Chronic suppurative otitis media in children of Luanda, Angola

Taipale, Anni; Pelkonen, Tuula; Taipale, Marko; Bernardino, Luís; Peltola, Heikki; Pitkäranta, Anne

doi:10.1111/j.1651-2227.2011.02192.x

Cited by 20 publications

(21 citation statements)

References 11 publications

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“…[4,5,[14][15][16] The predominance of unilateral disease in children with CSOM has previously been noted. [3,12,[16][17][18][19] Most children who had been treated prior to referral did not respond to the treatment given or relapsed, which was the reason for referral. Treatment failure may be due to failure to combine ear toilet with medical treatment, the use of ineffective treatment or the result of re-infection related to poor hygienic conditions.…”

Section: Discussionmentioning

confidence: 99%

“…This lack of effectiveness of acetic acid has been documented in a recent SA study. [21] CSOM is a condition occurring mainly in patients of low socioeconomic status, [2,12,18] who may not have access to clean water. Exposure of the auditory canals to contaminated water has been identified as a risk factor for CSOM.…”

Section: Discussionmentioning

confidence: 99%

“…to be the most commonly cultured bacteria. [18] The authors speculated that this was a result of the high rate of HIV infection predisposing patients to infections by low-virulence bacteria. However, we did not find a significant difference in the bacteria cultured between the HIVpositive and HIV-negative patients, nor was there a significant difference between the HIV-positive patients who were immunosuppressed and those who were not immunosuppressed.…”

Section: Discussionmentioning

confidence: 99%

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Paediatric chronic suppurative otitis media in the Free State Province: Clinical and audiological features

et al. 2013

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Background. Chronic suppurative otitis media (CSOM) is a chronic infection of the middle ear cleft. In sub-Saharan Africa >50% of cases occur in children <10 years of age. Objectives. To describe the otological, audiological and bacteriological findings in children with CSOM. Methods. We conducted a prospective study at the Ear, Nose and Throat (ENT) Clinic at Universitas Academic Hospital between August 2009 and December 2010. We included all children with CSOM over this period. Patients underwent ENT and paediatric examination, and were tested for HIV. Pus swabs were taken after an ear toilet for routine microbiology, fungal and Mycobacterium tuberculosis culture. We performed audiological testing after the otorrhoea had resolved. Results. Eighty-six children (113 ears) were included, with a median age of 4.6 years (range 1 -12 years). The mean duration of otorrhoea was 161.7 weeks (range 4 -572 weeks). Nine patients (10.5%) presented with coalescent mastoiditis and/or intracranial complications of CSOM. Of the 153 organisms identified, Gram-negative bacteria were present in 93 (82.3%) ears, with 94.8% of these being sensitive to quinolones. Only 1 case of tuberculous otitis media was identified. HIV infection was present in 54.6% of patients tested. There was a hearing loss in 44 (66.7%) of the tested affected ears. Conclusions. There was a long delay between the onset of symptoms and accessing ENT services. Most cases of CSOM were due to quinolone-sensitive Gram-negative aerobes. There was a high prevalence of cholesteatoma, hearing loss and other complications in children in this study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Paediatric chronic suppurative otitis media in the Free State Province: Clinical and audiological features

et al. 2013

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“…Having been breastfed protects against OM 43 . In developing countries, malnutrition, contaminated water, poor hygiene, overcrowding, human immunodeficiency virus infection, tuberculosis, malaria and poor access to health care increase the risk for chronicity and complications of OM 2,44,45 .…”

Section: Social and Environmental Risk Factorsmentioning

confidence: 99%

Otitis media

Schilder

Chonmaitree

Cripps

et al. 2016

Nat Rev Dis Primers

414

361

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Otitis media (OM) or middle ear inflammation is a spectrum of diseases, including acute otitis media (AOM), otitis media with effusion (OME; 'glue ear') and chronic suppurative otitis media (CSOM). OM is among the most common diseases in young children worldwide. Although OM may resolve spontaneously without complications, it can be associated with hearing loss and life-long sequelae. In developing countries, CSOM is a leading cause of hearing loss. OM can be of bacterial or viral origin; during 'colds', viruses can ascend through the Eustachian tube to the middle ear and pave the way for bacterial otopathogens that reside in the nasopharynx. Diagnosis depends on typical signs and symptoms, such as acute ear pain and bulging of the tympanic membrane (eardrum) for AOM and hearing loss for OME; diagnostic modalities include (pneumatic) otoscopy, tympanometry and audiometry. Symptomatic management of ear pain and fever is the mainstay of AOM treatment, reserving antibiotics for children with severe, persistent or recurrent infections. Management of OME largely consists of watchful waiting, with ventilation (tympanostomy) tubes primarily for children with chronic effusions and hearing loss, developmental delays or learning difficulties. The role of hearing aids to alleviate symptoms of hearing loss in the management of OME needs further study. Insertion of ventilation tubes and adenoidectomy are common operations for recurrent AOM to prevent recurrences, but their effectiveness is still debated. Despite reports of a decline in the incidence of OM over the past decade, attributed to the implementation of clinical guidelines that promote accurate diagnosis and judicious use of antibiotics and to pneumococcal conjugate vaccination, OM continues to be a leading cause for medical consultation, antibiotic prescription and surgery in high-income countries.

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“…Unexpectedly, Salmonella sp, Yersinia sp and Edwardsiella,were observed, findings not previously reported to the best of our knowledge. Our group, identified a case of Shigella from ear discharge in the same laboratory in Luanda (3). We assume that contaminated water, close contact between humans and animal feces and perhaps some traditional treatment practices (34) explain the variety of Gram-negative bacteria in our sample.…”

mentioning

confidence: 97%

Etiology of Childhood Otorrhea in Luanda, Angola, and a Review of Otitis Media in African Children

Karppinen

Bernardino²,

Anjos

et al. 2019

Pediatric Infectious Disease Journal

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Background: In resource-poor settings, otorrhea causes a significant burden of disease in children. Etiologic studies and structured data on otorrhea and chronic otitis media among African children remain scarce. Methods: Here, we reviewed 678 bacteriologically analyzed otorrhea samples from Luanda Children's Hospital from children ≤15 years of age bet een 2008 and 2015. We then compared these to data from other studies among African children through a literature review of 20 papers published over two decades. Results: Overall, 32 different bacteria were identified among 542 isolates from 654 children in Luanda. Gram-negative bacteria constituted the majority of all isolates (85%), whereby Pseudomonas sp was the most common (n = 158, 29%), followed by Proteus sp (n = 134, 25%). Among Staphylococcus aureus (n = 106, 10%), 69% of tested isolates were MRSA, and among Enterobacteriaceae 14% were ESBL isolates. Resistance to quinolones was rare. Furthermore, in a review of the literature, we found a high occurrence of otorrhea and chronic suppurative otitis media (CSOM) in children as well as possible gaps in existing knowledge. Conclusions: In Angola, Gram-negative rods emerged as common causative agents of otorrhea in children followed by S. aureus. The magnitude of chronic otorrhea in Africa represents a cause for public health concern.

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Chronic suppurative otitis media in children of Luanda, Angola

Cited by 20 publications

References 11 publications

Paediatric chronic suppurative otitis media in the Free State Province: Clinical and audiological features

Paediatric chronic suppurative otitis media in the Free State Province: Clinical and audiological features

Otitis media

Etiology of Childhood Otorrhea in Luanda, Angola, and a Review of Otitis Media in African Children

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