title: Co-morbidities in children presenting with chronic suppurative otitis media--a South African study.
abstract: BACKGROUND
  Chronic suppurative otitis media (CSOM) is common among children in southern Africa. Managing associated co-morbidities may result in earlier disease resolution.
  
  
  METHODS
  Children <13 years of age with otorrhoea lasting >4 weeks were recruited to the study. Each child underwent a full clinical examination, a blood count, an HIV test and CD4 cell count, if found to be infected.
  
  
  RESULTS
  The study included 86 children, and the median age was 4.6 years. HIV infection was present in 45 of 83 children (54.2%), of which 23 (51.1%) were receiving antiretroviral treatment at the time of presentation. Underweight was present in 22 of 85 (25.9%) children and in 17 of the 45 (37.8%) HIV-infected children. One or more clinical signs (not aural-related) were found in 46 of 86 (53.4%) children. Cholesteatoma was found in 23 of 113 (20.4%) ears, and 9 of 86 (10.5%) children had serious associated aural or intracranial complications.
  
  
  CONCLUSIONS
  A high percentage of children with CSOM have associated pathology that needs to be diagnosed to optimally manage CSOM.
authors.affiliation: Department of Paediatrics and Child Health, University of the Free State, Bloemfontein 9300, South Africa hallbute@ufs.ac.za.
authors.forename: Ute M
authors.initials: UM
authors.lastname: Hallbauer
authors.affiliation: Department of Paediatrics and Child Health, University of the Free State, Bloemfontein 9300, South Africa.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Atkins
authors.affiliation: Department of Otorhinolaryngology, University of the Free State, Bloemfontein 9300, South Africa.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Tiedt
authors.affiliation: Department of Otorhinolaryngology, University of the Free State, Bloemfontein 9300, South Africa.
authors.forename: Iain R T
authors.initials: IR
authors.lastname: Butler
authors.affiliation: Department of Medical Microbiology, NHLS and University of the Free State.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Pieters
authors.affiliation: Department of Medical Microbiology, NHLS and University of the Free State.
authors.forename: Eugene
authors.initials: E
authors.lastname: Elliott
authors.affiliation: Department of Biostatistics, University of the Free State, Bloemfontein 9300, South Africa.
authors.forename: Gina
authors.initials: G
authors.lastname: Joubert
authors.affiliation: Department of Otorhinolaryngology, University of the Free State, Bloemfontein 9300, South Africa.
authors.forename: Riaz Y
authors.initials: RY
authors.lastname: Seedat
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002781:Cholesteatoma / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D008297:Male; D044342:Malnutrition / Q000453:epidemiology; D010035:Otitis Media, Suppurative / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D015995:Prevalence; D011446:Prospective Studies; D013019:South Africa / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D044966:Anti-Retroviral Agents
keywords: HIV infection; children; chronic suppurative otitis media; co-morbidity; malnutrition