Otitis media in developing countries.

Objective

This article reviews the available information concerning the disease burden, epidemiology, and etiology of otitis media in developing countries and the likelihood that case management with appropriate antibiotic therapy can reduce the burden of this disease.

Methodology

The available literature was reviewed to determine the extent to which otitis media impacts mortality and morbidity in developing countries.

Epidemiology.

In community studies, perforation was present in 0.4% to 33.3% of children and youth ; otorrhea occurred in 0.4% to 6.1% ; and mastoiditis occurred in 0.19% to 0.74%. In school surveys, perforation was identified in 1.3% to 6.24% of students, and otorrhea was found in 0.6% to 4.4%. Mastoiditis was diagnosed in 18% of children and youth who presented to a hospital ear, nose, and throat (ENT) clinic in Uganda.

The proportion of patients presenting to ENT clinics with mastoiditis regardless of their initial symptoms varied from 1.7% to 5%. Hearing impairment was a major public health problem compromising the quality of life in approximately one third of the population of developing countries.

Conclusions

International research organizations should support controlled intervention studies to document the impact of case management of otitis in developing countries.

In addition, the efficacy of a conjugated pneumococcal vaccine to prevent otitis and its complications should be evaluated in a developing country site.