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Chilakamarri S, Amalanathan S, Colbert KR, Kumar S. Knowledge, Attitude, and Practices Regarding Risk Factors for Otitis Media among Caretakers of Children in Puducherry- A Descriptive Cross Sectional Study. Indian J Otolaryngol Head Neck Surg 2024; 76:2675-2683. [PMID: 38883498 PMCID: PMC11169352 DOI: 10.1007/s12070-024-04551-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 02/07/2024] [Indexed: 06/18/2024] Open
Abstract
Otitis media is a common childhood disease in developing countries and is the most important cause of preventable hearing loss among Indian children. To study the knowledge, attitude, and practices regarding risk factors for otitis media among caretakers of children in Puducherry. This was a questionnaire based descriptive cross-sectional study conducted from April 2023 to June 2023. All the caregivers of children aged 2-12 years presented or diagnosed with otitis media under our inclusion criteria were interviewed. Overall, most caretakers displayed good knowledge (67%), positive attitude (62%) and good care-seeking practices (49%). There was a positive correlation with sociodemographic parameters. The odd's ratio for overcrowding was high (OR = 4, p = 0.042 for knowledge and attitude, OR = 3.929, p = 0.041 for practices). Higher score was seen among middle class with odd's ratio 1.417 for knowledge and attitude and 4.875 for practices (p = 0.041). Graduate parents had higher score with the odd's ratio that was statistically significant. Most of the caregivers had a good knowledge regarding symptoms of otitis media and an acceptable level of caregivers' attitude and care seeking practices. Higher scores were associated with overcrowding, socioeconomic status, parental education. Improvement in risk factors and providing health education will reduce prevalence of OM in children and thereby reduce preventable hearing loss in children. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-024-04551-9.
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Affiliation(s)
- Srivalli Chilakamarri
- Department of ENT, Indira Gandhi Medical College & Research Institute, Puducherry, India
| | - Sophia Amalanathan
- Department of ENT, Indira Gandhi Medical College & Research Institute, Puducherry, India
| | - Kumaran Ramesh Colbert
- Department of ENT, Indira Gandhi Medical College & Research Institute, Puducherry, India
| | - Satish Kumar
- Department of ENT, Indira Gandhi Medical College & Research Institute, Puducherry, India
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Waterworth CJ, Marella M, Bhutta MF, Dowell R, Khim K, Annear PL. Access to ear and hearing care services in Cambodia: a qualitative enquiry into experiences of key informants. J Laryngol Otol 2024; 138:22-32. [PMID: 36154944 PMCID: PMC10772024 DOI: 10.1017/s0022215122002158] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE In Cambodia, little is known about the state of ear and hearing care, or the roles providers or key stakeholders play in delivering services. METHOD This was an exploratory study using semi-structured qualitative interviews and a questionnaire addressed to key stakeholders to explore their perceptions and experiences in providing services to people suffering from ear disease or hearing loss in Cambodia. RESULTS Several challenges were described including a lack of hearing services to meet the demand, especially outside Phnom Penh in primary care and aural rehabilitation. Supply-side challenges include a shortage of trained professionals, facilities and resources, poor co-ordination between providers, unclear referral pathways, and long wait times. CONCLUSION Now is an opportune time to build on the positive trend in providing integrated care for non-communicable diseases in Cambodia, through the integration of effective ear and hearing care into primary care and strengthening the package of activities delivered at government facilities.
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Affiliation(s)
- C J Waterworth
- Department of Audiology and Speech Pathology, University of Melbourne, Australia
- Nossal Institute for Global Health, University of Melbourne, Australia
| | - M Marella
- Nossal Institute for Global Health, University of Melbourne, Australia
| | - M F Bhutta
- Clinical and Experimental Medicine, Brighton & Sussex Medical School, Brighton, UK
- Department of ENT, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - R Dowell
- Department of Audiology and Speech Pathology, University of Melbourne, Australia
| | - K Khim
- Monitoring, Evaluation and Learning, Access Program, Phnom Penh, Cambodia
| | - P L Annear
- Nossal Institute for Global Health, University of Melbourne, Australia
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AlHefdhi HA, Al Qout MM, Alqahtani AY, Alqahtani MM, Asiri RM, Alshahrani OM, Almoghamer HD, Youssef N, Ghazy RM. Parents' Knowledge of and Attitude toward Acute Otitis Media and Its Treatment in Children: A Survey at Primary Healthcare Centers in the Aseer Region. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1573. [PMID: 37761534 PMCID: PMC10528457 DOI: 10.3390/children10091573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/07/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Acute otitis media (AOM) in children aged 5 years old and younger poses a critical health concern, affecting both the general health of children and the emotional well-being of parents. The objective of this study was to evaluate parental understanding, attitudes, and experiences related to AOM and its management, including the use of antibiotics without physician prescription. METHOD A cross-sectional study was carried out during the months of May and June of 2023. To collect data for this study, a validated questionnaire was converted into a Google form and given to parents of children aged 5 years and younger who sought healthcare for their children in primary healthcare centers in Abha city, Aseer region, Saudi Arabia. RESULTS A total of 406 parents participated in this study, 64.8% of them were women and 45.3% of them were in the age range of 25 to 34 years. The majority (90.1%) resided in urban areas and a significant proportion (72.2%) had a university education. Among the respondents, 22.7% agreed that bacteria are the cause of AOM, while 21.7% agreed that it is caused by viruses. A total of 51.0% acknowledged the need for antibiotics in the management of AOM. In terms of treatment, 84.5% and 83.5% believed that analgesics and antibiotics, respectively, were the most effective for otalgia. A substantial portion, 43.1%, 34.7%, and 37.7%, respectively, believed that antibiotics could reduce pain, relieve fever, and prevent recurrence. Almost three-quarters sought medical advice primarily from paediatricians and 37.7% obtained information about AOM from the Internet. Furthermore, almost a third (28.8%) chose not to wait for the physician's appointment and immediately administered antibiotics without the physician's prescription due to concerns about disease progression. Approximately two fifths (38.4%) requested physicians to prescribe antibiotics, a pattern that was in agreement with the actual rate of antibiotic prescriptions (38.4%). CONCLUSIONS A notable deficiency in knowledge and unsafe practices about AOM and its management is evident among parents in the Aseer region. This underscores the pressing need for an educational program aimed at improving parental health literacy regarding otitis media causes and treatments, as well as its preventive measures.
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Affiliation(s)
- Hayfa Abdulkhaleq AlHefdhi
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia;
| | - Maraam Mohammed Al Qout
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (M.M.A.Q.); (A.Y.A.); (M.M.A.); (R.M.A.); (O.M.A.); (H.D.A.)
| | - Alhanouf Yahya Alqahtani
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (M.M.A.Q.); (A.Y.A.); (M.M.A.); (R.M.A.); (O.M.A.); (H.D.A.)
| | - Meshal Mohammed Alqahtani
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (M.M.A.Q.); (A.Y.A.); (M.M.A.); (R.M.A.); (O.M.A.); (H.D.A.)
| | - Roaa Mohammed Asiri
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (M.M.A.Q.); (A.Y.A.); (M.M.A.); (R.M.A.); (O.M.A.); (H.D.A.)
| | - Omair Mohammed Alshahrani
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (M.M.A.Q.); (A.Y.A.); (M.M.A.); (R.M.A.); (O.M.A.); (H.D.A.)
| | - Hanan Delem Almoghamer
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (M.M.A.Q.); (A.Y.A.); (M.M.A.); (R.M.A.); (O.M.A.); (H.D.A.)
| | - Naglaa Youssef
- Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah Bint Abdulrah-Man University, Riyadh 11671, Saudi Arabia;
| | - Ramy Mohamed Ghazy
- Tropical Health Department, Alexandria University, Alexandria 21561, Egypt
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Srivastava T, Harinath S. Benefit of Educational Video on Parental Knowledge, Attitude and Practice About Middle Ear Infection in Children. Indian J Otolaryngol Head Neck Surg 2023; 75:23-31. [PMID: 37206757 PMCID: PMC10188746 DOI: 10.1007/s12070-022-03102-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 10/19/2021] [Indexed: 10/15/2022] Open
Abstract
The aim of the study was to determine the benefit of educational video on parental knowledge, attitude and practice about risk factors of middle ear infection in children. An educational video was developed in English with information on anatomy of the ear, signs and symptoms, risk factors, consequences, prevention, and management related to ear infections. A KAP (Knowledge, attitude and practice) questionnaire was also developed comprising of 33 questions. Parents were requested to fill the questionnaire online and after watching the educational video they were asked to fill the same questionnaire after 1 month. 61 parents responded to both pre questionnaire and post questionnaire. In knowledge domain, thirty five parents gave correct answers to more than sixty percent of questions in the pre questionnaire and fifty six parents gave correct answers to more than sixty percent of the question in the post questionnaire. In attitude domain, all sixty one parents gave correct answers to more than sixty percent of questions in the pre questionnaire. In practice domain, twenty six parents gave correct answers to more than sixty percent of questions in the pre questionnaire and forty nine parents gave correct answers to more than sixty percent of the question in the post questionnaire after watching the educational video. Using the test of proportion, there was statistically significant difference in scores in pre questionnaire and post questionnaire in knowledge and practice domain. In the present study, there was statistically significant improvement in parents overall knowledge and practice about middle ear infection after watching the educational video.
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Affiliation(s)
- Tejaswini Srivastava
- Faculty of audiology and speech language pathology, Sri Ramachandra Institute of Higher Education and Research (DU), Porur, Chennai, India
| | - Sathya Harinath
- Faculty of audiology and speech language pathology, Sri Ramachandra Institute of Higher Education and Research (DU), Porur, Chennai, India
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Waterworth CJ, Watters CTM, Sokdavy T, Annear PL, Dowell R, Grimes CE, Bhutta MF. Disparities in access to ear and hearing care in Cambodia: a mixed methods study on patient experiences. J Laryngol Otol 2023; 137:373-389. [PMID: 35698817 PMCID: PMC10040287 DOI: 10.1017/s0022215122001396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Chronic suppurative otitis media is a major global disease disproportionately affecting low- and middle-income countries, but few studies have explored access to care for those with ear and hearing disorders. METHOD In a tertiary hospital in Cambodia providing specialist ear services, a mixed method study was undertaken. This study had three arms: (1) quantitative analysis of patients undergoing ear surgery, (2) a questionnaire survey and (3) semi-structured in-depth interviews. RESULTS Patients presented with advanced middle-ear disease and associated hearing loss at rates that are amongst the highest per capita levels globally. Patients reported several structural, financial and socio-cultural barriers to treatment. This study showed a significant burden of ear disease in Cambodia, which reflects a delay in receiving timely and effective treatment. CONCLUSION This study highlights the opportunity to integrate effective ear and hearing care into primary care service provision, strengthening the package of activities delivered at government facilities.
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Affiliation(s)
- C J Waterworth
- Department of Audiology and Speech Pathology, University of Melbourne, Melbourne, Australia
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | - C T M Watters
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - T Sokdavy
- Children's Surgical Centre, Kien Khleang Rehabilitation Centre, Phnom Penh, Cambodia
| | - P L Annear
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | - R Dowell
- Department of Audiology and Speech Pathology, University of Melbourne, Melbourne, Australia
| | - C E Grimes
- King's Centre for Global Health and Health Partnerships, School of Population Health and Environmental Sciences, King's College London, London, UK
| | - M F Bhutta
- Clinical and Experimental Medicine, Brighton & Sussex Medical School, Brighton, UK
- Department of ENT, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
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Lukama L, Aldous C, Michelo C, Kalinda C. Ear, Nose and Throat (ENT) disease diagnostic error in low-resource health care: Observations from a hospital-based cross-sectional study. PLoS One 2023; 18:e0281686. [PMID: 36758061 PMCID: PMC9910637 DOI: 10.1371/journal.pone.0281686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/28/2023] [Indexed: 02/10/2023] Open
Abstract
Although the global burden of ear, nose and throat (ENT) diseases is high, data relating to ENT disease epidemiology and diagnostic error in resource-limited settings remain scarce. We conducted a retrospective cross-sectional review of ENT patients' clinical records at a resource-limited tertiary hospital. We determined the diagnostic accuracy and appropriateness of patient referrals for ENT specialist care using descriptive statistics. Cohens kappa coefficient (κ) was calculated to determine the diagnostic agreement between non-ENT clinicians and the ENT specialist, and logistic regression applied to establish the likelihood of patient misdiagnosis by non-ENT clinicians. Of the 1543 patients studied [age 0-87 years, mean age 25(21) years (mean(SD)], non-ENT clinicians misdiagnosed 67.4% and inappropriately referred 50.4%. Compared to those aged 0-5 years, patients aged 51-87 years were 1.77 (95%CI: 1.03-3.04) fold more likely to have a referral misdiagnosis for specialist care. Patients with ear (aOR: 1.63; 95% CI: 1.14-2.33) and those with sinonasal diseases (aOR: 1.80; 95% CI: 1.14-2.45) had greater likelihood of referral misdiagnosis than those with head and neck diseases. Agreement in diagnosis between the ENT specialist and non-ENT clinicians was poor (κ = 0.0001). More effective, accelerated training of clinicians may improve diagnostic accuracy in low-resource settings.
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Affiliation(s)
- Lufunda Lukama
- Department of Otorhinolaryngology, Head and Neck Surgery, Ndola Teaching Hospital, Ndola, Zambia
- College of Health Sciences, Nelson R Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
- * E-mail:
| | - Colleen Aldous
- College of Health Sciences, Nelson R Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Charles Michelo
- School of Public Health, Department of Epidemiology, Harvest University, Lusaka, Zambia
- Strategic Centre for Health Systems Metrics & Evaluations (SCHEME), School of Public Health, University of Zambia, Lusaka, Zambia
| | - Chester Kalinda
- Bill and Joyce Cummings Institute of Global Health, University of Global Health Equity, Kigali, Rwanda
- Howard College Campus, College of Health Sciences, School of Public Health and Nursing, University of KwaZulu-Natal, Durban, South Africa
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Waterworth CJ, Marella M, O'Donovan J, Bright T, Dowell R, Bhutta MF. Barriers to access to ear and hearing care services in low- and middle- income countries: A scoping review. Glob Public Health 2022; 17:3869-3893. [PMID: 35319345 DOI: 10.1080/17441692.2022.2053734] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
People living in low- and middle- income countries (LMICs) meet significant challenges in accessing ear and hearing care (EHC) services. We conducted a scoping review to identify and summarise such barriers, to recognise gaps in the literature, and to identify potential solutions. Reviewers independently screened titles, abstracts and full-text articles and charted data. We undertook thematic analysis of supply and demand side dimensions of access, and summarised findings mapped against the Levesque framework. Of 3048 articles screened, 62 met inclusion criteria for review. Across the five access dimensions, supply-side constraints were more frequently described, the most common being a shortage of EHC workforce or appropriate facilities, despite high demand. We identified a thin geographical spread of literature on barriers to accessing EHC services in LMICs, reflecting low availability of such services. LMICs face a diverse range of demand and supply side challenges including workforce, equipment and resource shortages, and challenges for the majority of the population to pay for such services. There is a need for many LMICs to develop health policy and programmes in EHC, including integration into primary care, scaling up the EHC workforce through increased training and education, and improving EHC literacy through public health measures.
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Affiliation(s)
- Christopher J Waterworth
- Department of Audiology and Speech Pathology, University of Melbourne, Melbourne, Australia.,Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | - Manjula Marella
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | - James O'Donovan
- Postgraduate School of Primary Care, Health Education North East England, Newcastle-upon-Tyne, UK
| | - Tess Bright
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Richard Dowell
- Department of Audiology and Speech Pathology, University of Melbourne, Melbourne, Australia
| | - Mahmood F Bhutta
- Clinical and Experimental Medicine, Brighton & Sussex Medical School, Brighton, UK.,Department of ENT, University Hospitals Sussex NHS Trust, Brighton, UK
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Meherali S, Hartling L, Campbell A, Robin F, Scott S. Parent information needs and experience regarding acute otitis media in children: A systematic review. PATIENT EDUCATION AND COUNSELING 2021; 104:554-562. [PMID: 32998839 DOI: 10.1016/j.pec.2020.09.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/07/2020] [Accepted: 09/12/2020] [Indexed: 05/23/2023]
Abstract
BACKGROUND Acute otitis media (AOM)-inflammation of the middle ear-is the most common pediatric condition, affecting up to 75 % of children at some time before age 5 years. Despite the high incidence of AOM in children, it presents diverse challenges to parents who do not have accurate information on AOM and its management. OBJECTIVE To respond to this paucity of information we sought to synthesize the literature to provide a comprehensive understanding of parental information needs and experiences relating to AOMmanagement. This systematic review is an important first step in developing parent-informed knowledge translation tools for AOM to bridge the knowledge-practice gap. PATIENT INVOLVEMENT None. METHOD Four electronic databases were searched and articles were screened according to pre- established inclusion criteria. Articles were included in the review if they (1) examined parental information needs and experiences with respect to AOM; (2) were written in English; and (3) were published from January 2000 onward. RESULTS Out of 1121 articles retrieved, 21 articles met the inclusion criteria. The findings from this review revealed that parents' knowledge about AOM is generally limited. Further, parents were often poorly informed about what AOM was, which resulted in uncertainty about how to help their child with AOM. DISCUSSION Our review findings illustrate that parents of children with AOM have pervasive unmet information needs and information deficits negatively impact AOM management, child and family well-being. PRACTICAL VALUE Parental experiences and information needs identified through this review were used to develop innovative, evidence-based knowledge translation tools for parents of children with AOM.
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Alsuhaibani M, Almijmaj M, Almushaigeh A, Alhomidani R, Aldakheel Y, Alaqeel A. Awareness and attitudes of Saudi parents toward otitis media in children. J Family Med Prim Care 2020; 9:6177-6182. [PMID: 33681060 PMCID: PMC7928161 DOI: 10.4103/jfmpc.jfmpc_1690_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/26/2020] [Accepted: 10/12/2020] [Indexed: 01/29/2023] Open
Abstract
Background: An ear infection is a common health problem in children. Parents’ awareness about otitis media (OM) among children, varies across the world. We aimed to explore parents’ knowledge, attitude, and practices toward OM among their children. Methods: A quantitative cross-sectional study was done from May 1, 2020 to June 30, 2020, in Qassim, Saudi Arabia. Results: This study comprised 703 participants; Mothers comprised the majority (77.1%), 43.2% of the participants were aged between 31 and 40 years of age, and 73% of them had Bachelor's degrees or diplomas. More than half of the participants had suboptimal knowledge of OM. Although the result showed that 56% of them had positive attitudes, 86.6% did not view vaccination as a prevention measure of acute OM (AOM). Besides, 81.8% of parents were willing to follow the watchful waiting approach, in case their child had OM. Conclusion: Most of the parents in the Qassim region have inadequate knowledge regarding OM among children. Based on our result findings, we recommend further education programs to enhance the knowledge regarding OM and AOM, among the Qassim population, Saudi Arabia including family members of patients and the healthcare workers.
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Affiliation(s)
- Mohammed Alsuhaibani
- Department of Pediatrics, College of Medicine, Qassim University, Qassim 51452, Saudi Arabia
| | - Muna Almijmaj
- Medical Intern, College of Medicine, Qassim University, Qassim 51452, Saudi Arabia
| | | | - Raghad Alhomidani
- Medical Intern, College of Medicine, Qassim University, Qassim 51452, Saudi Arabia
| | - Yasser Aldakheel
- Medical Intern, College of Medicine, Qassim University, Qassim 51452, Saudi Arabia
| | - Aqeel Alaqeel
- Department of Pediatrics, College of Medicine, Qassim University, Qassim 51452, Saudi Arabia
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A study of knowledge, attitude and practices about otitis media in parents in Navi-Mumbai. J Otol 2020; 16:89-94. [PMID: 33777121 PMCID: PMC7985005 DOI: 10.1016/j.joto.2020.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/07/2020] [Accepted: 11/09/2020] [Indexed: 11/23/2022] Open
Abstract
Although otitis media poses a serious health risk in developing countries, being a frequent occurrence in children below five years of age, parental awareness and practices about otitis media have not been adequately researched. Present cross-sectional study was undertaken in Navi Mumbai schools, from October 2019 to December 2019, wherein parents with children ≤5 years of age answered a questionnaire which gathered data on their knowledge, attitude and practices about otitis media in their wards. Chi-square tests, Cramer’s V were used to study association between gender, age-group and education of parents with their knowledge, practice and attitude about otitis media. Out of 425 valid responses, overall most parents displayed adequate knowledge (77%), positive attitude (61%) and good care-seeking practices (70%). There was a positive correlation of knowledge and practice with level of education. This study shows acceptable levels of knowledge, attitude and practices in parents about otitis media. Parents who did not seek treatment from health centre attributed the behaviour to poverty, ignorance and lack of health insurance. The positive correlation of knowledge and practices with level of education highlights the importance of role of education in modifying parental awareness and care seeking behaviour. Our findings call for a need to further strengthen community-based healthcare and improve parental confidence in healthcare services for early detection and adequate treatment of otitis media.
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Alharbi MM, Almasri MS, Aldayel AY, Alkhonezan SM. Parental Knowledge, Attitudes and Practices Towards Paediatric Ear Infections in Riyadh, Saudi Arabia: A quantitative study. Sultan Qaboos Univ Med J 2019; 19:e114-e121. [PMID: 31538009 PMCID: PMC6736261 DOI: 10.18295/squmj.2019.19.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/10/2019] [Accepted: 02/07/2019] [Indexed: 01/25/2023] Open
Abstract
Objectives This study aimed to assess the knowledge, attitude and care-seeking practices of parents towards childhood ear infections in Riyadh, Saudi Arabia. Methods This quantitative cross-sectional study was conducted in Riyadh, Saudi Arabia, between April and June 2018. An online survey was sent to a random selection of parents who were ≥18 years old with children of ≤10 years old. Associations between parental knowledge, attitude, care-seeking practices, socioeconomic status, level of education and age were assessed using the chi square test and logistic regression analysis. Results A total of 782 subjects participated in this study (response rate: 78.2%). Most respondents were knowledgeable (76.2%), had a positive attitude (78.9%) and had positive care-seeking practices (89.5%). There was a statistically significant difference on both bivariate and multivariate analyses (P <0.05) between parental care seeking practice and knowledge. Parents who sought modern approaches to treatment were found to be almost nine times more likely to have a good attitude towards ear infections than those who did not seek treatment (odds ratio = 8.907, 95% confidence interval = 2.655–34.928; P <0.001). A statistically significant relationship was found between good care-seeking practice and age, as well as socioeconomic status (P <0.05 each). Conclusion This study showed that knowledge, attitude and practice regarding paediatric ear infections were positive in the majority of parents in Riyadh, Saudi Arabia. Future studies should assess other factors that enhance the knowledge, attitude and practices regarding ear infections.
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Affiliation(s)
- Muteb M Alharbi
- College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Mohammed S Almasri
- College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdulrahman Y Aldayel
- College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Saleh M Alkhonezan
- College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
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12
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O'Donovan J, Verkerk M, Winters N, Chadha S, Bhutta MF. The role of community health workers in addressing the global burden of ear disease and hearing loss: a systematic scoping review of the literature. BMJ Glob Health 2019; 4:e001141. [PMID: 30899572 PMCID: PMC6407559 DOI: 10.1136/bmjgh-2018-001141] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 01/18/2019] [Accepted: 01/25/2019] [Indexed: 12/21/2022] Open
Abstract
Introduction Community health workers (CHWs) have the potential to improve access to ear and hearing services for people across low-income or middle-income countries, remote, underserved, or resource-poor areas of the world. We performed a systematic scoping review to identify evidence on how CHWs are currently deployed in the prevention, screening, diagnosis, treatment and management of ear disease and hearing loss; methods to train and support CHWs in this context; and cost-effectiveness of CHWs. Methods We performed a systematic search of the literature from September 1978 to 18 March 2018 from 11 major databases and the grey literature. Results We identified 38 original studies that met the inclusion criteria, taking place across South Asia (n=13), Oceania (n=7), North America (n=7), South America (n=6) and Africa (n=5). 23 studies showed CHWs can increase community participation in screening. They can conduct screening using whispered voice tests, noisemakers for neonatal screening, automated audiological tests and otoscopy. Eight studies focused specifically on the evaluation of programmes to train CHWs, and three provided a general programme description. Three studies documented a role of CHWs in the treatment of ear disease or hearing loss, such as performing ear washouts, instillation of topical antibiotics or fitting of hearing aids. Only one study provided an indepth cost-utility analysis regarding the use of CHWs to conduct hearing screening, and no studies commented on the role of CHWs in the prevention of hearing loss. Conclusion CHWs have been employed in diverse ways to address the global burden of ear disease and hearing loss. Future research needs to explore the role of CHWs in preventative strategies, identify optimum methods to train and support CHWs, and explore their cost-effectiveness.
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Affiliation(s)
- James O'Donovan
- Department of Education, University of Oxford, Oxford, UK.,Division of Research and Health Equity, Omni Med, Mukono, Uganda
| | - Misha Verkerk
- Department of Otolaryngology, King's College Hospital NHS Foundation Trust, London, UK
| | - Niall Winters
- Department of Education, University of Oxford, Oxford, UK
| | - Shelly Chadha
- WHO Programme for Prevention of Deafness and Hearing Loss, World Health Organization, Geneva, Switzerland
| | - Mahmood F Bhutta
- Department of ENT, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
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Causes of Delayed Care Seeking for Chronic Suppurative Otitis Media at a Rwandan Tertiary Hospital. Int J Otolaryngol 2018; 2018:5386217. [PMID: 30057615 PMCID: PMC6051111 DOI: 10.1155/2018/5386217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 04/30/2018] [Indexed: 01/22/2023] Open
Abstract
Background Chronic suppurative otitis media causes serious lifelong consequences when treatment is delayed. Early detection and effective treatment result in a good outcome and possible complications are thus avoided. The aim of this study was to determine the factors resulting in delayed care seeking for treatment of CSOM. Method and Patient The study was a cross-sectional survey conducted at a tertiary teaching hospital in Rwanda. A questionnaire was used to collect data of patients diagnosed with CSOM who attended ENT Department during the study period. We defined delayed care seeking as seeking treatment 6 months after onset of symptoms. Data was entered and analysed using SPSS 16.0. Result This study enrolled 109 patients, 97 (88.9%) of whom had delays in care seeking. Majority were young adults ranging between 21 and 30 years (39.2%) while 58.8% were rural residents. Fifty-eight patients (56.9%) of those with delayed presentation used traditional medicine. The main reason for delayed care seeking was low knowledge of CSOM reported by 88 (90.7%) patients. Conclusion This study shows that majority of patients with delayed care seeking are young adult patients. There is low knowledge concerning this disease and this significantly contributes to delayed care seeking.
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Mukara KB, Lilford RJ, Tucci DL, Waiswa P. Prevalence of Middle Ear Infections and Associated Risk Factors in Children under 5 Years in Gasabo District of Kigali City, Rwanda. Int J Pediatr 2017; 2017:4280583. [PMID: 29348761 PMCID: PMC5733628 DOI: 10.1155/2017/4280583] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/11/2017] [Accepted: 10/26/2017] [Indexed: 11/25/2022] Open
Abstract
Middle ear infections are common in children, and delay in diagnosis and treatment may result in complications such as delays in speech and language development and deafness. The aim of this study was to determine the prevalence and care seeking behaviour for middle ear infections in children under five years in Kigali city. We conducted a cross-sectional study among 810 children aged 6-59 months in Gasabo district of Kigali city, Rwanda. The prevalence of middle ear infections was 5.8%, of whom 4% had chronic suppurative otitis media. A child was less likely to develop middle ear infections if they lived in an urban setting (OR = 0.52, 95% CI: 0.285-0.958) but more likely to develop middle ear infections if exposed to household smoke (OR = 2.54, 95% CI: 1.18-5.46). Parents were unlikely to know that their child had an ear infection (OR: 0.15, 95% CI: 0.06-0.34). Middle ear infection remains a public health problem in Rwanda but many parents were not aware of its presence in the affected children. There is a need to raise awareness of parents about ear infection and to promote early care seeking from qualified health workers.
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Affiliation(s)
- Kaitesi Batamuliza Mukara
- ENT Department, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda
| | | | - Debara Lyn Tucci
- Head and Neck Surgery & Communication Sciences, Duke University, Durham, NC, USA
| | - Peter Waiswa
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda
- Global Health Division, Karolinska Institutet, Stockholm, Sweden
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