PDF(Pubmed)
Abstract：
Outer and middle ear pathologies are known to disproportionately affect low-income countries but data is limited. We aim to quantify the prevalence rate of patients presenting with middle/outer ear pathologies at ABC Hearing Clinic and Training Centre in Lilongwe, Malawi. Audiological consultations (adult and paediatric) from 2018-2020 were reviewed for outer and middle ear pathologies. Secondary outcomes included patient type (private vs. community) compared to otoscopy findings, tympanometry findings, need for follow up, and follow up compliance. Out of 1576 patients reviewed, the proportion of abnormal cases\' was 98.2%, with 41.4% being unilateral and 57.4% bilateral. Eighty-three percent presented with outer/middle ear pathologies. 68% of those presented with a pathology often associated with some degree of conductive hearing loss (occluding wax, perforation, discharge, Type B/Type C tympanogram). Average age was 29 + 0.527 years; 41.6% private and 58.2% community patients. Cerumen impaction was most common finding (51%). Higher rates of otoscopic abnormalities and type B tympanograms were noted in community vs. private patient (~40% vs. ~30%; ~70% vs. ~30%). Adherence to follow up was higher for community vs. private patients (29% vs. 17%); ~70% reported subjective improvement upon follow up. The majority required multiple interventions on follow up. Secondary follow up was recommended in 64.8%. A significant disease burden of outer and middle ear pathologies was identified. Further research is required to understand the disease burden and promote health policy.
摘要：
众所周知，外耳和中耳病变对低收入国家的影响不成比例，但数据有限。我们的目标是量化在利隆韦ABC听力诊所和培训中心出现中/外耳病变的患者的患病率，马拉维。审查了2018-2020年的听力学咨询（成人和儿科）的外耳和中耳病变。次要结果包括患者类型(私人与社区)与耳镜检查结果相比，鼓室测量结果,需要跟进，并跟进合规。在检查的1576名患者中，异常病例的比例为98.2%，41.4%是单边的，57.4%是双边的。83％的人患有外耳/中耳病变。68%的患者出现病理，通常与一定程度的传导性听力损失相关(阻塞蜡，穿孔,放电,B型/C型鼓室图)。平均年龄为29+0.527岁；41.6%的私人患者和58.2%的社区患者。耳垢嵌塞是最常见的发现（51％）。在社区与社区中注意到较高的耳镜异常和B型鼓室图发生率。私人患者(~40%vs.~30%;~70%vs.~30%)。社区与社区的跟进依从性更高。私人患者(29%vs.17%)；~70%报告随访后主观改善。大多数人需要在后续行动中采取多种干预措施。64.8%建议二次随访。确定了外耳和中耳病理的重大疾病负担。需要进一步研究以了解疾病负担并促进卫生政策。
