Prevalence of paediatric chronic suppurative otitis media and hearing impairment in rural Malawi: A cross-sectional survey

被引:37
|
作者
Hunt, Luke [1 ]
Mulwafu, Wakisa [2 ]
Knott, Victoria [3 ]
Ndamala, Chifundo B. [4 ]
Naunje, Andrew W. [4 ]
Dewhurst, Sam [5 ]
Hall, Andrew
Mortimer, Kevin [1 ]
机构
[1] Univ Liverpool Liverpool Sch Trop Med, Liverpool, Merseyside, England
[2] Coll Med, Blantyre, Malawi
[3] Sheffield Teaching Hosp NHS Fdn Trust, Sheffield, S Yorkshire, England
[4] Malawi Liverpool Wellcome Trust Clin Res Program, Blantyre, Malawi
[5] Univ Hosp Leicester NHS Fdn Trust, Leicester, Leics, England
来源
PLOS ONE | 2017年 / 12卷 / 12期
基金
英国惠康基金; 英国医学研究理事会;
关键词
PRIMARY-SCHOOL CHILDREN; VIDEO-OTOSCOPY; EAR; SCHOOLCHILDREN; PERFORMANCE; DISORDERS; DISTRICT; TANZANIA; DISEASE; KENYA;
D O I
10.1371/journal.pone.0188950
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Objective To estimate the prevalence of World Health Organization-defined chronic suppurative otitis media (CSOM) and mild hearing impairment in a population representative sample of school-entry age children in rural Malawi. A secondary objective was to explore factors associated with CSOM in this population. Methods We performed a community-based cross-sectional study of children aged 4-6 years in Chikhwawa District, Southern Malawi, utilising a village-level cluster design. Participants underwent a structured clinical assessment, including video-otoscopy and screening audiometry. Diagnoses were made remotely by two otolaryngologists who independently reviewed clinical data and images collected in the field. Hearing impairment was classified as failure to hear a pure tone of 25dB or greater at 1, 2 or 4kHz. Results We recruited 281 children across 10 clusters. The prevalence estimates of CSOM, unilateral hearing impairment and bilateral hearing impairment were 5.4% (95% CI 2.2-8.6), 24.5% (95% CI 16.3-30.0), and 12.5% (95% CI 6.2-16.9) respectively. Middle ear disease was seen in 46.9% of children with hearing impairment. A trend towards increased risk of CSOM was observed with sleeping in a house with >2 other children. Interpretation We found a high burden of middle ear disease and preventable hearing impairment in our sample of school-entry age children in rural Malawi. There are important public health implications of these findings as CSOM and hearing impairment can affect educational outcomes, and may impact subsequent development. The identification and management of middle ear disease and hearing impairment represent major unmet needs in this population.
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页数:12
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