawi. Audiological consultations (adult and paediatric) from 2018-2020 were reviewed for outer and middle ear pathologies. Secondary outcomes included patient type (private vs. community) compared to otoscopy findings, tympanometry findings, need for follow up, and follow up compliance. Out of 1576 patients reviewed, the proportion of abnormal cases' was 98.2%, with 41.4% being unilateral and 57.4% bilateral. Eighty-three percent presented with outer/middle ear pathologies. 68% of those presented with a pathology often associated with some degree of conductive hearing loss (occluding wax, perforation, discharge, Type B/Type C tympanogram). Average age was 29 + 0.527 years; 41.6% private and 58.2% community patients. Cerumen impaction was most common finding (51%). Higher rates of otoscopic abnormalities and type B tympanograms were noted in community vs. private patient (~40% vs. ~30%; ~70% vs. ~30%). Adherence to follow up was higher for community vs. private patients (29% vs. 17%); ~70% reported subjective improvement upon follow up. The majority required multiple interventions on follow up. Secondary follow up was recommended in 64.8%. A significant disease burden of outer and middle ear pathologies was identified. Further research is required to understand the disease burden and promote health policy.
已知外耳和中耳疾病对低收入国家的影响尤为严重，但相关数据有限。我们旨在量化马拉维利隆圭ABC听力诊所及培训中心患有中耳/外耳疾病患者的患病率。回顾了2018年至2020年成人和儿童的听力咨询记录，以确定外耳和中耳疾病情况。次要结果包括患者类型（私立患者与社区患者）与耳镜检查结果、鼓室图检查结果、随访需求及随访依从性的比较。在1576名接受检查的患者中，异常病例的比例为98.2%，其中41.4%为单侧病变，57.4%为双侧病变。83%的患者患有外耳/中耳疾病。其中68%的患者患有通常与某种程度的传导性听力损失相关的疾病（耵聍堵塞、穿孔、流脓、B型/C型鼓室图）。平均年龄为29±0.527岁；私立患者占41.6%，社区患者占58.2%。耵聍堵塞是最常见的症状（51%）。社区患者的耳镜检查异常率和B型鼓室图比例高于私立患者（约40%对约30%；约70%对约30%）。社区患者的随访依从性高于私立患者（29%对17%）；约70%的患者在随访时表示主观症状有所改善。大多数患者在随访时需要多次干预。64.8%的患者建议进行二次随访。研究发现外耳和中耳疾病存在重大疾病负担。需要进一步研究以了解疾病负担并推动卫生政策的制定。
