The magnitude and factors associated with ear infections in a tertiary hospital in Dar es Salaam, Tanzania

Abstract

Background: Ear infection is a common public health problem in developing countries. There is limited data on the factors associated with ear infections, which have hastened their spread and the repercussions of ear infections, including hearing loss. The study aimed to determine the magnitude and factors associated with ear infection among patients attending the Otorhinolaryngology clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania.

Methods: A hospital-based cross-sectional study was conducted from March to July 2021. Participants with signs and symptoms of ear infection who attended the otorhinolaryngology clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania, were recruited into this study. The clinical information from the participants was collected using a standardized data collection tool, and an ear swab was collected and taken to the lab for culture and identification. Data analysis was conducted using Statistical Package for the Social Sciences (SPSS v23), and proportions and percentages were used to indicate the magnitude. The Chi-square test was employed to assess associations between variables, with statistical significance determined at a p-value of 0.05. Logistic regression was used to measure the strength of the association between dependent and independent variables.

Results: A total of 255 eligible participants were enrolled, with ages ranging from 1 to above 50 years (median 31 years; IQR: 15–49). The magnitude of ear infection was found to be 53.3% (136 out of 255). The majority (26.8%) of participants with ear infection were elderly above 50 years, followed by children under 10 years (17.9%). Additionally, we observed that the factors such as cotton buds use (AOR 2.78, 95%CI 1.08–7.15, p=0.035) and ear cleaning using objects other than cotton buds, including keys, pins, and pens (AOR 3.45, 95%CI 1.44–8.25, p=0.005), p=0.035), cerumen impaction (AOR 12.86, 95%CI 2.78-59.33, p <0.001), p=0.035), cerumen impaction (AOR 12.86, 95%CI 2.78-59.33, p <0.001), recurrent upper respiratory tract infection (URTI) (AOR 3.43, 95%CI 1.22-10.03, p=0.019), and nasal /congestion/discharge (AOR 3.55, 95% CI 1.36-9.27, p = 0.010) were independently associated with ear infection.

Conclusions: The present study has revealed a 53.3% magnitude of ear infection, with elders above 50 years and children below 10 years accounting for most cases. Our study findings showed that nasal congestion, recurrent URTI, use of cotton buds, cerumen impaction and ear cleaning were potential risk factors for ear infection.

Recommendations: Health education campaigns promoting safe ear hygiene, early treatment of URTI and nasal congestion, and discouragement of the use of cotton buds and sharp objects for ear cleaning are recommended to reduce the burden of ear infections in similar settings.