Earache in Young African Children: Causes, Signs and Treatment

 

By Ibironke Taiwo. Freelance Health Writer, with medical review and editorial support from The DLHA Team

Sign of earache. Black child with hands covering both ears.

 

 

INTRODUCTION 

 

Earache is a common illness among African children and this usually has a lot of impact on their daily activities, for instance, a child who cannot play, eat, or sleep due to earache.

 

Nevertheless, early diagnosis and treatment can prevent complications and help relieve the pain thereby helping the children get back on their feet again

 

This article aims to explain the causes of earaches, their impacts on young African Children, and care tips to help relieve the pain from earaches. So, please keep reading.

 

 

STRUCTURE OF THE EAR 

 

The importance of the ear as one of the organs of the body cannot be overlooked as it helps in hearing and balance. Infection or pain in the ear can disrupt its functions. Before we go deeply into what earache is all about, let us dive a bit into the anatomical structure of the ear. [1]

 

The ear is divided into three parts namely (See Fig 1 and the video below):

Figure 1: Basic anatomy of the ear. Image credit. NIH/NIDCD. Click on image to enlarge.

 

 

The Outer Ear 

 

This consists of the Pinna (also known as the auricle), the outermost part of the ear made up of cartilage and covered by skin. The pinna is responsible for collecting sound waves and transmitting them into the Ear Canal, the second part of the outer ear. The skin lining the ear canal contains tiny hairs and glands for the production of ear wax which protects the ear from dust and debris.

 

The Middle Ear 

 

The middle ear is an air-filled chamber that consists of three tiny bones (malleus, Incus, and stapes) generally referred to as ossicles. This part of the ear takes part in hearing by transferring sound vibrations from your eardrum to your inner ear. 

 

The middle ear also contains the Eustachian Tubes, a pressure equalizing valve that drains fluid collected from the middle ear to the back of the throat.

 

The Inner Ear 

 

This is made up of three important organs, namely the Cochlea (a snail-shaped organ filled with fluid and surrounded by tiny hairs), and the Labyrinth (responsible for balance and signals to the brain the position of the head in space) and the Vestibule (responsible for sensing horizontal and vertical movements and acts as a link between the Cochlea and Labyrinth).

 

Video: Basic Anatomy of the ear. Click on images play

 

 

WHAT IS EARACHE? 

 

Earache which is also known in medical terms as Otalgia is a pain in the ear, which could be a sharp, dull, or burning one. It occurs in one or both ears and it ranges from mild to severe. [2]

 

Earache can be broken down into two categories, primary and secondary.

 

Primary earache arises directly from the ear itself, while secondary earache is referred from somewhere else to the ear. 

 

 

WHAT ARE THE COMMON CAUSES OF PRIMARY EARACHE IN CHILDREN?

 

These include:
 

• Ear Infection

 

This is the most common cause of earache in children. It often affects the middle ear, when it is referred to medically as Otitis Media. Otitis media can be acute(ie. sudden and short term) or chronic or long term. Ear infection arises as a result of your child introducing dirty foreign objects into the ear or infection of the upper airways or throat. It is indicated by the presence of watery or pus-like fluid coming out of the ear. In most cases, ear infection clears up on its own within a few days or weeks without treatment.

 

One study in Southwestern Nigeria found a combined prevalence of acute and chronic otitis media to be 14.7% in the study population with a peak age of occurrence in the age group 1-4 years, while the least age of occurrence was found to be in the age group less than 1 year. [3]
 

• Putting objects in the ear 

 

Children are fond of playing with different objects. The moment any of these objects like paper, pen, stick, metal, etc., get into their ear, it could cause pain. At this point, you should never attempt to remove the object yourself as you may push it further and damage the eardrum. Instead, visit the hospital for the removal.
 

• Earwax build-up 

 

Ear wax, a natural substance meant to protect the ear from dust and dirt could be a cause of earache as a result of build-up 
 

• Ear injury 

 

This can occur from the use of cotton buds to scrape ear wax from the ear canal which can damage the eardrum if the cotton bud is taken too far into the ear.
 

• Others

 

Earache can also be caused by throat and sinus infections like tonsillitis and sinusitis

 

 

WHAT ARE THE COMMON CAUSES OF SECONDARY EARACHE IN CHILDREN?

 

These include:
 

• Teeth eruption and or infection 

 

These are common reasons why your child may be pulling the ear to signal secondary earache.
 

• Others

 

Additional sources of secondary earache are caused by disorders of the heart, bowel, and lungs. These sources are not common in children as they are in adults.

 

 

HOW COMMON IS EARACHE IN AFRICAN CHILDREN? 

 

An ear infection or Otitis Media is one of the major causes of earache in children and it is the commonest reason globally why parents bring their children to see a doctor. 

 

In the United States, five out of every six children are known to experience at least one ear infection before the age of three years. [4] Comparable data for most African countries are hard to come by but reports from hospital studies in Osun state, Nigeria confirm a high occurrence of ear infection in children who are under 5 years of age. [3] 

 

Children experience more ear infection and earache than adults because the passageway that connects the middle ear to the throat (i.e. the Eustachian tube) is shorter and flat (horizontal) thereby allowing easy access of germs (bacteria and viruses) into the middle ear.

 

 

HOW TO TELL IF YOUR CHILD HAS EARACHE? 

 

The best way to know if your child has earache is through the signs and symptoms exhibited, which is why you should always observe your child and be able to notice changes as soon as possible to help them get the treatment they need to get better.

 

The symptoms of earache vary depending on the cause and level of severity. Here are some of the symptoms of earache in children.
 

• Children with earaches are restless, fussy, lose appetite, and have trouble sleeping. These symptoms are not specific for earaches alone.

• Rubbing and pulling of the ear: This is a result of the pain and discomfort they feel in the ear. This symptom is common among babies or children who can't express themselves verbally and all they can think of is rubbing and pulling their ears.

• Discharge from one or both ears (Runny ear).

• Fever: This is manifested by a rise in temperature of about 38°C (100.4^oF) or above and may be associated with vomiting.

• Headache.

• Dizziness and balance problems.

• Hearing difficulties: This symptom is detected when your child does not react to sound around them which they ought to have reacted to if nothing was wrong with their ears. This ranges from mild to severe and it could be temporary or permanent.

 

 

HOW TO PREVENT YOUR CHILD FROM HAVING EARACHE? 

 

It is very much possible to prevent your child from having earache. Here are some preventive measures against earache.

• Avoid wood smoke and smoking near your child or exposing them to secondhand smoke. Smoke irritates the lining of the ear canal making your child susceptible to ear infections which could lead to earache.

• Within available resources, minimise overcrowded sleeping conditions in poorly ventilated rooms.

• Ensure that you dry your child's ears after swimming or bathing. The presence of moisture in the ear attracts germs and this can cause an infection.

• At no point should you use a cotton swab or sharp object to clean your child's ear, these things can push the ear wax deeper and may cause complete blockage. The ear is self-cleansing, should in case there be an excess build-up of ear wax and it is making your child uncomfortable visit a doctor for appropriate removal.

• Keep watch on your child and make sure they do not put foreign objects like toys, dust, sand, etc in their ears. Should any object get stuck in their ear, never try to remove it by yourself, get them to the hospital, and let the professional do that. 

• Encourage your children to wash their hands often especially after playing outside and with other kids.

• Ensure that your children are up-to-date with their immunisations especially against common respiratory disorders like whooping cough (Pertussis), Haemophilus influenzae and Pneumococcal disease.

• Avoid allergies by treating your child's allergy or cold promptly. Allergies increase the risk of ear infections.

 

 

EFFECTIVE TREATMENT OPTIONS FOR EARACHE 

 

The treatment of earache depends on the cause. For instance, 

• Antibiotics may be prescribed for earaches that occur as a result of bacterial ear infection.

• For earache caused by earwax buildup, the ear wax can be removed by a doctor using ear drops or irrigation.

• Nasal spray can be used to relieve earache caused by sinus infection.

• Over-the-counter drugs like acetaminophen or ibuprofen can also be given to ease pain. Do not give ibuprofen to children younger than 6 months old or aspirin to children under the age of 16 years unless on the advise of a doctor.

 

 

HOME REMEDIES AND TIPS FOR PARENTS AND CAREGIVERS 

 

Not all earaches require a prescription, some earaches can be relieved using home remedies and care tips such as: [6]

 

Cold or Warm Compress: Apply a cold or warm compress on the affected ear for like 20 minutes several times a day till the child is relieved. 

 

Eating Garlic: Garlic is claimed in naturopathic circles to have both antibiotics and pain relieving properties. It has been used as a remedy for earache over the years. If your child is on prescribed antibiotics you should check with your doctor before giving garlic. 

 

Chiropractic: This is a health approach that helps to reduce pain by using hands to manipulate the bones and muscles around your child's ear and other parts of the body. The essence of this process is to bring the bones back in line and back to a comfortable posture thereby helping to reduce earache. A scientific basis for the effectiveness of this practice is not available. 

 

Olive Oil: Although the use of olive oil has no scientific proof, its antibacterial properties have been attributed to be helpful in relieving earache. A couple of drops of room-temperature olive oil are said to be effective.

 

Ensure your child sleeps upright by elevating their head. This helps to ease pressure and pain in the ear.

 

 

WHEN TO SEEK MEDICAL HELP? 

 

You should seek medical help: [5]

• For an appropriate diagnosis of your child's earache.

• If your child is experiencing hearing loss.

• When your child's symptoms worsen after several medication or care tips.

• When there is discharge, pus, blood or fluid from your child's ear.

• When you child has headache and swelling on one side of the ear.

• When you child has earache and a fever of 39°C (102.2^oF) or higher. 

 

 

CONCLUSION 

 

Earache, or Otalgia, is a common illness among African children. It is characterized by the feeling of pain or discomfort in one or both ears. The pain could be mild, moderate or severe.

 

Earache is usually associated with some common symptoms such as fever, discomfort, difficulty in sleeping, irritability, and lack of appetite. 

 

Its treatment depends on the cause of the earache, which could be an infection, ear wax buildup, ear injury, or putting sharp objects in the ear. 

 

Earache can be treated using antibiotics, over-the-counter drugs like acetaminophen or ibuprofen, and home remedies such as the use of cold or warm compress, garlic, olive oil, chiropractic, etc.

 

Should in case your child's symptoms worsen after several interventions, seek medical help.

 

 

SOURCES:

 

1. Dr. Wallace. Anatomy of the ear. [Internet n.d]. Hearing Center of Excellence. Accessed December 10, 2023. Available from: https://hearing.health.mil/Resources/Education/Overview-of-the-Ear/Anatomy-of-the-Ear

2. Coulter J, Kwon E. Otalgia. NIH. National Library of Medicine. StatPearls [Internet. Last updated August 1, 2022.] Accessed February 18, 2024. Available from:  https://www.ncbi.nlm.nih.gov/books/NBK549830/

3. Amusa Y, Ijadunola K, Onayade, O. Epidemiology of Otitis media in a local tropical African population. West African journal of medicine. 2006, 24. 227-30. DOI:10.4314/wajm.v24i3.28202. Available from: https://www.researchgate.net/publication/7490983_Epidemiology_of_Otitis_media_in_a_local_tropical_African_population

4. NIH. National Institute on Deafness and Other Communication Disorders. Ear infection in children. [Internet. Last reviewed, March 16, 2022]. Accessed, February 18, 2024. Available from: https://www.nidcd.nih.gov/health/ear-infections-children.

5. Nemours KidsHealth. How to handle an earache. [Internet. Reviewed March 2023. Accessed December 10, 2023. Available from: https://kidshealth.org/en/parents/earaches-sheet.html.

6. May, B. 15 Effective options for treating earache. [Internet. Updated June 13, 2023]. Medical News Today. Accessed December 10, 2023. Available from: https://www.medicalnewstoday.com/articles/312634

 

 

Related:

Fever in children: What African arents need to know

Common cold in babies: What African parents should know

 

 

Published: September 19, 2023

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