A point prevalence of otitis media in a Nigerian village

One hundred seventy children and 103 adults from a rural Nigerian village were examined for the presence of middle and external ear pathology. Ear, nose and throat examination included: (1) pneumatic otoscopic exam, (2) tympanometry and (3) contralateral acoustic reflex. A diagnostic algorithm was applied to these 3 findings for each subject and each ear. Our data showed a point prevalence of otitis media in children (≤ 15 years) to be 21.2% compared to 4% in adults (> 15 years). Of the 36 children with otitis media, only 3 had perforation and otorrhea; a diagnosis of otitis media with effusion behind an intact tympanic membrane was made in the other 33 children. The prevalence of otitis media varied significantly with age and evidence of upper respiratory tract infection. There was no significant difference between sexes. External ear pathology was found as an independent variable in 24% of the 170 children; three-fourths of these children had concurrent middle ear pathology. The results are discussed in relation to the current understanding of the differences that exist in the epidemiology and pathogenesis of otitis media in different racial groups.