title: Otitis Media and Its Sequelae in Kenyan Schoolchildren.
abstract: 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.
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora.|Center for Global Health, Department of Epidemiology, Colorado School of Public Health, Aurora.|Department of Pediatric Infectious Diseases, Children's Hospital Colorado, Aurora.
authors.forename: Eric A F
authors.initials: EA
authors.lastname: Simões
authors.affiliation: Department of Surgery, College of Health Sciences, University of Nairobi, Kenya.|Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Francis
authors.initials: F
authors.lastname: Kiio
authors.affiliation: Department of Pediatric Infectious Diseases, Children's Hospital Colorado, Aurora.
authors.forename: Phyllis J
authors.initials: PJ
authors.lastname: Carosone-Link
authors.affiliation: Department of Surgery, College of Health Sciences, University of Nairobi, Kenya.|Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Serah N
authors.initials: SN
authors.lastname: Ndegwa
authors.affiliation: Department of Surgery, College of Health Sciences, University of Nairobi, Kenya.|Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: John
authors.initials: J
authors.lastname: Ayugi
authors.affiliation: Department of Surgery, College of Health Sciences, University of Nairobi, Kenya.|Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Isaac M
authors.initials: IM
authors.lastname: Macharia
mesh_terms: D000158:Acoustic Impedance Tests; D000208:Acute Disease; D000293:Adolescent; D001299:Audiometry; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006801:Humans; D007223:Infant; D007630:Kenya / Q000453:epidemiology; D008297:Male; D010033:Otitis Media / Q000453:epidemiology* / Q000473:pathology*; D038781:Otoscopy; D015995:Prevalence; D011795:Surveys and Questionnaires
keywords: acute otitis media; chronic suppurative otitis media; otitis media with effusion; otoscopy; perforation; tympanic membrane