title: Middle ear problems in children hospitalised because of lower respiratory tract infections: a comparison between two cohorts in Burundi and Italy.
abstract: OBJECTIVE
  To compare the prevalence of acute otitis media (AOM) and otitis media with effusion (OME) in children hospitalized for acute lower respiratory infections (LRTIs) in Burundi and Italy.
  
  
  METHODS
  The study, which was conducted from 1 February to 30 April 2011 at the hospital of Kiremba (Burundi, Africa) and at Paediatric Clinic 1 of the University of Milan (Italy), enrolled patients aged <5 years who were hospitalised because of LRTIs. Upon admission, the children underwent an otological examination (pneumatic otoscopy and tympanometry), and middle ear diseases were compared between the two groups.
  
  
  RESULTS
  A total of 108 children enrolled in Burundi (44 males; median age 17 months) were compared to 108 patients enrolled in Italy (53 males; median age 19 months). About one-third of the children in Burundi (33, 30.6%) had normal middle ears. AOM was never diagnosed, whereas OME was detected in 74 children (68.5%: bilateral in 51, 68.9%, and unilateral in 23, 31.1%). The prevalence of OME decreased with increasing age: it was 86.5% in children aged <12 months, 73.7% in those aged 12-24 months, and 43.8% in those aged >24 months (p < 0.001). There was no difference in the proportion of children with OME in Burundi (68.5%) and Italy (63.9%; p = 0.47). OME was significantly more frequent in the children with pneumonia admitted in Burundi than in the children with pneumonia admitted in Italy (p = 0.004).
  
  
  CONCLUSIONS
  In children hospitalized for lower respiratory tract infection, OME is almost as frequently seen in developing countries like Burundi, Africa, as in developed countries like Italy. Follow-up monitoring of these children might be required to assess if OME is just a transient phenomenon.
authors.affiliation: Pediatric Clinic 1, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Baggi
authors.forename: Margherita
authors.initials: M
authors.lastname: Semino
authors.forename: Sonia
authors.initials: S
authors.lastname: Bianchini
authors.forename: Miriam
authors.initials: M
authors.lastname: Fattizzo
authors.forename: Chiara
authors.initials: C
authors.lastname: Rosazza
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.forename: Paola
authors.initials: P
authors.lastname: Marchisio
mesh_terms: D000208:Acute Disease; D017677:Age Distribution; D001991:Bronchitis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D002063:Burundi / Q000453:epidemiology; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D003906:Developing Countries; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D010033:Otitis Media / Q000175:diagnosis* / Q000453:epidemiology*; D010034:Otitis Media with Effusion / Q000175:diagnosis / Q000453:epidemiology; D038781:Otoscopy / Q000379:methods; D011014:Pneumonia / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution
keywords: Acute otitis media; Children; Developing countries; Lower respiratory tract infections; Middle ear diseases; Otitis media with effusion