Persistent rhinorrhoea in rural Indian children: Prevalence and consequences

To determine whether persistent rhinorrhoea constitutes a significant probl em requiring intervention, 17 rural day care centres (Balwadis) in Tamilnad u, India, were visited, Among 414 children in the Balwadis 92 (22 per cent) children with persistent rhinorrhoea (15 days duration or longer) were ide ntified. Demographic and clinical data and nasopharyngeal swabs for bacteri al culture were obtained from 56 such children and 91 age-matched controls from the same Balwadi, Type of housing or nutritional status did not appear to be significant risk factors. There was a significantly higher number of children aged 5-15 years in the household of cases as compared to controls (1.23 +/- 1.08 vs. 0.83 +/- 0.95, p = 0.02), Other illnesses were noted in 25 (44.6 per cent) cases and seven (7.7 per cent) controls (OR 11.5; CI, 4 .13-33.4; p < 0.00001), Notably, chronic ear discharge was noted in 6 (11.7 per cent) cases but in none of the controls (p = 0.007), Streptococcus pne umoniae was isolated from nasopharyngeal swabs in 42/49 (85.7 per cent) cas es and 44/80 (55 per cent) controls (p < 0.001) and H. influenzae from seve n cases and five controls; S. pneumoniae was isolated in all children with chronic ear discharge and H. influenzae from one child. Serotypes of pneumo cocci commonly associated with otitis media, i.e., types 6, 14, 19, and 23 were isolated from 25 (51 per cent) Eases and 16 (20 per cent) controls (OR 4.17; 95% CI, 1.78-9.85; p < 0.001), Persistent rhinorrhoea, presumably du e to pneumococcus, is a common condition among rural Indian children and ap pears to be associated with chronic otitis media.