Dataset Information

Effect of a participatory intervention in women's self-help groups for the prevention of chronic suppurative otitis media in their children in Jumla Nepal: a cluster-randomised trial.

ABSTRACT:

Background

Chronic suppurative otitis media (CSOM) causes preventable deafness and disproportionately affects children living in poverty. Our hypothesis was that health promotion in women's groups would increase their knowledge, attitudes and practices (KAP) regarding ear disease and reduce the prevalence of CSOM in their children.

Methods

We did a cluster randomised trial in two village development committees (VDCs) in Jumla, Nepal. In July 2014, 30 women's groups were randomly allocated to intervention or control, stratified by VDC and distance to the road. The intervention groups participated in three sessions of health promotion using the WHO Hearing and Ear Care Training Resource Basic Level. The primary outcome was women's KAP score and the secondary outcome was prevalence of CSOM in their children at 12?month follow-up. Analyses were by intention to treat. Participants and the research team were not masked to allocation.

Results

In June and July 2014 we recruited 508 women and 937 of their children. 12?months later there was no difference in the women's KAP score (mean difference 0.14, 95% CI -?0.1 to 0.38, P?=?0.25) or the prevalence of CSOM in their children (OR 1.10, 95%CI 0.62 to 1.84, P?=?0.75) between intervention and control groups. However, overall, there was a significant improvement in the KAP score (mean difference?-?0.51, 95% CI -?0.71,to -?0.31, P?ConclusionsHealth promotion in women's groups did not improve maternal KAP or reduce prevalence of CSOM. Over time there was a significant improvement in women's KAP score and reduction in the prevalence of CSOM which may be attributable to our presence in the community offering treatment to affected children, talking to their parents and providing ciprofloxacin drops to the local health posts. More research is needed in low resource settings to test our findings.

Trial registration

Australia and New Zealand Clinical Trial Registry 12,614,000,231,640 ; Date of registration: 5.3.2014: Prospectively registered.

SUBMITTER: Clarke S

PROVIDER: S-EPMC6533658 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Publications

Effect of a participatory intervention in women's self-help groups for the prevention of chronic suppurative otitis media in their children in Jumla Nepal: a cluster-randomised trial.

Clarke Susan S Richmond Robyn R Worth Heather H Wagle Rajendra R Hayen Andrew A

BMC pediatrics 20190523 1

<h4>Background</h4>Chronic suppurative otitis media (CSOM) causes preventable deafness and disproportionately affects children living in poverty. Our hypothesis was that health promotion in women's groups would increase their knowledge, attitudes and practices (KAP) regarding ear disease and reduce the prevalence of CSOM in their children.<h4>Methods</h4>We did a cluster randomised trial in two village development committees (VDCs) in Jumla, Nepal. In July 2014, 30 women's groups were randomly a ...[more]

PMID: 31122224

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Project description:BackgroundChronic suppurative otitis media (CSOM) is an important cause of hearing loss in children and constitutes a serious health problem globally with a strong association to resource-limited living conditions. Topical antibiotics combined with aural toilet is the first-hand treatment for CSOM but antimicrobial resistance and limited availability to antibiotics are obstacles in some areas. The goal of this study was to define aerobic pathogens associated with CSOM in Angola with the overall aim to provide a background for local treatment recommendations.MethodsSamples from ear discharge and the nasopharynx were collected and cultured from 152 patients with ear discharge and perforation of the tympanic membrane. Identification of bacterial species was performed with matrix-assisted laser desorption/ionization-time of flight mass spectrometry and pneumococci were serotyped using multiplex polymerase chain reactions. Antimicrobial susceptibility testing was done according to EUCAST.ResultsOne hundred eighty-four samples from ear discharge and 151 nasopharyngeal swabs were collected and yielded 534 and 289 individual isolates, respectively. In all patients, correspondence rate of isolates from 2 ears in patients with bilateral disease was 27.3% and 9.3% comparing isolates from the nasopharynx and ear discharge, respectively. Proteus spp. (14.7%), Pseudomonas aeruginosa (13.2%) and Enterococcus spp. (8.8%) were dominating pathogens isolated from ear discharge. A large part of the remaining species belonged to Enterobacteriaceae (23.5%). Pneumococci and Staphylococcus aureus were detected in approximately 10% of nasopharyngeal samples. Resistance rates to quinolones exceeded 10% among Enterobacteriaceae and was 30.8% in S. aureus, whereas 6.3% of P. aeruginosa were resistant.ConclusionsThe infection of the middle ear in CSOM is highly polymicrobial, and isolates found in nasopharynx do not correspond well with those found in ear discharge. Pathogens associated with CSOM in Angola are dominated by gram-negatives including Enterobacteriaceae and P. aeruginosa, while gram-positive enterococci also are common. Based on the results of antimicrobial susceptibility testing topical quinolones would be the preferred antibiotic therapy of CSOM in Angola. Topical antiseptics such as aluminium acetate, acetic acid or boric acid, however, may be more feasible options due to a possibly emerging antimicrobial resistance.

Dataset Information

Effect of a participatory intervention in women's self-help groups for the prevention of chronic suppurative otitis media in their children in Jumla Nepal: a cluster-randomised trial.

Background

Methods

Results

Trial registration

Publications

Effect of a participatory intervention in women's self-help groups for the prevention of chronic suppurative otitis media in their children in Jumla Nepal: a cluster-randomised trial.

Similar Datasets

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