Middle ear problems in children hospitalised because of lower respiratory tract infections: a comparison between two cohorts in Burundi and Italy

Int J Pediatr Otorhinolaryngol. 2013 Dec;77(12):1984-6. doi: 10.1016/j.ijporl.2013.09.018. Epub 2013 Oct 3.

Abstract

Objectives: To compare the prevalence of acute otitis media (AOM) and otitis media with effusion (OME) in children hospitalized for acute lower respiratory infections (LRTIs) in Burundi and Italy.

Methods: The study, which was conducted from 1 February to 30 April 2011 at the hospital of Kiremba (Burundi, Africa) and at Paediatric Clinic 1 of the University of Milan (Italy), enrolled patients aged <5 years who were hospitalised because of LRTIs. Upon admission, the children underwent an otological examination (pneumatic otoscopy and tympanometry), and middle ear diseases were compared between the two groups.

Results: A total of 108 children enrolled in Burundi (44 males; median age 17 months) were compared to 108 patients enrolled in Italy (53 males; median age 19 months). About one-third of the children in Burundi (33, 30.6%) had normal middle ears. AOM was never diagnosed, whereas OME was detected in 74 children (68.5%: bilateral in 51, 68.9%, and unilateral in 23, 31.1%). The prevalence of OME decreased with increasing age: it was 86.5% in children aged <12 months, 73.7% in those aged 12-24 months, and 43.8% in those aged >24 months (p < 0.001). There was no difference in the proportion of children with OME in Burundi (68.5%) and Italy (63.9%; p = 0.47). OME was significantly more frequent in the children with pneumonia admitted in Burundi than in the children with pneumonia admitted in Italy (p = 0.004).

Conclusions: In children hospitalized for lower respiratory tract infection, OME is almost as frequently seen in developing countries like Burundi, Africa, as in developed countries like Italy. Follow-up monitoring of these children might be required to assess if OME is just a transient phenomenon.

Keywords: Acute otitis media; Children; Developing countries; Lower respiratory tract infections; Middle ear diseases; Otitis media with effusion.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Age Distribution
  • Bronchitis / diagnosis
  • Bronchitis / epidemiology
  • Bronchitis / therapy
  • Burundi / epidemiology
  • Child, Preschool
  • Cohort Studies
  • Comorbidity
  • Developing Countries
  • Female
  • Hospitalization / statistics & numerical data
  • Hospitals, Pediatric
  • Humans
  • Incidence
  • Infant
  • Italy / epidemiology
  • Male
  • Otitis Media / diagnosis*
  • Otitis Media / epidemiology*
  • Otitis Media with Effusion / diagnosis
  • Otitis Media with Effusion / epidemiology
  • Otoscopy / methods
  • Pneumonia / diagnosis
  • Pneumonia / epidemiology*
  • Pneumonia / therapy
  • Respiratory Tract Infections / diagnosis*
  • Respiratory Tract Infections / epidemiology*
  • Respiratory Tract Infections / therapy
  • Risk Assessment
  • Severity of Illness Index
  • Sex Distribution