Classification and management challenges of otitis media in a resource-poor country

Abstract

The clinical features and sequelae of otitis media (OM) vary depending on the duration, severity and progression of the disease. As a result, opinions on the modes of classification and management protocols have differed over the years. The need to critically appraise these opinions according to the peculiarities of each region is imperative. This work was aimed at reviewing the world literature on the subject and also highlights the limitations in management in our region. A wide literature search was conducted using the following search engines: PubMed, AJOL and University of Toronto Library. Also incorporated were essential materials obtained from the authors' clinical practices. The search engines returned 22,903 related articles on OM. Further filtration yielded 88 articles on "classification and management" and these were obtained in full and thoroughly read. Extracted materials for review spanned between 1980 and 2008. OM is prevalent the world over with potentially severe complications if inadequately managed, especially in the developing countries. It is of note that in the developing countries, poverty, ignorance, dearth of specialists and limited access to medical care amongst others conspire to worsen the course and complications of OM.

A survey of the burden of management of chronic suppurative otitis media in a developing Country

“…CSOM is commoner in developing countries, with its prevalence being reported as high as 11%,[81315] whereas it is a vanishing disease in more developed part of the world where incidence is less than 2%. [81416] In the developing countries still, poverty, ignorance, dearth of specialists and limited access to medical care amongst others conspire to worsen the course and complications (sometimes life-threatening) of CSOM.…”

“…[81416] In the developing countries still, poverty, ignorance, dearth of specialists and limited access to medical care amongst others conspire to worsen the course and complications (sometimes life-threatening) of CSOM. [13]…”

“…Ear discharge form CSOM is often recalcitrant to management and prone to recurrences and occasionally, with life-threatening complications; hence it is recommended that all cases of CSOM be referred to otorhinolaryngologists for prompt management. [131617181920] The otorhinolaryngologist will add little or is unlikely to add to patient's improvement if the expertise and facilities are not there at his/her disposal. [1920]…”

“…These challenges were similarly identified as factors militating against the improvement of medicare of CSOM in developing countries. [13161819]…”

“…[78131415] Often the commonly reported organisms responsible for most cases of CSOM include Pseudomonas aeruginosa , Staphylococcus aureus , Klebsiella pneumonia , Escherichia coli , and anaerobes. [3578]…”