Risk factors of acute otitis externa seen in patients in a Nigerian tertiary institution

Abstract

Background: Acute otitis externa is a common clinical problem which is associated with preventable risk factors. Objective: The aim of this study is to determine the practices that are risk factors in patients with acute otitis externa in a Nigerian tertiary institution. Patients and Methods: This was a 6-month cross-sectional study of patients with acute otitis externa carried out between April and September 2013 at the Ear, Nose, and Throat Clinic of the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Results: A total of 2350 patients were seen during the study period, of which 88 (3.7%) were diagnosed with acute otitis externa. The males and females were 32 (36.4%) and 56 (63.6%), respectively, with a ratio of 1:1.8 The age range was 3 months to 70 years, with the mean age of 18.9 years. Self-ear cleaning with cotton bud 65 (73.9%) constituted the majority of object introduced into the ear canal(s) and the reasons for self-ear cleaning were because of itching of the ear(s) in 47 (53.4%), habitual 9 (10.2%), and perceiving that the ears were dirty 32 (36.4%). The introduction of extraneous moisture into the ears was seen in 46 (52.3%) including self-medication with topical antibiotic, instilling plain and soapy water in the ear canal(s), and swimming. The comorbid conditions which are known risk factors for otitis externa were seen in 35 (39.8%) patients, of which allergy was the most frequent with 22 (25%), followed by diabetic mellitus 7 (8%) and AIDS 6 (6.8%). Only 14 (16%) of these patients had their comorbid conditions diagnosed at their first presentation. Conclusion: Self-ear cleaning with cotton bud was the major risk factor seen in our patients with otitis externa, followed by the introduction of extraneous moisture into the ear canals and untreated comorbid risk factors for acute otitis externa. These risk factors are preventable through creation of awareness and prompt treatment of other associated disease conditions.