Prevalence and factors associated with chronic suppurative otitis media complications among adult patients at Muhimbili National Hospital

Abstract

ABSTRACT Background: Chronic suppurative otitis media (CSOM) is still a problem in developing countries affecting both pediatric and adult patients. However rare the disease is, complications both extra cranial and intracranial may arise. The factors that seem to fuel the progression of CSOM to its complications also appear to have an impact on patients' quality of life, hence existence of the risk factors linked to CSOM complications can be addressed early to prevent the consequences of the disease. Aim: To determine the prevalence of chronic suppurative otitis media and the factors associated with its complications among adult patients at Muhimbili National Hospital. Methodology: A hospital based cross-sectional study was employed to collect data from patients with CSOM. Data was collected through the use of a data collecting tool, which included; demographic information about the patients, clinical characteristics and information about CSOM complications that were identified during imaging investigations in addition to physical examination results. The analysis of the data was done with Statistical Package for Social Sciences (SPSS) version 23. Whereas categorical variables were summarized by percentage, continuous variables were summarized by median and interquartile range. To investigate the relationship between the factors under investigation and complicated CSOM, logistic regression was used. The statistical significance was established at p<0.05. Results: A total of 52 patients with CSOM were recruited, male to female ratio was 1:1, median (IR) age was 39 (22) years. The prevalence of complicated CSOM was found to be 51.9%. Extracranial complications were found in all patients with complicated CSOM and 19% of the patients had also intracranial complications. Higher proportion of complicated CSOM was found in male patients (61.5%), those with atticoantral type of CSOM (100%) and those who used local remedies to the diseased ear (72.7%). Binary logistic regression analysis showed that use of local remedies to the diseased ear was an independent factor for a complicated CSOM. Conclusion: The prevalence of complicated CSOM in our setting was 51.9% and most patients had extracranial complications. The use of local remedies was found to be an independent factor contributing to the development of complications from CSOM and thus necessitating advocacy for proper healthcare seeking behaviour and education in our society