Otitis Media and Its Sequelae in Kenyan Schoolchildren

J Pediatric Infect Dis Soc. 2016 Dec;5(4):375-384. doi: 10.1093/jpids/piv038. Epub 2015 Jul 9.


Background: The goal of this study was to obtain representative Kenyan data on the point prevalence of acute otitis media (AOM) and its sequelae (otitis media with effusion [OME] and chronic suppurative otitis media [CSOM]), a major cause of preventable hearing loss in children in developing countries. In Africa, there are limited studies on the prevalence of AOM and its sequelae in children.

Methods: Study subjects were children aged 2 to 15 years and were enrolled from randomly selected preprimary and primary schools. After parental or guardian consent, subjects had a questionnaire administered, otoscopy and tympanometry were done, and audiometry was performed on those with ear problems detected on these examinations.

Results: A total of 9825 (75%) children was from rural schools. The prevalence of CSOM was 15 of 1000, OME was 15 of 1000, and AOM was 7 of 1000 children. Rural Rift Valley schoolchildren had the highest prevalence of CSOM (24 of 1000) compared with other regions (12 of 1000; P < .0001). Ear discharge occurred before 3.5 years in 50% of 901 children with ear discharge. A history of ear discharge was associated with abnormal tympanograms (odds ratio [OR], 11.9-19.2) and mild-to-severe hearing loss (OR, 21.6-38.6), even in children without ear disease (OR, 10.7-24.4).

Conclusions: The burden of AOM sequelae in Kenyan preschool and schoolchildren is significant, and it occurs mostly in the first 4 years of life. By preventing early recurrent AOM, pneumococcal vaccination might partly avert nonreversible sequelae.

Keywords: acute otitis media; chronic suppurative otitis media; otitis media with effusion; otoscopy; perforation; tympanic membrane.

MeSH terms

  • Acoustic Impedance Tests
  • Acute Disease
  • Adolescent
  • Audiometry
  • Child
  • Child, Preschool
  • Disease Progression
  • Female
  • Humans
  • Infant
  • Kenya / epidemiology
  • Male
  • Otitis Media / epidemiology*
  • Otitis Media / pathology*
  • Otoscopy
  • Prevalence
  • Surveys and Questionnaires