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Chronic suppurative otitis media in the Solomon Islands: a prospective, microbiological, audiometric and therapeutic
Abstract:
Chronic suppurative otitis media affected 3.8% of 3500 Solomon Island children under 15 years (and 6.1% under 5 years) and was the sole cause of conductive hearing loss recorded in 265 children tested audiometrically. It was characterised by early onset (65% under 18 months) male preponderance and large central tubotympanic perforations. Measles, respiratory infections, swimming and malnutrition were identified as aetiological factors amenable to intervention. Proteus and pseudomonas were the principle aerobes isolated from ear pus and gentamicin the only antibiotic tested to be effective against them. However although a prospective therapeutic trial demonstrated a significantly improved outcome after aural toilet, no additional benefit was imparted by concurrent ototopical boric acid or aminoglycoside solution or oral antianaerobic clindamycin. Parental tuition in aural cleaning, avoidance of ear water entry, nose blowing and breathing will yield a good result in up to 60% of children in half of whom tympanic healing occurred.
Insights
Chronic suppurative otitis media (CSOM) is a significant cause of hearing loss in Solomon Island children. Aural toilet and parental education improved outcomes, with no added benefit from medications.
Area of Science:
- Pediatric Otolaryngology
- Infectious Diseases
- Public Health
Background:
- Chronic suppurative otitis media (CSOM) significantly impacts children's health in the Solomon Islands.
- CSOM was the primary cause of conductive hearing loss in the studied pediatric population.
Purpose of the Study:
- To investigate the prevalence, characteristics, and risk factors of CSOM in Solomon Island children.
- To evaluate the efficacy of different therapeutic interventions for CSOM.
Main Methods:
- Audiometric testing was performed on 265 children.
- A prospective therapeutic trial assessed outcomes of aural toilet, topical/oral medications, and parental education.
- Microbiological analysis identified causative pathogens and antibiotic sensitivities.
Main Results:
- CSOM affected 3.8% of children under 15, with early onset (65% under 18 months) and male predominance.
- Measles, respiratory infections, swimming, and malnutrition were identified as risk factors.
- Aural toilet significantly improved outcomes; additional medications (boric acid, aminoglycosides, clindamycin) showed no added benefit.
- Parental education on ear care led to good results in 60% of children, with tympanic healing in half.
Conclusions:
- CSOM is a prevalent issue in Solomon Island children, leading to conductive hearing loss.
- Aural toilet and comprehensive parental education are effective interventions for CSOM.
- Targeted public health strategies addressing identified risk factors are crucial for prevention and management.