Clinico-epidemiological study of safe and unsafe chronic suppurative otitis media

Abstract

Introduction: Chronic Suppurative Otitis Media (CSOM) remains one of the most commonest chronic infectious diseases worldwide particularly in children and adolescents. India has been classified as the high prevalence country with national prevalence of 4%. Knowledge of differential regional prevalence of risk factors is required for adequate health education of masses and for customised preventive and control measures in respective areas. Aims: To study the clinical and socio-demographic profile of patients with CSOM. Methods: The study was carried out in the department of Otorhinolaryngology, Jawaharlal Nehru Medical College, AMU, Aligarh from November, 2017 to December, 2019. Patients with CSOM attending the otorhinolaryngology OPD and those admitted in IPD were included in the study. Results: A total 200 cases of chronic suppurative otitis media including both safe (mucosal) and unsafe (squamous) type were studied. The mean age of participants was 22.8 ± 15.18 years. Of the total participants, 111 (55.5%, 95% CI 48.6 to 62.2) were males, 89 (44.5%, 95% CI 37.8 to 51.4) were females and the majority (60.5%, 95% CI 53.6 to 67) of them were from rural background. Around one-fourth of the patients were illiterate (23%, 95% CI 17.7 to 29.3) and the patients mostly belonged to lower side (lower middle, upper lower and lower) of the spectrum of Kuppuswamy socioeconomic classification. The distribution of age-group, gender and laterality (side of involvement) was similar (P>0.05) in both safe and unsafe type. Overall, 151(75.5%, 95% CI 69.9 to 80.9) patients were found to have conductive hearing loss, 30 (15%, 95% CI 10.7 to 20.6) with mixed and 19 (9.5%, 95% CI 6.2 to 14.4) did not have any hearing loss at presentation. The distribution of patients with regards to hearing loss was found to be similar in both safe and unsafe groups (P = 0.311). Conclusion: CSOM particularly afflicts younger age populations from rural background with poor socioeconomic status. Appropriate timely interventions in the form of health promotion, education about the risk factors and improvement in the living conditions will result in decrease in incidence and prevalence of the disease. Moreover, knowledge of symptoms and signs of the disease is likely to result in early seeking of healthcare and hence better treatment outcomes and prevention of complications.