Genetic counseling in an indigenous Filipino community with a high prevalence of A2ML1-related otitis media

Abstract

In this report, we describe the knowledge and beliefs on causes and management of otitis media of an indigenous Filipino community with a high prevalence of otitis media that is associated with an A2ML1 variant. Community lectures and individual genetic counseling were provided as intervention. Knowledge, beliefs, and health care-seeking behavior pertaining to otitis media were assessed pre- and post-genetic counseling. Twenty-five heads of households were interviewed. Beliefs regarding etiology of ear discharge varied widely, with swimming in the sea as the most commonly cited cause of ear discharge. During the post-counseling session, poor personal hygiene, dirty environment, and familial inheritance were mentioned as risk factors for otitis media or ear discharge. Knowledge about the genotypes for the A2ML1 variant and otitis media diagnoses within the household influenced beliefs on the role of hygiene and genetic susceptibility to otitis media and attitudes towards health care-seeking behavior. Genetic counseling was associated with variable improvement in knowledge on otitis media and in their understanding of genetic susceptibility to otitis media due to the A2ML1 variant. Language barriers, literacy level, cultural factors, and the complex nature of genetic information made genetic counseling in the particular population a challenge. Insights drawn from this experience recommend follow-up visits in the community.

A meta-analysis on genetic susceptibility to chronic otitis media

“…Bacterial infection rapidly activates the host's mucosal immune response, and promotes the in ltration of white blood cells, mucosal hyperplasia and the formation of middle ear effusion [6]. The innate immune system of the mucosa is characterized by epithelial and mucosal cells, and has dual functions of anti-infection and defense [7]. The middle ear mucosa plays a major barrier role in the pathology of otitis media, which is equivalent to the rst line of defense of the middle ear mucosa against bacterial infection [8].…”