Otitis media with effusion in Africa‐prevalence and associated factors: A systematic review and meta‐analysis

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Otitis media with effusion in Africa‐prevalence and associated factors: A systematic review and meta‐analysis


JournalLaryngoscope Investigative Otolaryngology
Article typeJournal research article – Systematic review
Publication date – Nov – 2020
Authors – Emmanuel Choffor‐Nchinda, Antoine Bola Siafa, Jobert Richie Nansseu
KeywordsAfrica, otitis media with effusion, prevalence, Risk factors, systematic review
Open access – Yes
SpecialityENT surgery
World region Central Africa, Eastern Africa, Middle Africa, Northern Africa, Southern Africa, Western Africa

Language – English
Submitted to the One Surgery Index on December 16, 2020 at 11:25 am
Abstract:

Objectives
To estimate the overall and subgroup prevalence of otitis media with effusion (OME) in Africa, and identify setting‐specific predictors in children and adults.

Methods
PubMed, African Journals Online, African Index Medicus, Afrolib, SciELO, Embase, Scopus, Web of Science, The Cochrane Library, GreyLit and OpenGray were searched to identify relevant articles on OME in Africa, from inception to December 31st 2019. A random‐effects model was used to pool outcome estimates.

Results
Overall, 38 studies were included, with 27 in meta‐analysis (40 331 participants). The overall prevalence of OME in Africa was 6% (95% CI: 5%‐7%; I2 = 97.5%, P < .001). The prevalence was 8% (95% CI: 7%‐9%) in children and 2% (95% CI: 0.1%‐3%) in adolescents/adults. North Africa had the highest prevalence (10%; 95% CI: 9%‐13%), followed by West and Southern Africa (9%; 95% CI: 7%‐10% and 9%; 95% CI: 6%‐12% respectively), Central Africa (7%; 95% CI: 5%‐10%) and East Africa (2%; 95% CI: 1%‐3%). There was no major variability in prevalence over the last four decades. Cleft palate was the strongest predictor (OR: 5.2; 95% CI: 1.4‐18.6, P = .02). Other significant associated factors were age, adenoid hypertrophy, allergic rhinitis in children, and type 2 diabetes mellitus, low CD4 count in adults.

Conclusion
OME prevalence was similar to that reported in other settings, notably high‐income temperate countries. Health care providers should consider age, presence of cleft palate, adenoid hypertrophy and allergic rhinitis when assessing OME in children and deciding on a management plan. More research is required to confirm risk factors and evaluate treatment options.

OSI Number – 20808

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