Delays in seeking ear and hearing care among pediatric patients with chronic suppurative otitis media at a Mulago National Referral Hospital

Background CSOM is a common cause of preventable hearing loss in low- and middle-income countries. Effective treatments exist however; many patients present late. Identifying delay points can guide action. Objective We identified the delays in seeking ear and hearing care services and the associated factors among patients with CSOM attending the ENT clinic at Mulago National Referral Hospital. Methods We conducted a cross-sectional study of 198 participants under 18 years with CSOM who attended the ENT outpatient clinic from January to March 2025. Structured questionnaires captured sociodemographic data, clinical features, care seeking behaviour, and drivers of delay using Thaddeus and Maine’s Three Delays Model. We applied descriptive statistics and logistic regression. Adjusted odds ratios were calculated routinely. Results The mean age was 117 months, 53.0 percent male. Monthly household income below 200,000 UGX for 42.9 percent of caregivers. First contact was clinics or drug shops for 40.4 percent. Median time to first ear and hearing care was 14.9 months. Overall, 64.6 percent had significant delay, and these participants waited a median of 38.7 months before receiving care. The commonest delay was the decision to seek care. In this stage, 77.3 percent waited a median of 14.8 months. Age 5 years or less lowered delay odds (adjusted odds ratio, aOR, 0.32). Primary education (aOR 8.39), secondary education (aOR 6.40), household income below 200,000 UGX (aOR 4.34), herbal medicine use (aOR 3.72), general clinical officer consultation (aOR 6.83), and facility overcrowding (aOR 2.84) were associated with higher odds of delay. Conclusion Delays in ear and hearing care for paediatric CSOM at Mulago are common and concentrate at the decision stage. Key priorities are community education, early identification and referral, and stronger facility capacity for timely, appropriate services.