Abstract
IntroductionUpper respiratory tract infection is a nonspecific term used to describe an acute infection involving the nose, paranasal sinuses, pharynx and larynx. Upper respiratory tract infections in children are often associated with Eustachian tube dysfunction and complicated by otitis media, an inflammatory process within the middle ear. Environmental, epidemiologic and familial risk factors for otitis media (such as sex, socioeconomic and educational factors, smoke exposure, allergy or duration of breastfeeding) have been previously reported, but actually no data about their diffusion among Sicilian children with upper respiratory tract infections are available. ObjectiveTo investigate the main risk factors for otitis media and their prevalence in Sicilian children with and without upper respiratory tract infections. MethodsA case–control study of 204 children with upper respiratory tract infections who developed otitis media during a 3 weeks monitoring period and 204 age and sex-matched healthy controls. Seventeen epidemiologically relevant features were inventoried by means of standardized questionnaires and skin tests were performed. Univariate analysis and multivariate logistic regression analysis were used to examine the association between risk factors and occurrence of otitis media. ResultsOtitis media resulted strongly associated to large families, low parental educational attainment, schooling within the third years of life (p<0.05); children were more susceptible to develop otitis media in the presence of asthma, cough, laryngopharyngeal reflux disease, snoring and apnea (p<0.05). Allergy and urban localization increased the risk of otitis media in children exposed to smoke respectively of 166% and 277% (p<0.05); the joint effect of asthma and presence of pets in allergic population increased the risk of recurrence of 11%, while allergy, cough and runny nose together increased this risk of 74%. ConclusionsUpper respiratory tract infections and otitis media are common childhood diseases strongly associated with low parental educational attainment (p=0.0001), exposure to smoke (p=0.0001), indoor exposure to mold (p=0.0001), laryngopharyngeal reflux disease (p=0.0002) and the lack of breast-feeding (p=0.0014); an increased risk of otitis media recurrences was observed in the presence of allergy, persistent cough and runny nose (p=0.0001). The modification of the identified risk factors for otitis media should be recommended to realize a correct primary care intervention.
Highlights
Upper respiratory tract infection is a nonspecific term used to describe an acute infection involving the nose, paranasal sinuses, pharynx and larynx
Upper respiratory tract infection (URTI) in children are often complicated by otitis media (OM), an inflammatory process within the middle ear, with an incidence ranging from 6% to 64%
The 15.7% (32/204) of cases had positive skin tests for inhalant and food allergens whereas the 16.6% (34/204) of controls resulted atopic (p = 0.78); statistical analysis showed a significant difference between the groups regarding the prevalence of asthma, with a higher percentage of asthmatic children in the Group A (7.8%) respect to Group B (0.9%) (p = 0.0007)
Summary
Upper respiratory tract infection is a nonspecific term used to describe an acute infection involving the nose, paranasal sinuses, pharynx and larynx. Upper respiratory tract infections in children are often associated with Eustachian tube dysfunction and complicated by otitis media, an inflammatory process within the middle ear. Upper respiratory tract infection (URTI) is a non-specific term used to describe an acute infection involving nose, paranasal sinuses, pharynx and larynx.[1,2] According to World Health Organization (WHO), URTIs are responsible for 20% of annual deaths among children under 5 years of age, and for 13,000 hospitalizations.[3] URTIs in children are often complicated by otitis media (OM), an inflammatory process within the middle ear, with an incidence ranging from 6% to 64%.2,4. The main reasons for the young-age preference include: poorly developed immune defense, shorter and more horizontal Eustachian tube, well-endowed with lymphoid follicles and adenoids.[6]
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