Prevalence and risk factors of otitis media with effusion in patients with adenoid hypertrophy at Kigali University Teaching Hospital ( CHUK)

Abstract

Background: Otitis media with effusion is a middle ear effusion without signs and symptoms of middle ear infections. It is mainly due to Eustachian tube dysfunction or sequelae of acute otitis media. There are different risk predisposing to OME, among them adenoid hypertrophy. Objectives: To determine the prevalence and risk factors of otitis media with effusion in children with adenotonsillar hypertrophy. Methodology: This was a prospective descriptive study were children presenting at CHUK with symptoms and signs of adenoid hypertrophy were included. They were from 1 year to 12 years of age. Parents/ guardian were asked to fill a questionnaire about the clinical presentation and about other known risk factors for otitis media with effusion. A physical examination was done with pneumatic otoscopy and fiberoptic nasopharyngoscopy to grade the size of adenoids. As investigation tympanometry was performed to confirm the presence of OME. Results: 152 children met inclusion criteria.68.4% were male, the predominant age group was children from 1-4 years which account for 75%. The prevalence of otitis media with effusion was 46.1%. About other the risk factors associated with OME we found the age group 1-4 years was associated with OME P value 0.024, originating from the North and South of Rwanda was associated with OME, P value 0.02 and 0.01 respectively. Socioeconomic status ubudehe category 2 and 3 were also associated with OME 0.01 and 0.03 respectively. History with a sibling with OME is a risk factor P value 0.2, and living in overcrowded home P value 0.002. Attending day care centers, parents with OME, previous AOM, smoking at home, bottle feeding and feeding while supine were not shown to be risk factors. Conclusion: Otitis media with effusion is highly prevalent in children with adenoid hypertrophy. Proper examination is mandatory to prevent possible sequels from unnoticed OME.