Prevalence and Risk Factors of Otitis Media with Effusion Among School Children in Saudi Arabia

Abstract

Objectives:

Determine prevalence of otitis media with effusion (OME) in school children and analyze relevant risk factors.

Methods:

Through a cross-sectional study, 1488 children in the age range, 6 to 12 years were randomly selected from 25 primary schools. A questionnaire was used to determine risk factors for OME. Otoscopy and tympanometry were used to diagnose and confirm OME. Pure tone average for children with confirmed OME was measured. Teachers of the children were asked to complete a questionnaire evaluating child’s level of school performance. Those with or without OME were compared.

Results:

Prevalence of OME was 7.5% (112/1488). In univariate analysis, it was strongly associated with recurrent acute otitis media (AOM; P < .0001) a large family size (P < .0001), young age (P < .0001), low maternal education (P < .0001), and hearing loss symptom (P < .0001). OME was significantly higher in schools located in rural districts (P < .001). It is less strongly associated with history of preschool acute otitis media (P = .002), nasal discharge (P = .003), and snoring (P = .03). Of these factors, 5 were found to be significant in the multivariate logistic regression model: age (odds ratio [OR] = 0.191, 95% confidence interval [CI]: 0 .124-0.295), family size (OR = 4.192, 95% CI: 2.033-8.643), school district (OR = 3.037, 95% CI: 1.933-4.772), maternal education (OR = 0.399, 95% CI: 0.256-0.621), and recurrent AOM (OR = 4.914, 95% CI: 2.677-9.02).

Conclusions:

Prevalence of OME in Qassim region reaches 7.5% in school children. Young age, large family size, low maternal education, preschool AOM, hearing loss symptom, recurrent AOM, nasal discharge, and snoring are significant factors associated with the disease.