Effect of a participatory intervention in women’s self-help groups for the prevention of chronic suppurative otitis media in their children in Jumla Nepal: a cluster-randomised trial

Abstract

Background Chronic suppurative otitis media (CSOM) causes preventable deafness and disproportionately affects children living in poverty. Our hypothesis was that health promotion in women’s groups would increase their knowledge, attitudes and practices (KAP) regarding ear disease and reduce the prevalence of CSOM in their children. Methods We did a cluster randomised trial in two village development committees (VDCs) in Jumla, Nepal. In July 2014, 30 women’s groups were randomly allocated to intervention or control, stratified by VDC and distance to the road. The intervention groups participated in three sessions of health promotion using the WHO Hearing and Ear Care Training Resource Basic Level . The primary outcome was women’s KAP score and the secondary outcome was prevalence of CSOM in their children at 12 month follow-up. Analyses were by intention to treat. Participants and the research team were not masked to allocation. Results In June and July 2014 we recruited 508 women and 937 of their children. 12 months later there was no difference in the women’s KAP score (mean difference 0.14, 95% CI − 0.1 to 0.38, P = 0.25) or the prevalence of CSOM in their children (OR 1.10, 95%CI 0.62 to 1.84, P = 0.75) between intervention and control groups. However, overall, there was a significant improvement in the KAP score (mean difference − 0.51, 95% CI − 0.71,to − 0.31, P < 0.0001) and in the prevalence of CSOM from baseline 11.2% to follow-up 7.1% ( P < 0.0001). Conclusions Health promotion in women’s groups did not improve maternal KAP or reduce prevalence of CSOM. Over time there was a significant improvement in women’s KAP score and reduction in the prevalence of CSOM which may be attributable to our presence in the community offering treatment to affected children, talking to their parents and providing ciprofloxacin drops to the local health posts. More research is needed in low resource settings to test our findings. Trial registration Australia and New Zealand Clinical Trial Registry 12,614,000,231,640 ; Date of registration: 5.3.2014: Prospectively registered. Electronic supplementary material The online version of this article (10.1186/s12887-019-1539-y) contains supplementary material, which is available to authorized users.

Disparities in access to ear and hearing care in Cambodia: a mixed methods study on patient experiences

“…38 Regarding CSOM specifically, many social factors reportedly contribute to the complexity of the disease, including impoverishment, marginalisation, malnutrition, a lack of quality health services, poor education and a lack of evidence-based treatment protocols. 39 Compared with similar studies in other countries, our findings confirm that the degree of hearing loss and disease progression for the Children's Surgical Centre cohort is amongst the most severe reported globally for patients undergoing either tympanoplasty [40][41][42][43][44][45][46] or mastoidectomy surgery. [41][42][43][47][48][49][50][51] Patients presented to the Children's Surgical Centre on average 13-14 years after they initially became aware of their symptoms, a delay which likely contributed to the severity of the disease and degree of hearing loss.…”

“…Although hearing loss has been ranked the fourth leading chronic disease globally, data are available across only 16.5 per cent of all geographic areas 38 . Regarding CSOM specifically, many social factors reportedly contribute to the complexity of the disease, including impoverishment, marginalisation, malnutrition, a lack of quality health services, poor education and a lack of evidence-based treatment protocols 39 . Compared with similar studies in other countries, our findings confirm that the degree of hearing loss and disease progression for the Children's Surgical Centre cohort is amongst the most severe reported globally for patients undergoing either tympanoplasty 40–46 or mastoidectomy surgery 41–43,47–51 .…”

Analisis Faktor-Faktor Yang Berhubungan Dengan Kejadian Otitis Media Supuratif Kronis Pada Pasien Anak

“…Salah satu intervensi yang dilakukan adalan mengenalkan anak-anak dengan kolam renang komunitas atau kolam renang semi privat. Namun hal ini tidak dapat secara signifikan mengurangi prevalensi OMSK 11 .…”

Effects of online social media on improving mothers’ behaviors towards preventing their children’s otitis media based on the PRECED model: a randomized educational intervention trial

“…Some of the risk factors in the occurrence of otitis media can be mentioned as lack of breastfeeding, family history, taking care of children outside of home and in crowded areas, and inhaling cigarette smoke [3]. Studies emphasize the role of knowledge, attitude and behavior of parents, especially mothers, for the prevention of otitis media [16][17][18]. In a study by Baghiani Moghadam, 4.5% of mothers with children less than 2-year-old had good knowledge about Otitis media [19].…”

“…Studies also, emphasize the necessity of educational intervention in order to improve the knowledge, attitude and behavior of mothers regarding otitis media [18]. Training mothers is one of the effective ways to prevent otitis media [17]. In this regard, educational interventions, campaigns and community-oriented interventions and the necessity of attention of health care providers [20] are suggested in the field of otitis media prevention.…”