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Mathema L, Adhikari A, Poudyal P, Chalise GB, Chaudhary P, Khatri B. Chronic Otitis Media among Patients Visiting Community-Based Static Outreach Clinics. JNMA J Nepal Med Assoc 2023; 61:923-926. [PMID: 38289754 PMCID: PMC10792720 DOI: 10.31729/jnma.8369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction Chronic otitis media is a chronic inflammation of the middle ear and mastoid cavity, with recurrent ear discharges or otorrhoea through a tympanic perforation for the past 3 months. It is a common cause of hearing impairment, disability, and poor scholastic performance and can lead to fatal intracranial infections and acute mastoiditis. This study aimed to find out the prevalence of chronic otitis media among patients visiting community-based static outreach clinics. Methods A descriptive cross-sectional study was conducted among patients visiting the community-based static outreach clinics from 1 January 2017 to 31 December 2019. The ethical approval was taken from the Ethical Review Board. The diagnosis of chronic otitis media was done using otoscopy. The records of patients coming to outreach clinics visiting for ear, nose and throat care were reviewed using a pre-designed study proforma. A systematic random sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results Among 385 patients, 37 (9.61%) (6.67-12.55, 95% Confidence Interval) had chronic otitis media. The mean age of patients with chronic otitis media was 27.59±13.24 years, with 28 (75.67%) patients aged between 18-60 years. Among them, 30 (81.08%) had unilateral and 34 (91.89%) had a mucosal type. Conclusions The prevalence of chronic otitis media was lower than in other studies done in similar settings. Keywords community health services; otitis media; patients; prevalence.
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Affiliation(s)
- Luna Mathema
- Department of Otolaryngology & HNS, B.P. Eye Foundation, Hospital for Children, Eye, ENT, and Rehabilitation Services, Madhyapur Thimi, Bhaktapur, Nepal
| | - Arun Adhikari
- Department of Otolaryngology & HNS, B.P. Eye Foundation, Hospital for Children, Eye, ENT, and Rehabilitation Services, Madhyapur Thimi, Bhaktapur, Nepal
| | - Prasanta Poudyal
- Department of Otolaryngology & HNS, B.P. Eye Foundation, Hospital for Children, Eye, ENT, and Rehabilitation Services, Madhyapur Thimi, Bhaktapur, Nepal
| | - Ganesh Bahadur Chalise
- Department of Otolaryngology & HNS, B.P. Eye Foundation, Hospital for Children, Eye, ENT, and Rehabilitation Services, Madhyapur Thimi, Bhaktapur, Nepal
| | - Preeti Chaudhary
- Department of Otolaryngology & HNS, B.P. Eye Foundation, Hospital for Children, Eye, ENT, and Rehabilitation Services, Madhyapur Thimi, Bhaktapur, Nepal
| | - Bijay Khatri
- Academic and Research Department, B.P. Eye Foundation, Hospital for Children, Eye, ENT, and Rehabilitation Services, Madhyapur Thimi, Bhaktapur, Nepal
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Shangali A, Kamori D, Massawe W, Masoud S, Kibwana U, Mwingwa AG, Manisha A, Mwandigha AM, Mirambo MM, Mshana SE, Manyahi J, Majigo M. Aetiology of ear infection and antimicrobial susceptibility pattern among patients attending otorhinolaryngology clinic at a tertiary hospital in Dar es Salaam, Tanzania: a hospital-based cross-sectional study. BMJ Open 2023; 13:e068359. [PMID: 37012005 PMCID: PMC10083798 DOI: 10.1136/bmjopen-2022-068359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
OBJECTIVES To determine the aetiological pathogens causing ear infections and their antimicrobial susceptibility patterns among patients with ear complaints at a tertiary hospital in Dar es Salaam. DESIGN Hospital-based cross-sectional study. SETTINGS Otorhinolaryngology clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania. PARTICIPANTS Patients presenting with signs and symptoms of ear infection. MAIN OUTCOME MEASURE Bacteria and fungi isolated from ear swab specimens of patients presenting with signs and symptoms of ear infection; and antimicrobial susceptibility patterns of isolated bacteria. RESULTS Two hundred and fifty-five participants were enrolled, with a median age of 31 years and an IQR of 15-49. Otitis externa was the predominant type of ear infection, accounting for 45.1%. We observed positive bacteria culture in 53.3% of study participants, in which 41% of isolates were obtained from patients with chronic suppurative otitis media. Moreover, Staphylococcus aureus (27.3%) and Pseudomonas aeruginosa (24.2%) were the most frequently isolated bacteria, while Candida spp, 12 (63.8%) and Aspergillus spp, 9 (36.2%) were the only isolated fungi. Furthermore, we report that 93% of isolated Enterobacterales were resistant to amoxicillin/clavulanic acid, and 73% were resistant to ceftazidime. In addition, we detected 34.4% extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) and 44.4% methicillin-resistance S. aureus (MRSA). We also found that 22% of the bacteria isolates were resistant to ciprofloxacin, a primary topical antibiotic used in managing ear infections. CONCLUSIONS The findings from this study reveal that the leading aetiological agent of ear infection is bacteria. Furthermore, our findings show a significant proportion of ESBL-PE and MRSA-causing ear infections. Hence, detecting multidrug-resistant bacteria is crucial to improving ear infection management.
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Affiliation(s)
- Aminiel Shangali
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
- Department of Microbiology and Immunology, Mwanza University, Mwanza, Tanzania, United Republic of
| | - Doreen Kamori
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
| | - Willybroad Massawe
- Department of Otorhinolaryngology, Muhimbili National Hospital, Dar es Salaam, Tanzania, United Republic of
| | - Salim Masoud
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
| | - Upendo Kibwana
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
| | - Anthony G Mwingwa
- Department of Microbiology and Immunology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
| | - Anselmo Manisha
- Department of Microbiology and Immunology, Mwanza University, Mwanza, Tanzania, United Republic of
| | - Ambele M Mwandigha
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania, United Republic of
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania, United Republic of
| | - Joel Manyahi
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
| | - Mtebe Majigo
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
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A study of bacterial pathogens and antibiotic susceptibility patterns in chronic suppurative otitis media. The Journal of Laryngology & Otology 2017; 132:41-45. [PMID: 29151379 DOI: 10.1017/s0022215117002249] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the frequency of bacterial agents in chronic suppurative otitis media and the antibiotic susceptibility patterns of isolates among patients. METHODS A total of 185 patients clinically diagnosed with chronic suppurative otitis media were interviewed and middle-ear effusion samples were collected using sterile swabs. All bacterial isolates were identified by conventional microbiological methods. Antibiotic susceptibility patterns of the isolates were determined by Kirby-Bauer disc diffusion. RESULTS Staphylococci spp. (64.9 per cent) were the most prevalent bacteria isolated, followed by Klebsiella spp. (12.9 per cent) and Pseudomonas aeruginosa (10.3 per cent). The most effective antibiotic for treatment of bacterial chronic suppurative otitis media was ciprofloxacin. Statistical analysis showed no significant difference in bacterial infestations among chronic suppurative otitis media patients and the antimicrobial susceptibility patterns of the bacterial isolates based on gender and age (p > 0.05). CONCLUSION Our findings highlight the importance of a continuous and periodic evaluation of the bacteriological profile and antibiotic susceptibility patterns in chronic suppurative otitis media patients for efficacious treatment of the infection.
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