Prevalence and clinico-bacteriological aspects of chronic suppurative otitis media at the Renaissance University Hospital in N'Djamena, Chad

Abstract

BackgroundChronic suppurative otitis media is a major cause of hearing impairment and morbidity in poor socioeconomic developing countries.ObjectivesTo determine the prevalence of chronic suppurative otitis media in a tertiary care hospital and to analyze its clinico-bacteriological aspects.MethodsThis is a cross-sectional, descriptive and analytical study conducted at the ENT and Head and Neck Surgery Department in the Renaissance University Hospital in N'Djamena, Chad. All the patients that were diagnosed with chronic suppurative otitis media from 1 January 2017 to 31 December 2019 were included.ResultsThe hospital prevalence was 6.1%. The sex ratio (male/female) was 1.09. The median age of patients was 28 years with [1 to 74 years]. The median time from the onset of otorrhea to coming for medical consultation was 6 years with [4 months to 42 years]. The main symptom associated with otorrhea was hearing impairment which was in 55.6% of cases (n = 50). Perforations ≥ ¾ of the tympanic membrane surface were noted in 51.3% of cases (n = 60). The tympanic cavity floor was erythematous in 49.6% of cases (n = 58) and erythematous with a discharge in 42.7% of cases (n = 50). There was an association between the size of the perforation and the appearance of the tympanic mucosa (p = 0.003), and between the age of the disease and the side of the ear affected with chronic suppurative otitis media (p = 0.016). The culture positivity rate was 86.1% (n = 31) and with two other microbial cases. Staphylococcus aureus was isolated in 28.1% of cases (n = 9) followed by Pseudomonas aeruginosa which was 25% of the cases (n = 8).ConclusionChronic suppurative otitis media affects both children and adults. Delay in medical consultation to the ENT department is relatively high. Staphylococcus aureus and Pseudomonas aeruginosa are the most common causes.