Background Undernutrition and chronic suppurative otitis media (CSOM) in children are common in low resource settings but there are few studies of their interactions.
Objective The purpose of this study was to determine nutritional factors associated with CSOM in Yemeni children.
Methods A case–control study of 75 children with CSOM and 74 healthy controls. Assessment included dietary history, anthropometry, haemoglobin, and serum analytes zinc, copper, selenium, iron, calcium, phosphate and total 25-hydroxy vitamin D (25(OH)D).
Results Cases had lower mean z scores for weight-for-age, weight-for-height, body mass index and mid-upper arm circumference (MUAC) (all p<0.05), and lower mean haemoglobin (p=0.003), serum zinc (p=0.002), and selenium (p<0.001) concentrations. There was high prevalence of low serum zinc concentration (≥90%), and vitamin D deficiency in both cases (80%) and controls (96%). Duration of ear discharge was negatively correlated with total 25(OH)D (p=0.028), adjusted calcium for albumin (p<0.001), phosphate (p=0.002), transferrin receptor/ferritin ratio (p=0.004) and copper (p<0.001), and positively correlated with child age and MUAC (p<0.001).
Conclusions Children with CSOM were more undernourished than controls with lower mean serum zinc and selenium concentrations. Vitamin D deficient and iron replete children had longer duration of infection and severe disease. Trials evaluating specific micronutrients are required to assess specific nutrient-infection interactions in CSOM.
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