Sociodemographic profile and the associated factors of chronic otitis media in rural areas of eastern Nepal




Otitis media, Rural community, Sociodemographic profile, Practices


Background: Otitis media is one of the commonest infections in children. The present study was aimed to determine the sociodemographic profile and the associated factors of chronic otitis media along with the health related practices and beliefs among the family of rural children with otitis media in Morang district of eastern Nepal.

Methods: This cross sectional study was done over one year in different ear camps conducted in the various rural areas of Morang district of eastern Nepal. The attending guardians of the children with chronic otitis media were interviewed according to the pretested questionnaire regarding their socioeconomic status, health related practices, beliefs and other related issues. All the collected data were tabulated and analyzed.  

Results: A total of 102 attendants were interviewed. Most of the attending guardians were from low socioeconomic status with majority from medium sized family (4-7 persons). Most of them were illiterate. Most of the children lived in Kachha house. Inspite of only nearly 40% family having latrine, sanitation habits were satisfactory in above 80%. 53.92% of the children with chronic otitis media used to take bath in ponds and lake. Most of the guardians had the habit of cleaning ears in unsafe way. Nearly, a third of the guardians were not aware about importance of head position during breast feeding. Most of the guardians were not aware about the causes and treatment of otitis media. In case of ear discharge, most of them seeked help in health institutions. 14.7% would rely on house hold remedies like oil, herbs instilled in to ears and 2.94% would go to faith healer. However 75.5% of the attendants perceived that the use of antibiotics was the method to treat otitis media.

Conclusions: The prevailing chronic otitis media in rural children is associated with several risk factors. The lack of appropriate knowledge, perception and erroneous practices stresses the importance of specific health education to the population. Early detection and preventive programs for better ear care can possibly help to alleviate this burden of chronic illness in the society. 

Author Biographies

Sanjeev Kumar Thakur, Department of ENT, Nobel Medical College, Kanchanbari, Biratnagar, Nepal


Department of ENT

Nobel Medical College

Sanjay Kumar Singh, Department of ENT, Nobel Medical College, Kanchanbari, Biratnagar, Nepal

Department of ophthalmology

Biratnagar Eye Hospital

Rabin Acharya, Department of ENT, Nobel Medical College, Kanchanbari, Biratnagar, Nepal

ear consultant

department of ear

biratnagar eye hospital

Afaque Anwar, Department of ENT, Nobel Medical College, Kanchanbari, Biratnagar, Nepal

health educator
department of health education

Biratnagar Eye Hospital

Nisha Ghimire, Department of ENT, Nobel Medical College, Kanchanbari, Biratnagar, Nepal

assistant professor

department of physiology

nobel medical college


Mahadevan M, Navarro-Locsin G, Tan HK, Yamanaka N, Sonsuwan N, Wang PC, et al. A review of the burden of disease due to otitis media in the Asia-Pacific. Int J Pediatr Otorhinolaryngol. 2012;76:623-35.

Little P, Bridges A, Guragain R, Friedman D, Prasad R, Weir N. Hearing impairment and ear pathology in Nepal. J Laryngol Otol. 1993;107(5):395-400.

Upadhyay MP. Sunsari health examination survey, B P Koirala Institute of Health Sciences. 1996.

Maharjan M, Bhandari S ,Singh I ,Mishra SC. Prevalence of otitis media in school-going children in eastern Nepal. Kathmandu Univ Med J. 2006;16:479-82.

Mishra SC, Shah PK, Kandpal N. Hearing retardation amongst school age Bhutanese refugees. Indian J Otolaryngol. 2002;8(1):5-8.

WHO/CIBA Foundation workshop report. Prevention of hearing impairment from chronic otitis media. UK 19–21 November 1996. Available at

otitis_media.pdf. Accessed on 21 January 2017.

Rupa V, Jacob A, Joseph A. CSOM: prevalence and practices among rural south indian children. Int J Pediatr Otorhinolaryngol. 1999;48(3):217–21.

Villasenor A, Arriaga MA, Eavey RD, Santos JI, Chissone E. Educational outcomes of an otitis media workshop for primary care providers in Latin America. Otolaryngol Head Neck Surg. 1998;118:394–6.

Shaheen M M, Raquib A, and Ahmad S M Chronic Suppurative Otitis Media and Its Association with Socio-Econonic Factors Among Rural Primary School Children of Bangladesh Indian J Otolaryngol Head Neck Surg. 2012; 64(1): 36–41.

Dhingra R, Dhillon V, Monga S, Mehta AS, Kaur G, Kaur M. Sociodemographic profile and evaluation of associated factors in Chronic suppurative otitis media patients reporting to tertiary care Hospital of Punjab. Int Archives of Integrated Med. 2016;3(6):6-10.

Bairwa M, Rahput M, Sachdeva S. Modified kuppuswamy's socioeconomic scale: social researcher should include updated income criteria, 2012. Indian J of Community Med. 2013;38(3):185-6.

Siddique BH, Khan AH. CSOM in a rural area based study. SSMC J. 1995;3:31–3.

Biswas AC, Joarder AH, Siddiquee BH. Prevalence of CSOM among rural school going children. Mymensingh Med J. 2005;14(2):152–5.

Kamal N, Joarder AH, Chowdhury AA, Khan AW. Prevalence of chronic suppurative otitis media (CSOM) among the children living in two selected slums of Dhaka city. Bangladesh Med Res Counc Bull. 2004;30(3):95–104.

Biswas AC, Haq AHMZ, Khan FA, Alauddin M, Dutta PG. A comparative study of chronic suppurative otitis media (CSOM) between rural and urban school going children. Bangladesh J Otolaryngol. 2005;11(12):17–21.

Rupa V, Raman R. CSOM: complicated versus uncomplicated disease. Acta Otolaryngol. 1991;111:530–5.

Narayanan I, Singh S, Mathu R, Jain. Ear infection and infant feeding practices. Indian J Pediatrics. 1989;56(3):399–402.

Sabirov A, Casey J, Murphy T, Pichichero M. Breastfeeding is associated with a reduced frequency of acute otitis media and high serum antibody levels against NTHi and outer membrane protein vaccine antigen candidate P6. Pediatr Res. 2009;66(5):565–70.

Srikanth S, Isaac R, Rebekah G, Rupa V. Knowledge, attitudes and practices with respect to risk factors for otitis media in a rural South Indian community. Int J Pediatric Otorhinolaryngol. 2009;73:1394–8.

Hansen M, Howlett J, Del Mar C, Hoffman T. Parents’ beliefs and knowledge about the management of acute otitis media: a qualitative study. BMC Fam Pract. 2015;16:82.

Verma AK, Vohra A, Maitra A, Banerjee M, Singh R, Mittal SK, et al. Epidemiology of chronic suppurative otitis media and deafness in a rural area and developing an intervention strategy. Indian J Pediatr. 1995;62:725-9.






Original Research Articles