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Determinants of Acute Otitis Media in Children: A Case-Control Study in West Java, Indonesia
Arif Dermawan1, Bejo Ropii2, Lina Lasminingrum1
1Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universitas Padjadjaran, Kota Bandung 40161, Indonesia.
Insights
This study identifies allergic rhinitis, cigarette smoke, stunted growth, and incomplete immunizations as key risk factors for childhood Acute Otitis Media (AOM) in Indonesia. Addressing these can reduce AOM incidence.
Area of Science:
- Pediatrics
- Epidemiology
- Public Health
Background:
- Acute Otitis Media (AOM) is a significant childhood illness causing fever, ear pain, and hearing loss, potentially leading to chronic complications.
- Risk factors like allergies and smoke exposure are known globally, but data is limited in Indonesian rural areas, increasing disease burden.
- High smoking prevalence and low immunization rates in regions like Bandung Regency, Indonesia, further elevate AOM risks.
Purpose of the Study:
- To investigate the specific risk factors associated with Acute Otitis Media (AOM) in children aged 24-59 months in Bandung Regency, Indonesia.
- To provide data to inform public health interventions aimed at reducing AOM incidence in vulnerable populations.
Main Methods:
- A case-control study was conducted from September 2019 to February 2020 in Bandung Regency, Indonesia.
- Data collection involved structured questionnaires, anthropometric measurements, and ENT examinations for 168 AOM-positive and 367 AOM-negative children.
- Multivariable analysis was employed to identify significant risk factors for AOM.
Main Results:
- Allergic rhinitis (AOR 1.92), cigarette smoke exposure (AOR 1.79), and stunted growth (AOR 1.48) were significantly associated with AOM.
- Incomplete basic immunizations also showed a strong association with AOM (AOR 1.77).
- These findings underscore the impact of environmental and nutritional factors on AOM development.
Conclusions:
- The study validates known risk factors for AOM, including allergic rhinitis and cigarette smoke exposure.
- It highlights stunted growth and incomplete childhood immunizations as potentially significant, modifiable risk factors requiring further investigation.
- Interventions targeting nutrition and vaccination are crucial for mitigating AOM incidence.
Abstract:
Background and Objectives: Acute Otitis Media (AOM) is a leading cause of morbidity in children, characterized by fever, otalgia, and hearing loss. If untreated, AOM may progress to chronic complications requiring surgical management. Globally, factors such as allergies, environmental tobacco smoke, and nutritional deficiencies are well-established risk factors, but in Indonesia, particularly rural areas like Bandung Regency, limited awareness and data exacerbate the burden of disease. Smoking prevalence and low immunization rates further increase risks for AOM. Materials and Methods: This case-control study, conducted between September 2019 and February 2020 in Bandung Regency, evaluated risk factors for AOM in children aged 24-59 months. Data were collected through structured questionnaires, anthropometric assessments, and ENT examinations. A total of 168 AOM-positive and 367 AOM-negative children were recruited from primary healthcare facilities. Results: Multivariable analysis identified significant associations with AOM: allergic rhinitis (AOR 1.92), cigarette smoke exposure (AOR 1.79), stunted growth (AOR 1.48), and incomplete basic immunizations (AOR 1.77). These findings highlight the importance of addressing modifiable factors such as nutrition and immunization to reduce AOM incidence. Conclusions: The rhinitis allergy and exposure to cigarette smoke are among the well-established risk factors that our results validate. Additional research is necessary to validate if our findings involving two modifiable risk factors, stunted children and insufficient basic vaccination, may increase the risk of AOM.
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