The changing epidemiological and complications profile of chronic suppurative otitis media in a developing country after two decades.

Abstract

To evaluate the shift in epidemiological and complication profiles of chronic suppurative otitis media (CSOM) over two decades in a resource-limited economy. A retrospective analysis of the prevalence of CSOM and its complications in tertiary health institution a over a period of 2years were compared between 203 cases seen in 2009 and December 2010 (present era); and 343 cases seen in 1990 and 1991 (previous era). Data were collected on the demographic characteristics of the patients, age of onset of otorrhoea, the disease type, laterality and complications of CSOM. The prevalence of CSOM significantly reduced from 9% in the previous era to 5.1% in the present era (P<0.0001). The mean age of the recent group was 27.6±19.3years, and was 21.6±18.2years in the previous group. (P=0.009). Although both group had peak age prevalence at 11-20years, recent group saw more significant adult population >20years of age (P≤0.001). More significant cases of cholesteatoma were documented in the recent group (3.4%) than previous era (0.9%) (P=0.02). Although no significant change was noted regarding the rates of complication of CSOM in the two eras (P=0.18), there was a notable shift toward predominant extracranial pattern of complication in the recent group (P=0.04). The prevalence of CSOM has shown a significant reduction after two decades and it appears that there has been a shift in the epidemiology of CSOM towards a predominantly adult population in the recent years. Despite an overall reduction in the incidence of intracranial complications of CSOM in our series, its complication rates have not changed remarkably after 20years.