Etiology of Childhood Otorrhea in Luanda, Angola, and a Review of Otitis Media in African Children.

BACKGROUND: In resource-poor settings, otorrhea causes a significant burden of disease in children. Etiologic studies and structured data on otorrhea and chronic otitis media among African children remain scarce.

METHODS: Here, we reviewed 678 bacteriologically analyzed otorrhea samples from Luanda Children's Hospital from children ≤15 years of age between 2008 and 2015. We then compared these to data from other studies among African children through a literature review of 20 papers published over two decades.

RESULTS: Overall, 32 different bacteria were identified among 542 isolates from 654 children in Luanda. Gram-negative bacteria constituted the majority of all isolates (85%), whereby Pseudomonas sp was the most common (n = 158, 29%), followed by Proteus sp (n = 134, 25%). Among Staphylococcus aureus (n = 106, 10%), 69% of tested isolates were MRSA, and among Enterobacteriaceae 14% were ESBL isolates. Resistance to quinolones was rare. Furthermore, in a review of the literature, we found a high occurrence of otorrhea and chronic suppurative otitis media (CSOM) in children as well as possible gaps in existing knowledge.

CONCLUSIONS: In Angola, Gram-negative rods emerged as common causative agents of otorrhea in children followed by S. aureus. The magnitude of chronic otorrhea in Africa represents a cause for public health concern.