Etiology of Childhood Otorrhea in Luanda, Angola, and a Review of Otitis Media in African Children

Abstract

Background: In resource-poor settings, otorrhea causes a significant burden of disease in children. Etiologic studies and structured data on otorrhea and chronic otitis media among African children remain scarce. Methods: Here, we reviewed 678 bacteriologically analyzed otorrhea samples from Luanda Children's Hospital from children ≤15 years of age bet een 2008 and 2015. We then compared these to data from other studies among African children through a literature review of 20 papers published over two decades. Results: Overall, 32 different bacteria were identified among 542 isolates from 654 children in Luanda. Gram-negative bacteria constituted the majority of all isolates (85%), whereby Pseudomonas sp was the most common (n = 158, 29%), followed by Proteus sp (n = 134, 25%). Among Staphylococcus aureus (n = 106, 10%), 69% of tested isolates were MRSA, and among Enterobacteriaceae 14% were ESBL isolates. Resistance to quinolones was rare. Furthermore, in a review of the literature, we found a high occurrence of otorrhea and chronic suppurative otitis media (CSOM) in children as well as possible gaps in existing knowledge. Conclusions: In Angola, Gram-negative rods emerged as common causative agents of otorrhea in children followed by S. aureus. The magnitude of chronic otorrhea in Africa represents a cause for public health concern.

Hearing impairment in Angolan children with acute bacterial meningitis with and without otitis media

“…aureus (5%–14%). In our result the most common pathogen causing otorrhoea was Proteus, which is in correspondence with the literature review from Africa 20 . In studies from Kenya for instance, Proteus is frequently detected as the most common agent causing otorrhoea among children and young adults 21 .…”

“…In our result the most common pathogen causing otorrhoea was Proteus, which is in correspondence with the literature review from Africa. 20 In studies from Kenya for instance, Proteus is frequently detected as the most common agent causing otorrhoea among children and young adults. 21 In our study, the most common pathogens found in the ear discharge of the children with BM were likely to be related more to chronic than acute middle ear infections.…”

Suppurative otitis media in Angola: clinical and demographic features

“…In Africa, the highest incidence rates for AOM (43 per 1000) and CSOM (4.79 per 1000) are found in the Central African region and Angola [7]. The prevalence rates of CSOM are consistently reported to exceed the magnitude of a public health concern [4, 9].…”

Hearing Impairment in Angolan Children with Acute Bacterial Meningitis With and Without Otitis Media and Otorrhea

“…(37%), Pseudomonas spp. (13-15%) and S. aureus (5-14%) 22 . We found that the most common pathogen causing otorrhea was Proteus, which is in correspondence with the literature review from Africa 22 .…”

“…(13-15%) and S. aureus (5-14%) 22 . We found that the most common pathogen causing otorrhea was Proteus, which is in correspondence with the literature review from Africa 22 . In studies from Kenya for instance, Proteus is frequently detected as the most common agent causing otorrhea among children and young adults 23,24 .…”