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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 13  |  Issue : 3  |  Page : 98-101

Attitude of parents in a Niger Delta community towards ear, nose and throat diseases among their children: A preliminary study


1 Department of Otorhinolaryngology-Head and Neck Surgery, Federal Medical Centre, Yenagoa, Nigeria
2 Department of Otorhinolaryngology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
3 Department of Otorhinolaryngology, Niger Delta University Teaching Hospital, Okolobiri, Nigeria

Date of Submission17-Aug-2019
Date of Acceptance28-Oct-2019
Date of Web Publication6-Jan-2020

Correspondence Address:
Bright Otoghile
Department of Otorhinolaryngology-Head and Neck Surgery, Federal Medical Centre, Yenagoa
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/phmj.phmj_19_19

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  Abstract 


Background: Ear, nose and throat (ENT) diseases occur commonly in childhood. Some of these diseases are the potential causes of mortality among children, particularly when they are not managed appropriately and timely. Hence, the aim of this study was to find the attitude of parents towards ENT diseases among their children.
Methods: This was a cross-sectional, descriptive study carried out within 1 year (from August 2018 to July 2019) among the parents at Okolobiri, Bayelsa state, in the Niger Delta Region of Nigeria. Parents were interviewed with a structured questionnaire to find their attitude towards ENT diseases. Data obtained were analysed, and results were presented in a descriptive format.
Results: This study involved 61 parents. There were 7 male (fathers) and 54 female (mothers) with a mean age of 33 years. The children of 42 parents had a history of ear disease, 40 had a history of nasal complaint and 21 had a history of throat complaint. A total of 5 parents sought medical treatment, 32 parents embarked on self-medication and 16 parents sought no medical treatment.
Conclusion: Majority of parents at Okolobiri have negative attitude towards ENT diseases affecting their children. There is an urgent need to improve on community awareness programmes in this community to avoid risky health practices among parents towards their children.

Keywords: Attitude, disease, ear, nose, parents, throat


How to cite this article:
Otoghile B, Ibekwe MU, Totyen EL, Inei AN. Attitude of parents in a Niger Delta community towards ear, nose and throat diseases among their children: A preliminary study. Port Harcourt Med J 2019;13:98-101

How to cite this URL:
Otoghile B, Ibekwe MU, Totyen EL, Inei AN. Attitude of parents in a Niger Delta community towards ear, nose and throat diseases among their children: A preliminary study. Port Harcourt Med J [serial online] 2019 [cited 2020 Jan 26];13:98-101. Available from: http://www.phmj.org/text.asp?2019/13/3/98/275080




  Introduction Top


Ear, nose and throat (ENT) diseases are prevalent in children.[1] These diseases are of public health importance.[2] The diseases can potentially cause hearing loss and can affect speech, poor school performance, breathing, olfaction and swallowing.[3],[4] The risk factors for these ENT diseases include low socioeconomic status, overcrowding, poor parental educational level, atopy and vaccination status.[5] Some of these diseases run a chronic course with its attendant complications and others present as emergencies which carry a high risk of mortality when appropriate healthcare is delayed or denied from these children. Since children are dependent on their parents or guardian for their healthcare, the attitude of parents or guardian towards these children when sick is very important. The response of the parents towards their children has a significant role to play in the pattern and course of the ENT diseases. In a suburban community, such as Okolobiri in Bayelsa state of Nigeria, it has been noticed that many children present to the hospital with morbidity and complications, and in a significant proportion of them, the complications are due to local beliefs and health practices among the parents.[6] In this community, there are several health beliefs, and the members of this community have their traditional ways of treating ENT diseases. The parents would rather hold on to these beliefs instead of taking their sick children to the Niger Delta University Teaching Hospital despite its strategic location with good access road and located within the same community. Hence, the aim of this study was to examine the attitude of parents towards ENT diseases with a view to explaining the late presentation of cases seen in the Niger Delta University Teaching Hospital, Okolobiri.


  Methods Top


Study design

This was a cross-sectional, descriptive study.

Study location

The study was done in Okolobiri in Yenagoa Local Government area of Bayelsa state in the Niger Delta region of Nigeria from August 2018 to July 2019 (1 year).

Study protocol

A convenient sampling method was used and all parents who reside in the Okolobiri Community with their children and gave consent were recruited into the study. Parents who refused to give consent for the study or reside outside Okolobiri community were excluded from the study.

The minimum sample size was determined using the formula below [7]

n = 4pq/L2

where

n = Minimum required sample size

P = Proportion in the target population estimated to have particular characteristics. Available prevalence rate of ear diseases among children from a community-based study is 14.8%.[8] Using the formula above,

q = 1.0 − p =1 − 0.148 = 0.852

L = Absolute deviation or amount of difference allowed between the target and the study population (0.1).

Hence, N = 4 × 0.148 × 0.852/0.1 × 0.1 = 0.504384/0.01 = 50

The minimum acceptable sample size for this study is 50.

Parents were interviewed with a structured questionnaire to find their attitude towards ENT diseases. The attitude of the parents was classified as positive or negative. Parents who sought medical treatment were classified as having positive attitude, and parents who relied on self-medication or other forms of treatment apart from medical treatment were classified as having negative attitude. Data obtained were analysed using the Microsoft Excel, 2007 office software, and the results were presented in descriptive format.

Ethical approval

Ethical clearance was obtained from the Ethics and Research Committee of the Niger Delta University Teaching Hospital, Okolobiri.


  Results Top


This study involved 61 parents. There were 7 male (fathers) and 54 female (mothers) with a mean age of 33 years. The children of 42 parents had a history of ear disease, 40 had a history of nasal complaint and 21 had a history of throat complaint. The children of 8 parents had no ENT complaint, and the children of 53 parents had ENT complaint. Out of the 53 parents whose children had ENT complaint, only 5 parents sought medical treatment, 32 parents relied on self-medication and 16 parents did not seek for any form of treatment. The prevalence of ENT diseases among the children in this study and the attitude of their parents towards these diseases are shown in [Figure 1] and [Figure 2].
Figure 1: Prevalence of ear, nose and throat diseases among the respondents

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Figure 2: Attitudes of parents towards ear, nose and throat diseases

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  Discussion Top


Visiting the hospital seems to be an issue for many parents as found in this study. This makes most of the parents to seek an alternative form of treatment instead of presenting to the hospital. Findings from this study showed that ear complaints had the highest prevalence, followed by nasal and throat complaints. This corroborates the findings of Sharma et al., in Guwahati.[9] In this study, only 8% of respondents had positive attitude and sought for medical treatment in the hospital despite the location of a teaching hospital within their community. The implication is that majority of the ENT diseases will either eventually present late to the hospital with complications or with potential mortality, and this potentially affect the outcome of treatment which may become poor. Some diseases such as mastoid abscess, foreign bodies in the upper aerodigestive tract, acute epiglottitis, deep neck space infections and abscesses are ENT emergencies that require very urgent attention in the hospital, and any delay in proper healthcare results in potential morbidity and mortality.[10],[11] A significant proportion of the respondents did nothing about their children's health. This could probably be an act carelessness of these parents about the health of their children or they may have reasons for their attitude. Untreated diseases in children have a high risk of leading to a dangerous outcome.[12] Conditions such as otitis media which is very common among children, if left without any form of appropriate treatment, can progress to the stage of being complicated and can cause hearing loss and sometimes intra-cranial abscesses which are associated with high mortality rate.[13],[14] Hence, timely medical intervention is very important. [Figure 2] shows that more than half of the participants in this study sought for self-medication for their children. This is a dangerous trend in a community like this. Self-medication can also potentially result to morbidity and mortality as it delays the required adequate healthcare.[15] It can cause damage to the ear which can either be reversible or sometimes irreversible. For example, the use of ototoxic drugs can cause both reversible and irreversible damages to the ear.[16],[17] These parents often times are ignorant of the medications they are using for their children, and they are also ignorant of whether these drugs are ototoxic or not. These affected children can become socially handicapped, particularly when the damage to their hearing is irreversible. The attitude of the parents in this study possibly account for the poor turnover of patients seen in the ENT clinic of the Niger Delta University Teaching Hospital located at Okolobiri where this study was done. It is a known fact that delays in appropriate management of ENT diseases is a potential cause of morbidity and mortality in children.[18] Factors that could probably account for this poor patronage of the teaching hospital include traditional beliefs and cultural practices, poverty, low educational status, carelessness and other factors from the hospital include the attitude of health workers in the hospital, high hospital fees and the availability of required resources in the hospital.[19],[20]

The factors responsible for the attitude of parents towards the ENT diseases were not considered in this study. The majority of parents involved in this study were the mothers, and they were found at home during the time of visitation for this study, and the fathers too play a very important role in taking a decision whether to go to the hospital or not when a child is sick, however, majority of the fathers were not available at home as at the time of study. It was also difficult for some of the few fathers met to completely give details of the nature and intervention their children had when they had ENT diseases


  Conclusion Top


Majority of parents at Okolobiri have negative attitude towards ENT diseases affecting their children and would rather seek alternative treatment than medical treatment. We, therefore, recommend further studies to identify the factors responsible for the negative attitude of parents towards ENT diseases affecting their children in this community. We also recommend health education for the parents at Okolobiri on the need to seek medical care promptly when their children are sick.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest



 
  References Top

1.
Mohamed Anwar M, Jesudoss A, Sowmya PG, Thirumalaikolundusubramanian P, Ismail M. Morbidity profile of paediatricotorhinolaryngological disorders in a rural teaching hospital. Int J Otorhinolaryngol Head Neck Surg 2018;4:1-7.  Back to cited text no. 1
    
2.
Aljehani MJ, Alrasheed SK, Ahmed HM, Fallatah NE. The prevalence and attitude of ear nose throat (ENT) infections\problems among medical students, Taibah University, Al-Madinah AL-Munawara, Kingdom of Saudi Arabia (KSA). Int J Adv Res 2016;4:751-9.  Back to cited text no. 2
    
3.
Kishve SP, Kumar N, Kishve PS, Aarif SM, Kalakoti P. Ear, nose and throat disorders in paediatric patients at a rural hospital in India. Aust Med J 2010;3:786-90.  Back to cited text no. 3
    
4.
Singh A, Kumar S. A survey of Ear, nose and throat disorders in rural India. Indian J Otolaryngol Head Neck Surg 2010;62:121-4.  Back to cited text no. 4
    
5.
Al-Mendalawi MD, Mohsen HJ. Ear, nose and throat (ENT) diseases in children: Pattern and risk factors. Iraqi Postgrad Med J 2008;7:106-11.  Back to cited text no. 5
    
6.
Health Records. Department of Otorhinolaryngology, Niger Delta University Teaching Hospital, Okolobiri; 2018.  Back to cited text no. 6
    
7.
Rao NS, Murthy NS. Sampling techniques. In: Rao KV, editor. Applied Statistics in Health Sciences. 2nd ed. New Delhi: Jaypee; 2007. p. 94-107.  Back to cited text no. 7
    
8.
Chadha SK, Gulati K, Garg S, Agarwal AK. Prevalence of ear diseases in the children of Delhi. J Laryngol Otol 2015;129:425-9.  Back to cited text no. 8
    
9.
Sharma K, Bhattacharjya D, Barman H, Goswami S. Common ear, nose, and throat problems in paediatric age group presenting to the emergency clinic-prevalence and management: A hospital-based study. Indian J Clinic Pract 2014;24:755-60.  Back to cited text no. 9
    
10.
Osman WN, El-Mustafa OM. Common ORL surgical emergencies in Sudanese children 2011;6:191-4.  Back to cited text no. 10
    
11.
Devlin B, Golchin K, Adair R. Paediatric airway emergencies in Northern Ireland, 1990-2003. J Laryngol Otol 2007;121:659-63.  Back to cited text no. 11
    
12.
Khan MA, Akram S, Usman HB, Khan M, Khan AA. Audit of various otorhinolaryngological (ENT) diseases in Shangla Valley. Pak Armed Forces Med J 2018;68:531-4.  Back to cited text no. 12
    
13.
Adoga AA, Okwori ET, Yaro JP, Iduh AA. Pediatric otorhinolaryngology emergencies at the Jos University Teaching hospital: Study of frequency, management, and outcomes. Ann Afr Med 2017;16:81-4.  Back to cited text no. 13
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14.
Monasta L, Ronfani L, Marchetti F, Montico M, Vecchi Brumatti L, Bavcar A, et al. Burden of disease caused by otitis media: Systematic review and global estimates. PLoS One 2012;7:e36226.  Back to cited text no. 14
    
15.
Kitcher E, Jangu A, Baidoo K. Emergency ear, nose and throat admissions at the Korle-Bu Teaching hospital. Ghana Med J 2007;41:9-11.  Back to cited text no. 15
    
16.
Dhingra PL, Dhingra S. Hearing loss. In: Diseases of Ear, Nose and Throat. 5th ed. India: Elsevier; 2010. p. 30-40.  Back to cited text no. 16
    
17.
O'Leary S. Ototoxicity. In: Gleeson M, Browning GG, Burton MJ, Clarke R, Hibbert J, Jones NS, et al., editors. Scott-Brown's Otorhinolaryngology: Head and Neck Surgery. M. 7th. London: Edward Arnold Ltd.; 2008. p. 3567-76.  Back to cited text no. 17
    
18.
Saha S, Chandra S, Mondal PK, Das S, Mishra S, Rashid MA, Mondal AR. Emergency Otorhinolaryngological cases in medical college, Kolkata – A statistical analysis. Indian J Otolaryngol Head Neck Surg 2005;57:219-25.  Back to cited text no. 18
    
19.
Mbonye AK. Prevalence of childhood illnesses and care-seeking practices in rural Uganda. Scientific World Journal 2003;3:721-30.  Back to cited text no. 19
    
20.
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 Pediatr Otorhinolaryngol 2009;73:1394-8.  Back to cited text no. 20
    


    Figures

  [Figure 1], [Figure 2]



 

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