Understanding the perceptions of genetic testing by members of the deaf community may help in planning deafness genetics research, especially so in the context of strong adherence to cultural values ...as found among native Africans. Among Yorubas in Nigeria, deafness is perceived to be caused by some offensive actions of the mother during pregnancy, spiritual attack, and childhood infections. We studied attitudes towards, and acceptance of genetic testing by the deaf community in Nigeria. Structured questionnaires were administered to individuals sampled from the Vocational Training Centre for the Deaf, the religious Community, and government schools, among others. The main survey items elicited information about the community in which the deaf people participate, their awareness of genetic testing, whether or not they view genetic testing as acceptable, and their understanding of the purpose of genetic testing. There were 150 deaf participants (61.3 % males, 38.7 % females) with mean age of 26.7 years ±9.8. A majority of survey respondents indicated they relate only with other members of the deaf community (78 %) and reported believing genetic testing does more good than harm (79.3 %); 57 % expressed interest in genetic testing. Interest in genetic testing for deafness or in genetic testing in pregnancy was not related to whether respondents relate primarily to the deaf or to the hearing community. However, a significantly higher number of male respondents and respondents with low education reported interest in genetic testing.
Summary Background The incidence of chronic suppurative otitis media (CSOM) is high worldwide but increasing occurrence of complications appear peculiar to West Africa. However, knowledge of ...associated risk factors is sparse, we report the sociodemographic risk factors of CSOM with the aim of control of the disease and complications; and possible preventive strategies. Method This is a survey of children with CSOM in five sites spread in two suburban cities in two states in Nigeria. Questionnaire was administered on the informants followed by examination of the children. Result Of the 189 children, 114 (60%) had developed ear suppuration before 6 months of age, the number of attacks within the previous 18 months ranged between 2–12 with average of 7. Sociodemographic risk factors included low socioeconomic class in 153 (81%), 136 (72%) live in congested houses with more than 10 people and 79 (42%) belonged to families with more than 5 children. Indoor-cooking and infant daycare attendance were 117 (62%) while supine bottlefeeding was 115 (61%) and 34 (18%) of subjects had smoking father. The clinical risk factors were upper respiratory tract infection (URI) 85 (45%), allergy 53 (28%), adenoid 54 (28%) and malnutrition 65 (34%). The univariate analysis revealed that low social class (OR = 7.33, CI = 4.18–12.83, P = 0.0001), malnutrition (OR = 3.57, CI = 1.88–6.76, P = 0.00001), bottlefeeding (OR = 2.93, CI = 1.63–5.28, P = 0.0001), indoor-cooking (OR = 1.35, CI = 0.88–2.10, P = 0.161) and high number of people in a household (OR = 0.59, CI = 0.34–0.98, P = 0.04) are significant in development of OM; while multivariate logistic regression analysis showed malnutrition (OR = 3.48, CI = 1.633–7.425, P = 0.001), low social status (OR = 7.74, CI = 4.15–14.43, P = 0.0001) and indoor-cooking (OR = 2.34, CI = 1.18–4.66, P = 0.014), second table. Parental smoking, daycare attendance, allergy, adenoiditis/adenoidal hypertrophy and upper respiratory tract infection were not found significant. Conclusion Low socioeconomic class, malnutrition, congestion from high number of children in the household and bottlefeeding constitute significant risk factor. The early onset of disease (<6 months) may suggest a prenatal predisposition. We need further research for the understanding of the biologic effect of these factors while this remains a database for prevention and control of disease.
The inner ear in patients with nasal allergy Lasisi, Akeem O; Abdullahi, Mohammed
Journal of the National Medical Association,
08/2008, Letnik:
100, Številka:
8
Journal Article
Recenzirano
The endolymphatic sac has been proposed as a target organ responsible for inner-ear symptom in allergic subjects. This is a report of inner-ear symptoms in patients with nasal allergy.
Retrospective ...review of record charts of patients with known nasal allergy presenting to the otorhinolaryngology out-patient department of the University College Hospital, Ibadan in 5 years.
Ear symptoms were found in 95/144 (66%) subjects with nasal allergy. This comprises of 41 males and 44 females (M: F = 1:1). Of these, itching of the external ear canal, hearing loss and tinnitus accounted for 63 (66%), 55 (58%) and 39 (41%), respectively, while vertigo was found in 12 (13%). Peripheral vestibular signs of imbalance were seen in 11/95. The audiological assessment of 73 subjects revealed normal pure-tone average in 43 (59%), and sensorineural hearing loss (SHL) in 17 (23.3%). The severity of SHL was mild in 6/17, moderate in 7 and moderate-to-severe in 4. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were elevated in 10/15 (67%) and 6/15 (40%), while the skin sensitivity test showed reactions to dust in 32, cold in 25, cockroach in 7, perfume in 11, vegetable oil in 1 and insecticide in 2. The clinical diagnoses were idiopathic tinnitus in 25 (26.3%), Idiopathic SHL in 17 (18%), cochlear hydrop in 6 (6%) and autoimmune inner-ear disease in 6 (6%).
This report suggests some peculiar predisposition to inner-ear pathology in patients with nasal allergy. However a longitudinal assessment of cochleovestibular features of nasal allergy subjects will help in its validation.
To determine the differences in the outcome of treatment, the middle ear immune response, and micronutrient status between patients with purulent (POM) and mucoid (MOM) otitis media.
Children with ...acute otitis media were recruited, treated, and followed up for between 6 and 10 months. The sera and middle ear secretion (MES) were analyzed for immunoglobulins and zinc using enzyme-linked immunoassay and flame atomic absorption spectrophotometry, respectively. The parameters were compared with selected healthy controls.
There were 399 participants: 228 children with acute otitis media selected using the American Academy of Otolaryngology-Head and Neck Surgery criteria and 171 healthy controls, with ages ranging between 6 months and 9 years (mean 7 years; SD 2.32 years).
POM accounted for 126 of 228 patients, and MOM accounted for 102. The chronicity of otitis media (using the 3-month duration cutoff) was seen in 87 subjects (46%): 31 of 126 POM subjects and 56 of 102 MOM subjects (p = .002). The serum IgA to IgG ratios were 0.03 and 0.07 among POM and MOM, respectively; however, the MES IgA to IgG ratios were higher, 0.3 and 0.2, for POM and MOM, respectively. This gives a MES to serum ratio of IgA to IgG value of 0.3 to 0.03 (10) for POM and 0.2 to 0.07 (2.67) for MOM, which showed a significant statistical difference (p = .001). The MES to serum ratios of IgE were 0.89 and 1.3 among POM and MOM, respectively (p = .03). There was a significant difference in the serum IgG (p = .019), serum zinc (p = .009), and MES IgA (p = .028) and IgG (p = .01).
Chronicity was greater in MOM than in POM; POM had a higher middle ear immune response (measured by the MES to serum ratio of IgA to IgG) and serum zinc than MOM but a lower MES IgE.
Sinonasal malignancy is a cause of otorhinolaryngologic morbidity and mortality in West Africa. However, there is a dearth of information in the literature on its clinicopathologic presentation in ...West Africa. It is our aim to determine the prevalence of sinonasal malignancy and highlight the clinicopathologic features in our environment. A 10-year retrospective review of cases with histologically diagnosed malignant sinonasal tumors in University College Hospital, Ibadan, Oyo State, Nigeria was carried out. There were 82 cases-56 (68.29%) males and 26 (31.71%) females-whose ages ranged from 4-69 years. Epistaxis, rhinorrhea and nasal blockage were seen in all patients; other symptoms were facial 76 (93%), oral cavity 48 (59%), ophthalmic 33 (40%) and otologic 21 (25%). Squamous cell carcinoma accounted for 69/75 (92%) of epithelial tumors, and malignant lymphoma accounted for 4/7 (57%) of nonepithelial tumors. Advanced disease was the predominant presentation in our series, stage 3 in 59 (79%) and stage 4 in 12 (16%) cases. Therefore, health education on early presentation to hospitals and efforts at early detection of the disease are needed in order to achieve cure. Industrial workers should always wear face masks to protect their nasal cavity.
The onset of early otitis media (EOM), in the first few months of life has been reported to predict later chronic otitis media (CSOM), although the prevalence rates are increasing little is known ...about specific risk factors. In this survey we examined the hypothesis that higher risk factors is associated with the development of OM within 1 year compared to later onset and early onset otitis media (OM) has potential for negative outcome of CSOM. This is a survey of the age at onset of otorrhoea and associated risk factors in children with CSOM, in five sites spread in two sub-urban cities in two states in Nigeria. Questionnaires were administered on the informants followed by examination of the children. EOM was seen in 136/189 (70%) with CSOM, the age range was 1–150 months, mean of 59.25 (SD = 44.55). Of the 85 CSOM subjects with hearing loss, EOM accounted for 49 (57.7%) while 36 (42.4%) was later onset, On multivariate analysis (OR = 0.276, CI = 0.133–0.572,
P
= 0.001) revealing EOM was significant in the development of hearing loss however there was no correlation with the frequency of attack of otorrhoea (OR = 1.025, CI = 0.88–1.19,
P
= 0.75). Low socioeconomic status seen in 110/136 EOM (
P
= 0.000), allergy (
P
= 0.030) and number of people >10 in household (OR = 4.13, CI = 1.81–9.39,
P
= 0.001) constituted the significant risk for EOM compared to later onset. Bottlefeeding, adenoiditis/adenoid hypertrophy, indoor cooking and upper respiratory infection were not found to have statistical significance in early onset OM compared to later onset OM. This study found correlation between EOM and hearing loss and identified allergy, low social status and chronic exposure to overcrowding through increased number of children in the household significant risk factors for future research focus. This may help in controlling the prevalence of hearing loss accompanying CSOM.
Dizziness has been reported to be preponderant among the elderly people, however, little is known about the prevalence and risk factors in the sub Saharan population.
This longitudinal cohort study ...determines the prevalence of dizziness and the clinical and socio-epidemiological correlates in elderly persons residing in the Yoruba-speaking areas of Nigeria.
Dizziness was reported 318/1299, representing a prevalence of 24.6%. They were made up of 197(58.5%) females and 121(41.5%) males, 39 (27.6%) were in the 65-69 years age range, 91 in the 70-74years age range, 66(26.8%) in the 75-79 years and 122(45.5%) were above 80 years. The majority of the subjects (253/318) (%) lived in rural-sub-urban, with no formal education in (172/318) (%) and more than two-third (213/318) were of low economic status.
Balance test conducted in 1, 006 elderly subjects revealed poor balance (mean balance test score <3.3) in 93/250(37.2%) subjects with dizziness and 189/756(25%) subjects without dizziness(P=0.01). Logistic regression adjusting for age and gender revealed that the odds for poor balance were 1.5 times greater in elderly with dizziness.
Low economic status (P=0.05) and smoking (P=0.01) were found to be significant in univariate analysis while logistic regression revealed smoking(OR=1.51, CI=1.17-1.95, P=0.01) and gender(OR=0.77, CI=0.59-0.99, P=0.05) as significant correlate of dizziness while none of age, residence or educational level was significant.
Significant clinical correlates in the experience of dizziness included self report of suppurative otitis media (OR =2.07, CI=1.21- 3.52, P=0.01), head injury (OR=2.41, CI=1.61-3.61, P=0.00), recurrent rhinosinusitis (OR=2.97, CI=2.05-4.29,P=0.00), current hypertension(OR=1.43, CI=1.03-2.00, P=0.03) and transient ischemic attack(OR=1.97, CI=1.19-3.23, P=0.01), while diabetes mellitus(OR=1.50, CI= 0.83- 2.71, P= 0.18) was not.
The high incidence of dizziness among the community elderly and significant correlation with remediable medical conditions further suggest need for policy formulation for the care of the elderly in Nigeria.
Background and Objectives: An association between suppurative otitis media (SOM) and allergy has been reported in about 80% of patients with allergy. However, there is controversy regarding their ...relationship and the concept of middle-ear allergic response. We test the hypothesis that increased secretion of IgE in the middle ear is higher in chronic than in acute SOM.
Methods: Allergy skin testing and enzyme-linked immunoassay of specimens of middle-ear secretions and sera were analysed.
Results: Paired sera and middle-ear secretions (MES) from 37 subjects with SOM, 20 chronic (CSOM) and 17 acute (ASOM), and sera of 15 controls selected from children without otitis media were analysed. There were 30 males and 27 females aged between 6 months and 9 years, mean (SD) 6 years (3.26). A history of allergy and skin test positive to one or more of dust, house dust mite, mould, cockroach and poultry feathers were found in 80% of CSOM, 47% ASOM and 33% controls. The mean IgE levels in sera were: controls 52.1 mg/dL, ASOM 63.9 mg/dL and CSOM 79.2 mg/dL; the MES levels were: AOM 60.4 mg/dL and CSOM 102.0 mg/dL. The MES to serum IgE ratios were 0.75 for ASOM and 1.4 for CSOM. The serum IgE ratio of controls to ASOM was 1.22 and to CSOM was 1.5. Multivariate analysis of the mean showed significant correlation between IgE level of MES in ASOM and CSOM (p=0.04) but no correlation between IgE levels in control and ASOM sera (p=0.10), control and CSOM sera (p=0.7) or AOM and CSOM sera (p=0.3).
Conclusion: Allergy appears to play a contributory role in CSOM and elevated IgE in the MES suggests a likely mucosal response.
Despite the increasing occurrence of suppurative otitis media (SOM), the content of immunoglobulin fractions in the middle ear secretion (MES) has still not been determined.
The serum and MESwere ...analyzed for IgG and M using enzyme-linked immunoassay.
The subjects and controls were 30 males and 22 females, between 6 months and 9 years old, with a mean age of 6 years (SD = 3.26). The patient group included 20 chronic SOM (CSOM) and 17 acute SOM (ASOM) cases, and sera of 15 subjects made the control group. The mean serum IgG levels were for controls 1,051 mg/dl, ASOM 666.1 mg/dl and CSOM 1,321.1 mg/dl; the MES levels were for ASOM 203.4 mg/dl and CSOM 511.5 mg/dl. The mean serum IgM levels were for controls 35 mg/dl, ASOM 64.1 mg/dl and CSOM 40 mg/dl; the MES levels were for ASOM 22.59 mg/dl and CSOM 3.44 mg/dl. The mean MES:serum ratios for IgG and IgM were between 0.1 and 0.4 in ASOM and CSOM. The ratio of serum IgG levels of controls to ASOM cases was 0.66 while that of controls to CSOM was 1.3. The corresponding ratios of IgM were 1.6 and 0.88. Multivariate analysis revealed a significant correlation between serum IgG levels of ASOM and CSOM (p = 0.043) and MES IgG (p = 0.02) in ASOM and CSOM but no correlation between serum IgG levels in controls and ASOM (p = 0.25), serum IgM levels in controls and CSOM (p = 0.62) and serum IgM levels in controls and ASOM (p = 0.73), ASOM and CSOM (p = 0.064) and MES IgM levels of ASOM and CSOM (p = 0.06).
Monitoring of the serum and MES IgG in ASOM may provide a useful index to assess the possibility of progression to chronicity. This forms a database for the immunological status of SOM patients.
