Systematic Review and Meta-analysis of Otitis Media in Iran: Prevalence, Etiology, Antibiotic Susceptibility, and Complications

Otitis media (OM) is a relatively common infectious disease, and its chronic fonn may lead to complications such as hearing impairment. This study aims to determine the prevalence, etiology, antibiotic susceptibility, and complications of OM in Iran through meta-analysis. English language databases, including Science Direct, PubMed, Scopus, Web of Science, and Persian language databases, including SID, Magiran, Iranmedex, Medlib, as well as the Google Scholar search engine, were searched from 1994 to 2017, using the Mesh keywords: Otitis media, Middle ear, Causality, Etiology, and Iran. The heterogeneity assessment of the studies was done using Q-Cochran test and 12 index. Considering the high heterogeneity of the studies, the random effects model was used to estimate the point prevalence with 95% confidence interval. Data were analyzed using STAIA version 11.1 software. Fifty-one articles with a sample size of 10,675 were reviewed in this study, the most common types of OM involvement were right otitis (51% [95% confidence interval (CI): 33-681), left otitis (44% [95% CI: 36-521), and bilateral otitis (33% [95% Cl: 7-59]). The most common bacterial etiologies involved in OM were Pseudomonos aeruginoso (26% [CT 95%: 17-351), Proteus (21% [95% CT: 0%-45%1), and Staphylococcus (20% [95% CT: 0-42]). The fungal etiology of OM was estimated to be 22% (95% CI: 4-40). The most common OM pathologies were ossicular changes (56%[95% CI, 27-85]), granulation (49% [95% CI: 18-801), cholesteatoma (32% [95% Cl: 13-511), tympanosclerosis (17% [95% Cl: 10-231), and cholesterol granuloma (11% [95% CI: 0-261). The results of this meta-analysis provide useful information on the epidemiology of OM in Iran to otorhinologists and health policymakers.