Associated factors, health-related quality of life, and reported costs of chronic otitis media in adults at two otologic referral centers in a middle-income country

PLoS One. 2020 Dec 31;15(12):e0244797. doi: 10.1371/journal.pone.0244797. eCollection 2020.


Background: Despite the high prevalence of chronic otitis media (COM) in low to middle-income countries, there are few studies regarding its associated factors, health-related quality of life, and treatment costs. This study aimed to identify associated factors of COM, assess its impact on the quality of life as well as estimate the patients' reported costs of COM treatment in Colombia.

Methods: Cross-sectional study. Two otology-referral centers in Bogotá (Colombia) were included. Questionnaires focusing on sociodemographic and clinical associated factors, quality of life, and patients' reported costs were administered to 200 adults with COM diagnosis and 144 control adults. Otoscopic evaluation and audiometric data were collected.

Results: The mean age was 42.2 years (SD: 14.44). The median length of COM was 26.13 years (SD: 17.06), and 79.5% of the COM patients reported otorrhea during childhood (P-value: 0.01). The most frequently reported allergic disease among our study population was allergic rhinitis (26.5%). COM was less frequent in patients with a medium-high socioeconomic status (PR: 0.54; 95% CI: 0.39-0.72), and more frequent in patients who reported increased ear discharge due to upper respiratory tract infections (PR: 1.69; 95% CI: 1.68-1.70). The global score of the "Chronic Suppurative Otitis Media Questionnaire-12" showed a difference of 9 points between patients with active and inactive COM (P < 0.001). Patients spent between 12.07% to 60.37% of their household income on expenses related to COM.

Conclusions: Associated factors found in this study are consistent with previous reports. COM has a significant financial impact and affects patients' quality of life. Worldwide research addressing these issues in poor-resource countries is scarce, further studies are needed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chronic Disease / economics
  • Chronic Disease / psychology
  • Colombia
  • Cost of Illness
  • Cross-Sectional Studies
  • Female
  • Health Expenditures
  • Humans
  • Male
  • Middle Aged
  • Otitis Media / diagnosis*
  • Otitis Media / economics
  • Otitis Media / psychology
  • Quality of Life / psychology*
  • Surveys and Questionnaires

Grant support

This project was funded by the Unidad Medico Quirúrgica de Otorrinolaringología-UNIMEQ-ORL from Bogotá, Colombia. URL: The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.