Sociodemographic, Socioeconomic and Clinical Risk Factors for Chronic Otitis Media in Childreen

Yıl 2019, , 1583 - 1595, 15.08.2019

Ercan Kurt , Fatih Çelenk Burhanetin Gönüldaş Koray Tümüklü

https://doi.org/10.30569/adiyamansaglik.597273

Öz

Aim:The
aim of present study is to identify COM-related clinic, sociodemographic and
socioeconomic risk factors.

Method:
103 children diagnosed for COM and treated in Department of
Otorhinolaryngology, Faculty of Medicine, Gaziantep University during 2005-2015
and 116 healthy children were included in this study. The questionnaire about
risk factors of COM were filled by interviewing verbatim with mothers and/or
fathers of all children.

Result:
Patient and control groups were composed of 53 boys (51.5%) and 50 girls
(48.5%), and 48 boys (41.4%) and 68 girls (58.6%), respectively. The mean age
of patients was 13.1 years (range, 2-16), and the mean age of the control group
was 12.05 years (range, 6-16). Multiple logistic regression models and
univariate analysis were used to determine association between risk factors and
COM. Maternal smoking during pregnancy (p=0.014), otitis media history in the
first year of life (p=0.001), recurrent otitis media history (p=0.001), upper
respiratory tract infection history in the first year of life (p=0.001),  ventilation tube insertion history (p=0.001),
tonsillectomy and/or adenoidectomy history (p=0.001), otitis media history in
family members (p=0.008) and lack of health insurance (p=0.001) were found to
be significantly associated with COM. In multivariate analysis, otitis media
history in the first year of life (OR=8,00, %95 CI=
[3,34-19,17], p=0.001), father’s otitis media history (OR=8.43, %95
CI= [1,47-48,42], p=0.017) and lack of health insurance (OR=3,09 %95
CI=[1,35-7,11], p=0.008) were significantly associated with COM.

 

Conclusion: Chronic
otitis media (COM) is a long-term inflammation of middle ear that leads to
irreversible changes in eardrum. COM is a common disease in children, and if
not treated, it may cause severe complications and sequelae. Thus, if risk
factors causing COM are elucidated, the potential complications might be
prevented and prophylactic strategies can be developed. This study indicated
that history of otitis media in the first year of life, having a father with
history of otitis media and lack of health insurance are risk factors for COM. 

Anahtar Kelimeler

Chronic otitis media, Otitis media, risc factors

Çocuklarda Kronik Otitis Media için Sosyodemografik, Sosyoekonomik ve Klinik Risk Faktörleri

Öz

Amaç:
Bu çalışmanın amacı çocuklarda KOM ile ilişkili klinik, sosyodemografik ve
sosyoekonomik risk  faktörlerini belirlemektir.

Metot: Bu çalışmaya 2005-2015 yılları arasında Gaziantep
Üniversitesi Tıp Fakültesi KBB Anabilim Dalı’nda KOM tanı ve tedavisi almış 103
çocuk hasta ve 116 sağlıklı çocuk dahil edildi. Risk faktörlerini içeren
anketler hasta ve kontrol grubundaki çocukların anne ve/veya babası ile birebir
görüşülerek dolduruldu.

Bulgular:  Hastaların 53’ü erkek (%51,5) ve  50’si kızdı
(%48,5).  Kontrol grubunda 48 erkek (%41,4) ve 68 kız (%58,6) çocuk
bulunmaktaydı. Hastaların yaş ortalaması 13,1 (yaş aralığı, 2-16) ve kontrol
grubunun yaş ortalaması 12,05 (yaş aralığı, 6-16) idi. Belirlenen risk faktörleri
ile KOM arasındaki ilişkiyi belirlemek için çok değişkenli regresyon modeli ve
tek değişkenli analiz kullanıldı. Annenin gebelikte sigara kullanması
(p=0,014), ilk yaşta otitis media geçirme (p=0,001), sık otitis media geçirme
(p=0,001), ilk yaşta sık üst solunum yolu enfeksiyonu geçirme (p=0,001), önceki
kulak zarına ventilasyon tüpü tatbiki (p=0.001), önceki tonsillektomi ve/veya
adenoidektomi (p=0,001), babada (p=0.008) ve kardeşte otitis media hikayesi
(p=0,008) ve aile reisinin sigortasının olmaması (p=0.001)  KOM ile
anlamlı olarak ilişkili bulundu. Çok-değişkenli analizde ilk yaşta otitis media
geçirme (OR=8,00, %95 GA=[3,34-19,17], p=0.000),  babada  otitis
media  hikayesi (OR=8,438, %95 GA=[1,47-48,42], p=0.017) ve aile reisinin
sağlık güvencesinin olmaması (OR=3,091 %95 GA=[1,35-7,110], p=0.008) KOM ile
ilişkili risk faktörleri olarak bulundu.

Sonuç: Kronik otitis
media (KOM) orta kulağın kulak zarında kalıcı değişikliklere yol açan uzun
süreli enflamasyonudur. KOM çocuklarda sık görülen bir hastalıktır ve tam
olarak tedavi edilmezse ciddi komplikasyonlara ve sekellere yol açabilir. Bu
hastalıkla ilişkili risk faktörleri ortaya konulursa potansiyel komplikasyonlar
önlenebilir ve önleyici stratejiler geliştirilir. Bu çalışmada elde edilen
sonuçlara göre ilk yaşta otitis media geçirme, babada otitis media hikayesi
aile reisinin sağlık güvencesinin olmaması KOM için risk faktörleridir.

 

Anahtar Kelimeler

Aktif kronik otitis media, İnaktif kronik otitis media, Risk faktörleri

Kaynakça

• 1. Çelik., O., Kulak Burun Boğaz ve Baş Boyun Cerrahisi kitabı. 2. baskı 1. cilt
• 2. Akyıldız., A.N., Kulak Hastalıkları ve Mikrocerrahi Kitabı.
• 3. Kangsanarak, J., et al., Extracranial and intracranial complications of suppurative otitis media. Report of 102 cases. The Journal of Laryngology & Otology, 1993. 107(11): p. 999-1004.
• 4. Meyerhoff, W.L., C.S. Kim, and M.M. Paparella, Pathology of chronic otitis media. Annals of Otology, Rhinology & Laryngology, 1978. 87(6): p. 749-760.5. Papp, Z., et al., Sensorineural hearing loss in chronic otitis media. Otology & neurotology, 2003. 24(2): p. 141-144.
• 6. Eliçora, S.Ş., et al., Risk factors for otitis media effusion in children who have adenoid hypertrophia. International journal of pediatric otorhinolaryngology, 2015. 79(3): p. 374-377.
• 7. Jervis-Bardy, J., L. Sanchez, and A. Carney, Otitis media in Indigenous Australian children: review of epidemiology and risk factors. The Journal of Laryngology & Otology, 2014. 128(S1): p. S16-S27.
• 8. Skoner, A.R., K.R. Skoner, and D.P. Skoner. Allergic rhinitis, histamine, and otitis media. in Allergy and asthma proceedings. 2009. OceanSide Publications, Inc.9. Amusa, Y., I. Ijadunola, and O. Onayade, Epidemiology of otitis media in a local tropical African population. West African journal of medicine, 2004. 24(3): p. 227-230.
• 10. Bruneau, S., et al., Longitudinal observations (1987-1997) on the prevalence of middle ear disease and associated risk factors among Inuit children of Inukjuak, Nunavik, Quebec, Canada. International journal of circumpolar health, 2001. 60(4): p. 632-639.
• 11. Morinière S, S.C., Lescanne E, Ployet MJ. Rev Prat., [Epidemiology of otitis media with effusion]. . 1998 15;48:838-42.
• 12. Mills, R., Risk factors for chronicity in childhood otitis media with effusion. Clinical Otolaryngology & Allied Sciences, 1999. 24(4): p. 343-345.
• 13. Daly, K.A., et al., Epidemiology of otitis media onset by six months of age. Pediatrics, 1999. 103(6): p. 1158-1166.
• 14. Fireman, P., Otitis media and eustachian tube dysfunction: connection to allergic rhinitis. Journal of allergy and clinical immunology, 1997. 99(2): p. s787-s797.
• 15. Alho, O.-P., et al., Risk factors for chronic otitis media with effusion in infancy: Each acute otitis media episode induces a high but transient risk. Archives of Otolaryngology–Head & Neck Surgery, 1995. 121(8): p. 839-843.
• 16. Rasmussen, F., Protracted secretory otitis media. The impact of familial factors and day-care center attendance. International journal of pediatric otorhinolaryngology, 1993. 26(1): p. 29-37.
• 17. Kraemer MJ, M.S., Richardson MA., Etiologic factors in the development of chronic middle ear effusions. Clin Rev Allergy. , 1984 2:319-28.
• 18. Kim, C.S., H.W. Jung, and K.Y. Yoo, Prevalence and risk factors of chronic otitis media in Korea: results of a nation-wide survey. Acta oto-laryngologica, 1993. 113(3): p. 369-375.
• 19. Hammaren-Malmi, S., J. Tarkkanen, and P. Mattila, Analysis of risk factors for childhood persistent middle ear effusion. Acta oto-laryngologica, 2005. 125(10): p. 1051-1054.
• 20. Mion, O., et al., The role of rhinitis in chronic otitis media. Otolaryngology—Head and Neck Surgery, 2003. 128(1): p. 27-31.
• 21. van der Veen, E.L., et al., Predictors of chronic suppurative otitis media in children. Archives of Otolaryngology–Head & Neck Surgery, 2006. 132(10): p. 1115-1118.
• 22. Lasisi, A.O., O.A. Sulaiman, and O.A. Afolabi, Socio-economic status and hearing loss in chronic suppurative otitis media in Nigeria. Annals of tropical paediatrics, 2007. 27(4): p. 291-296.
• 23. Koch, A., et al., Chronic suppurative otitis media in a birth cohort of children in Greenland: population-based study of incidence and risk factors. The Pediatric infectious disease journal, 2011. 30(1): p. 25-29.
• 24. Jensen RG, H.P., Andersson M, Koch A., Int J Pediatr Otorhinolaryngol. Long-term follow-up of chronic suppurative otitis media in a high-risk children cohort. . 2011 75:948-54.
• 25. Shaheen MM, R.A., Ahmad SM., Int J Pediatr Otorhinolaryngol. Prevalence and associated socio-demographic factors of chronic suppurative otitis media among rural primary school children of Bangladesh. 2012 76:1201-4.