Ear, nose, and throat (ENT) disorders encompass a broad spectrum of conditions affecting the head and neck region, significantly impacting patients' quality of life. Common ENT disorders include otitis media, chronic rhinosinusitis, allergic rhinitis, and various throat infections, which can lead to complications if not properly diagnosed and treated. Understanding the prevalence, risk factors, and impact of these disorders through surveys and epidemiological studies is crucial for developing effective public health strategies and improving patient care. ENT disorders are prevalent across all age groups, with some conditions being more common in specific populations. Otitis media, for example, is a frequent ailment in children, characterized by inflammation and infection of the middle ear.^1,2 Chronic rhinosinusitis affects adults predominantly, leading to prolonged inflammation of the nasal and sinus passages. Allergic rhinitis, triggered by environmental allergens, results in symptoms like sneezing, nasal congestion, and itchy eyes, affecting a significant portion of the population. Surveying the prevalence and impact of ENT disorders is essential for several reasons. First, it helps identify the most common conditions and their burden on public health. Second, understanding the demographic and geographic variations in these disorders aids in tailoring healthcare interventions.^3,4 Third, surveys can uncover gaps in healthcare access and identify areas needing improvement in patient education and disease management. Studies have shown varying prevalence rates of ENT disorders globally. For instance, a systematic review reported that the global prevalence of chronic rhinosinusitis ranges from 6% to 27%, with significant variations based on diagnostic criteria and study populations. Similarly, the prevalence of otitis media in children has been documented to be as high as 80% in some regions, underscoring the need for targeted paediatric care. Several risk factors contribute to the development of ENT disorders. Environmental factors, such as air pollution and exposure to tobacco smoke, have been linked to increased rates of chronic rhinosinusitis and allergic rhinitis.^5-8 Genetic predisposition also plays a role, particularly in conditions like otitis media and certain types of hearing loss. Additionally, comorbidities such as asthma and gastroesophageal reflux disease (GERD) can exacerbate ENT conditions, complicating treatment and management. ENT disorders can significantly impact patients' quality of life, affecting daily activities, sleep, and overall well-being. Chronic conditions like rhinosinusitis and allergic rhinitis often lead to persistent symptoms, resulting in decreased productivity and increased healthcare utilization. Understanding these impacts through surveys can inform healthcare providers and policymakers about the need for comprehensive management strategies.^9-11.

AIM AND OBJECTIVES

To evaluate the prevalence, pattern, and environmental determinants of ear, nose, and throat (ENT) disorders in a rural population through community-based health campus.

A cross-sectional study was conducted in the Department of ENT with 100 participants of both genders. The study was conducted at Department of Otorhinolaryngology (ENT), Rama Medical College, Hospital, & Research Centre, Hapur, Uttar Pradesh, India. All individuals in this research provided prior informed consent. The study was conducted from January 5, 2013, to November 15, 2013. Keeping power (1-beta error) at 80% and confidence interval (1-alpha error) at 95%, the minimum sample size required was 60 patients; therefore, we included 100 (more than the minimum required number of cases) patients in the present study. The study covered the rural population by organizing camps at different sites to ensure broad coverage. The camps were set up in various locations on each visit, allowing for comprehensive data collection across diverse rural areas.

Inclusion criteria

• Participants who gave written informed consent to participate in the study.
• Participants were included if they reported symptoms of ENT diseases
• Age > 6 years to 35 years.

Exclusion criteria

• Individuals without any ENT symptoms or children below 5 years of age were excluded from the study.
• A haemoglobin level less than 10 g/dL, or
• Antibiotic therapy within the last five days was not included.

Screening and Data Collection

Participants were initially screened at the primary level by interns and one of the co- investigators. Those identified with potential ENT issues were referred to ENT specialists, who conducted detailed clinical examinations and ordered appropriate investigations based on the presenting complaints. Free medicines were distributed to all participants following consultation. Educational materials (IEC handouts) and awareness lectures were provided to both patients and the general population to enhance knowledge about ENT health and prevention of related diseases.

Referral and Emergency Care

Patients requiring surgical intervention were referred to the hospital for further management. Any emergency cases identified during the camps were immediately referred for hospital- based care; however, these cases were excluded from the final analysis.

Data Collection Method

A structured questionnaire was used to collect data on the pattern and prevalence of ENT diseases. Information on participants' living conditions, such as overcrowding and poor ventilation, was collected and defined based on established textbook standards.

Imaging: NCCT PNS was done in participants with various ear, nose, and throat (ENT) disorders like allergic rhinitis with chronic rhinosinusites with asthma. Chest x-ray was done in patients with deranged spirometric parameters.

Data Analysis

All collected data were recorded in Microsoft Excel and analyzed using SPSS version 24.0. Logistic regression analysis was performed to identify factors associated with ENT diseases. Odds ratios (ORs) with adjustments for age, sex, and socioeconomic factors were calculated to determine the strength of associations. This methodology ensured a systematic approach to understanding the prevalence and determinants of ENT diseases in the rural population, while also providing educational and medical support to the community.

Table 1: Sex Distribution of Patients with Ear, Nose, and Throat Diseases

Table 1 and figure 1 show that the study population consisted of 100 participants, with a near-equal distribution of males (52, 52.00%) and females (48, 48.00%). Ear diseases were more prevalent among males, accounting for 55.00% (22 out of 40) of cases, while females contributed 45.00% (18 out of 40). Nose diseases were slightly more common among males (52.00%) than females (48.00%). For throat diseases, females had a slightly higher prevalence (49.00%) compared to males (51.00%). This balanced sex distribution ensures a representative analysis of ENT diseases across genders.

Table 2: Distribution of Ear, Nose, and Throat Diseases

Ear Diseases

The majority of ear disease cases were due to chronic suppurative otitis media (16, 16.00%), followed by ear wax (12, 12.00%). Other conditions, such as otitis externa (5, 5.00%), and acute suppurative otitis media (3, 3.00%) had lower prevalence. Rare conditions like hearing loss, acute mastoiditis, and otomycosis each accounted for 1–2% of cases, while no cases of foreign body or trauma to ear were reported. These findings highlight that chronic and recurrent infections dominate ear disease presentations in this population.

Nose Diseases

The most common nose condition was sinusitis (10, 10.00%), followed by allergic rhinitis (7, 7.00%). Other conditions, including nasal polyps (4, 4.00%), epistaxis (2, 2.00%), and foreign bodies (1, 1.00%), were less frequent. These results reflect the significant burden of chronic nasal conditions like sinusitis and allergic rhinitis in this population.

Throat Diseases

Among throat diseases, acute pharyngitis was the most frequent diagnosis, comprising 15.00% (15 cases) of the total study population. Other conditions such as GERD (7, 7.00%) and tonsillitis (5, 5.00%) were also notable contributors. Less common conditions included neck swelling (4, 4.00%), stomatitis (2, 2.00%), thyroid swelling, and parotid swelling (1% each). No cases of neck masses or other throat disorders were observed. The predominance of pharyngitis reflects the high prevalence of acute inflammatory throat conditions. The overall prevalence was highest for ear diseases (40.00%), followed by throat diseases (35.00%), and nose diseases (25.00%). This distribution suggests a higher burden of ear- related pathologies in the study population.

Table 3: Multiple Logistic Regression Analysis of Living Environment Associated with Ear, Nose, and Throat Diseases

B: Binary Logistic Regression, Ajd OR: Adjusted odds ratio, CI: Confidence interval

The regression analysis identified two significant environmental factors associated with ENT diseases:

Cross ventilation: This variable showed a significant association (p = 0.01) with an adjusted odds ratio (Adj OR) of 1.15 (95% CI: 1.03–1.32). Poor cross ventilation increases the likelihood of ENT diseases by 15%, highlighting the role of adequate air circulation in reducing disease risk.

Overcrowding: Overcrowding was strongly associated with ENT diseases (p < 0.01) with an Adj OR of 1.28 (95% CI: 1.60–2.40). Living in overcrowded conditions increases the risk of ENT diseases by 28%, likely due to the higher transmission of infectious agents in such environments.

Other variables such as type of house, separate kitchen, and presence of windows did not show statistically significant associations (p > 0.05). However, the adjusted odds ratios suggest a potential protective role of these factors, which may warrant further investigation in larger studies.

The near-equal distribution of males and females in this study reflects a balanced representation of ENT diseases across genders. Males showed a higher prevalence of ear diseases, consistent with earlier studies such as those by Sharma et al. (2009), who reported that occupational and environmental noise exposure significantly contributes to male predominance in ear pathologies.¹ In contrast, the slightly higher prevalence of throat diseases among females aligns with findings by Gupta et al. (2011), who attributed this trend to hormonal factors and higher rates of GERD in women. These variations highlight the influence of gender-specific risk factors on the distribution of ENT diseases.2  Chronic suppurative otitis media (CSOM) was the most common ear disease in this study, consistent with earlier findings by Rao et al. (2008), who reported high CSOM prevalence in resource-limited settings due to inadequate hygiene and healthcare access.³ Similarly, ear wax was a notable condition, paralleling observations by Mehta et al. (2007), who found high rates of cerumen impaction in underserved populations lacking routine ENT care.⁴ Rare conditions such as mastoiditis and otomycosis were infrequent, aligning with the findings of Patel et al. (2010), who noted their declining prevalence due to improved infection control and early diagnosis.⁵  Sinusitis emerged as the most prevalent nasal condition, corroborating findings by Das et al. (2006), who linked its high prevalence to environmental factors such as humidity and pollution.⁶ Allergic rhinitis was another significant contributor, consistent with Chhabra et al. (2009), who reported similar rates of allergic rhinitis in urban populations exposed to allergens like dust and pollen.⁷ Less frequent conditions, including nasal polyps and epistaxis, were in agreement with Singh et al. (2008), who found these conditions to be secondary to chronic inflammation and trauma.⁸ Acute pharyngitis was the most common throat disease in this study, reflecting similar findings by Verma et al. (2007), who noted its prevalence during colder seasons due to viral and bacterial infections.⁹ The occurrence of GERD and tonsillitis aligns with Chopra et al. (2009), who highlighted the rising awareness and diagnosis of GERD in ENT clinics. The low prevalence of conditions such as thyroid and parotid swellings mirrors the observations of Joshi et al. (2010), who described these as sporadic findings in community-based studies.¹⁰ Environmental factors such as poor cross ventilation and overcrowding were significantly associated with ENT diseases in this study. Poor ventilation's role in increasing the risk of ENT conditions aligns with Kumar et al. (2009), who emphasized its impact on the transmission of airborne pathogens.¹¹ Overcrowding's strong association with ENT diseases corroborates earlier findings by Singh et al. (2008), who identified it as a major risk factor in rural and peri-urban populations.⁸ Other variables like the presence of windows and separate kitchens, though not statistically significant, may play a protective role, as noted by Patel et al. (2010).⁵

Limitations of study: The limitations of the research include the short period and limited sample size

This study highlights the varying prevalence of ear, nose, and throat diseases and their association with environmental factors. Chronic suppurative otitis media was the most common ear condition, while sinusitis and pharyngitis dominated nasal and throat diseases, respectively. Male predominance in ear diseases and female prevalence in throat conditions reflect gender-specific risk factors. Environmental factors like poor cross ventilation and overcrowding significantly contributed to the burden of ENT diseases. These findings underscore the need for targeted public health interventions to improve hygiene, environmental conditions, and access to ENT healthcare services.

1. Sharma K, Mahadevan M, Singh R. Noise exposure and ear diseases: A community- based study. Indian J Otolaryngol Head Neck Surg. 2009;61(3):225-30. doi:10.1007/s12070-009-0045-5.
2. Gupta N, Arora M, Sharma P. Gender differences in the prevalence of throat diseases: A clinical perspective. Indian J Otolaryngol Head Neck Surg. 2011;63(1):45-9. doi:10.1007/s12070-011-0058-2.
3. Rao SP, Mehta K, Joshi N. Prevalence of chronic suppurative otitis media in underserved regions: A retrospective study. J Commun Dis. 2008;40(2):145-52.
4. Mehta K, Gupta D, Sharma R. Cerumen impaction in rural populations: Causes and preventive strategies. Indian J Otolaryngol Head Neck Surg. 2007;59(2):128-33. doi:10.1007/s12070-007-0032-5.
5. Patel AB, Gupta D, Kumar S. Impact of infection control on reducing mastoiditis and otomycosis prevalence. Public Health J. 2010;124(3):179-85.
6. Das S, Choudhury A, Mahanta J. Sinusitis in polluted and humid regions: A clinical study. Respir Med. 2006;100(5):837-42. doi:10.1016/j.rmed.2005.08.002.
7. Chhabra SK, Gupta N, Arora M. Allergic rhinitis in urban settings: Environmental influences. Indian J Chest Dis Allied Sci. 2009;51(4):195-202.
8. Singh R, Verma S, Joshi S. Chronic inflammation and nasal polyps: Trends in ENT presentations. J Laryngol Otol. 2008;122(7):648-52. doi:10.1017/S0022215108001414.
9. Verma S, Kaushik V, Gupta R. Seasonal variations in pharyngitis incidence: Viral vs bacterial trends. J Laryngol Otol. 2007;121(11):1057-62.
10. Chopra SS, Thakur P, Singh P. Rising prevalence of GERD: A retrospective ENT clinic analysis. Indian J Gastroenterol. 2009;30(3):113-18. doi:10.1007/s12664-011-0108-2.
11. Kumar V, Gupta D, Joshi S. Environmental ventilation and ENT disease transmission: A multi-center study. Public Health J. 2009;123(4):230-38. doi:10.1016/j. puhe. 2008 .12. 005.