Prevalence and risk factors of otitis media with effusion in primary school and kindergarten children in provincial and district centers of Diyarbakır

Yıl 2012, Cilt: 2 Sayı: 1, 1 - 8, 01.03.2012

Recep Güzel Faruk Meriç Serdar Ferit Toprak Argün Ediz Yorgancılar Ramazan Gün

https://doi.org/10.2399/jmu.2012001001

Öz

Objective: The aim of the present study was to determine the prevalence of otitis media with effusion (OME) among primary school and kindergarten children in provincial and district centers of Diyarbakır. Methods: The study was conducted at 4 primary schools and 3 kindergartens in the city center, and at 13 primary schools in district centers. Using the combined physical examination and otoscopic and tympanometric evaluations, 256 children out of 1,763 (14.5%) were diagnosed with OME. Results: Among total OME cases (119 girls, 137 boys) 118 (46.1%) had bilateral while 138 cases (53.9%) had unilateral effusion (89 on left and 49 on right ear). The prevalence of OME among primary school students were 12.6% at the city center, 16.3% at district level schools and 15.2% among kindergarten students. Higher OME prevalence is associated with passive smoking and allergic rhinitis. Age, sex, attending kindergarten and socioeconomic status were not significantly related with OME. Conclusion: In conclusion, because of high prevalence of otitis media and its possible severe complications screening equipment should be ensured at primary level health institutions. Screening for OME should be a part of preventive health services particularly for all kindergarten and early elementary school students; and should be performed by ENT specialist or pediatricians/general practitioners trained in pneumatic otoscopic and tympanometric evaluation.

Anahtar Kelimeler

Otitis media with effusion, prevalence, primary school, kindergarten

Diyarbakır il ve ilçe merkezlerinde ilköğretim ve anaokulu çocuklarında efüzyonlu otitis media prevalansı ve risk faktörleri

Öz

Amaç: Bu çalışmada, Diyarbakır il ve ilçe merkezlerindeki ilköğretim ve kreş çocuklarında efüzyonlu otitis media (EOM) prevalansı ve risk faktörlerinin belirlenmesi amaçlanmıştır. Yöntem: Çalışmamıza il merkezinde bulunan 4 ve çevre ilçelerden 13 ilköğretim okulu ile il merkezindeki 3 anaokulu dahil edildi. Fizik muayene, otoskopi ve timpanometri ile değerlendirilen 1763 çocuğun 256'sında (%14.5) (119 kız, 137 erkek) EOM teşhisi konuldu. Bulgular: Hastalık 118 olguda (%46.1) çift tarafta iken 138 olguda (%53.9) (89 sol, 49 sağ) tek tarafta idi. Çalışmamızda ilköğretim okullarındaki öğrencilerde EOM prevalansının il merkezinde %12.6 iken ilçelerde %16.3 olduğu; anaokullarında ise %15.2 olduğu saptandı. EOM prevalansı, alerji ve pasif sigara içimi ile ilişkili bulunmuştur. Prevalansın, cinsiyet, yaş, kreşte bulunma, sosyoekonomik durum ile anlamlı ilişkisi tespit edilmemiştir. Sonuç: Sonuç olarak, otitis medianın yaygınlığı ve olası komplikasyonların ciddiyeti düşünüldüğünde birinci basamak sağlık hizmetlerinde kulak muayenesi yapabilecek ekipman bulundurulmalıdır. Özellikle kreş ve erken ilköğretim çağındaki çocuklar olmak üzere, EOM taraması koruyucu sağlık hizmetlerin bir parçası olarak sunulmalı ve taramalar kulak burun boğaz hastalıkları uzmanları veya pnömatik otoskopi, timpanometri konusunda eğitilmiş pediatristler veya pratisyen hekimler tarafından yapılmalıdır.

Anahtar Kelimeler

Efüzyonlu otitis media, prevalans, ilkokul, kreş

Kaynakça

• Aky›ld›z AN. Kulak Hastal›klar› ve Mikrocerrahisi. Ankara: Bilimsel T›p Yay›nevi; 1998. p. 275-330.
• Harsten G, Prellner K, Heldrup J, Kalm O, Kornfält R. Recurrent acute otitis media. A prospective study of children during the first three years of life. Acta Otolaryngol 1989;107: 111-9.
• Okur E, Yildirim I, Akif Kilic M, Guzelsoy S. Prevalence of otitis media with effusion among primary school children in Kahramanmaras, in Turkey. Int J Pediatr Otorhinolaryngol 2004;68:557-62.
• Meriç F, Çetin Y, Demirel M. Effusion otitis media incidence in the South-Eastern Anatolia [Abstract]. XV World Congress of Otorhino-laryngology Head and Neck Surgery, 20- 25 June 1993, Istanbul, Turkey.
• Gultekin E, Develio¤lu ON, Yener M, Ozdemir I, Külekçi M. Prevalence and risk factors for persistent otitis media with effusion in primary school children in Istanbul, Turkey.Auris Nasus Larynx 2010;37:145-9.
• Caylan R, Bektas D, Atalay C, et al. Prevalence and risk factors of otitis media with effusion in Trabzon, a city in northeastern Turkey, with an emphasis on the recommendation of OME screening. Eur Arch Otorhinolaryngol 2006;263:404-8.
• Çuhruk Ç, Beder E, Kandilci S, ve ark. TED Ankara koleji ilkokulu ö¤rencileri aras›nda KBB hastal›klar› prevalans›. Türk ORL Bülteni 1979;3:250-2.
• Özbilen S, Beder E, Aky›ld›z N, ve ark. Ankara Balgat çevre ilkokul ö¤rencileri aras›nda KBB hastal›klar› prevalans›. Türk ORL Kongresi Tutanaklar›. ‹stanbul, 1983;128-33.
• Kaya S, Akdafl F, Belgin E, ve ark. Ankara ili ve çevresinde okul dönemi çocuklar›nda orta kulak hastal›klar› insidans›. Türk Otolaringoloji Arflivi 1987;25:184-8.
• ‹nanl› S, Özer E, Öztürk O, ve ark. ‹stanbul’da okul öncesi ve okul ça¤›ndaki çocuklarda sekretuar otitis media prevalans› ve risk faktörleri. Türk Otolarengoloji Arflivi 2000;38:9-16.
• Özüer MZ, Topuz B, Kara CO, ve ark. Denizli merkez anaokullar›nda sekretuar otitis media prevalans› ve risk faktörleri. Kulak Burun Bo¤az ‹htisas Dergisi 1999;6:63-5.
• Midgley EJ, Dewey C, Pryce K, Maw AR. The frequency of otitis media with effusion in British pre-school children: a guide for treatment. ALSPAC Study Team. Clin Otolaryngol Allied Sci 2000;25:485-91.
• Saim A, Saim L, Saim S, Ruszymah BH, Sani A. Prevalence of otitis media with effusion amongst pre-school children in Malaysia. Int J Pediatr Otorhinolaryngol 1997;41:21-8.
• Castagno LA, Lavinsky L. Otitis media in children: seasonal changes and socioeconomic level. Int J Pediatr Otorhinolaryngol 2002;62:129-34.
• Martines F, Bentivegna D, Di Piazza F, Martinciglio G, Sciacca V, Martines E. The point prevalence of otitis media with effusion among primary school children in Western Sicily. Eur Arch Otorhinolaryngol 2010;267: 709-14.
• Teele DW, Klein JO, Rosner B. Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective cohort study. J Infect Dis 1989;160:83-94.
• Alho OP, Oja H, Koivu M, Sorri M. Risk factors for chronic otitis media with effusion in infancy. Each acute otitis media episode induces a high but transient risk. Ach Otolaryngol Head Neck Surg 1995;121:839-43.
• Van Cauwenberge PB. Relevant and irrelevant predisposing factor in secretory otitis media. Acta Otolaryngol 1984;(Suppl 414): 147-53.
• Aydo¤an B, Kiro¤lu M, Altintas D, Yilmaz M, Yorgancilar E, Tuncer U. The role of food allergy in otitis media with effusion. Otolaryngol Head Neck Surg 2004;130:747-50.
• Alles R, Parikh A, Hawk L, Darby Y, Romero JN, Scadding G. The prevalence of atopic disorder in children with chronic otitis media effusion. Pediatr Allergy Immunol 2001;12:102-6.
• Marseglia GL, Pagella F, Caimmi D, et al. Increased risk of otitis media with effusion in allergic children presenting with adenoiditis. Otolaryngol Head Neck Surg 2008;138:572-5.
• Kitchens GG. Relationship of environmental tobacco smoke to otitis media in young children. Laryngoscope 1995;105:1-11.
• White DR, Heavner SB, Hardy SM, Prazma J. Gastroesophageal reflux and eustachian tube dysfunction in rats: an animal model. Laryngoscope 2002;112:955-61.
• Tasker A, Dettmar PW, Panetti M, Koufman JA, Birchall JP, Pearson JP. Reflux of gastric juice and glue ear in children. Lancet 2002;359:493.
• Crapko M, Kerschner JE, Syring M, Johnston N. Role of extraesophageal reflux in chronic otitis media with effusion. Laryngoscope 2007;117:1419-23.