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Review
. 2020 Nov 17;5(6):1205-1216.
doi: 10.1002/lio2.502. eCollection 2020 Dec.

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

Emmanuel Choffor-Nchinda  1   2 , Antoine Bola Siafa  3   4 , Jobert Richie Nansseu  5
Affiliations
Review

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

Emmanuel Choffor-Nchinda et al. Laryngoscope Investig Otolaryngol. .

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%; I 2 = 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.

Level of evidence: 3a.

Keywords: Africa; otitis media with effusion; prevalence; risk factors; systematic review.

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Conflict of interest statement

The authors have no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Study selection flowchart
FIGURE 2
FIGURE 2
Funnel plot evaluating publication bias
FIGURE 3
FIGURE 3
Forest plot for meta‐analysis of prevalence of otitis media with effusion in Africa according to age group
FIGURE 4
FIGURE 4
Forest plot for meta‐analysis of prevalence of otitis media with effusion according to African sub‐region
See this image and copyright information in PMC

References

    1. Rosenfeld RM, Shin JJ, Schwartz SR, et al. Clinical practice guideline: otitis media with effusion (update). Otolaryngol Head Neck Surg. 2016;154(1):1‐41. - PubMed
    1. Higgins TS, Meyers AD. Otitis Media with Effusion. Medscape; 2018. https://emedicine.medscape.com/article/858990. Accessed February 23, 2020.
    1. Mandel EM, Doyle WJ, Winther B, Alper CM. The incidence, prevalence and burden of OM in unselected children aged 1‐8 years followed by weekly otoscopy through the "common cold" season. Int J Pediatr Otorhinolaryngol. 2008;72(4):491‐499. - PMC - PubMed
    1. Ahmed A, Kolo E, Aluko A, et al. Diagnosis and management of otitis media with effusion in a tertiary hospital in Kano: a best practice implementation project. JBI Database Syst Rev Implement Rep. 2018;16(10):2050‐2063. - PubMed
    1. Bennett KE, Haggard MP, Silva PA, Stewart IA. Behaviour and developmental effects of otitis media with effusion into the teens. Arch Dis Child. 2001;85(2):91‐95. - PMC - PubMed

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