title: Correlates of various presentation modes of acute otitis media in saudi children.
abstract: OBJECTIVE
  To describe correlates of various modes of presentation and identify some surrogates of poor outcome of children less than 5 years with Acute Otitis Media (AOM).
  
  
  METHODS
  This is a cross-sectional survey conducted at 11 primary health care centers in Riyadh city over 3 month period. A total of 140 children, each less than 5 years of age and presenting with a new episode of AOM were enrolled. Twenty-eight family physicians participated in the study. Each physician made the diagnosis of AOM based on history and clinical examination of the tympanic membranes (TM) using an otosocope. Poor outcome was defined as children presenting with otorrhea.
  
  
  RESULTS
  The majority of children presented with fever (62%), URTI (58%) and earache (54%). Presence of URTI, irritability, or sleeplessness were positively associated with redness and dullness of TM (p<0.05). Thumb sucking reduced the risk of bulging (OR = 0.29, 95% CI: 0.07-0.94). Children of illiterate fathers were more likely to present with otorrhea (X(2) = 4.66, p< 0.05). Bottle feeding increased the risk of otorrhea by two fold (OR = 2.26, 95% CI:1.01-5.05).
  
  
  CONCLUSIONS
  Children with AOM presenting as URTI, irritability or sleeplessness will showed redness and dullness of the TM as clinical signs of the disease. Thumb sucking was found to be protective from bulging of the TM. Having an illiterate father and being bottle fed were found to be surrogates of otorrhea .
authors.affiliation: Department of Family & Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: A J
authors.initials: AJ
authors.lastname: Al-Quaiz