Prevalence of obstructive sleep apnoea and validation of the OSA-5 questionnaire among children aged 2–7 years with adenotonsillar hypertrophy at Mulago Hospital: a prospective cross-sectional study

Background: Adenotonsillar hypertrophy is the commonest cause of obstructive sleep apnoea (OSA) in children. The gold standard for the diagnosis of OSA is polysomnography, however, it is expensive, time consuming and not readily available in Uganda. The Obstructive Sleep Apnoea 5 (OSA 5) Questionnaire is a simple questionnaire that performs well as a triage screening tool to identify those children at risk of OSA among large numbers of referrals for sleep disordered breathing (SDB). We studied its validity in screening for OSA in children with adenotonsillar hypertrophy in Mulago National Referral Hospital in Kampala, Uganda. The study aimed to determine the prevalence of obstructive sleep apnoea and to validate the OSA-5 questionnaire among children aged 2–7 years with adenotonsillar hypertrophy. Methods This was a cross sectional study. We enrolled 104 participants 2 to 7 years with adenotonsillar hypertrophy. They were subjected to OSA-5 questionnaire and then underwent overnight polysomnography (PSG) using the ambulatory Alice PDX sleep system on the ward. We then determined the prevalence of OSA among these children and the validity of OSA-5 questionnaire in detecting OSA in children with adenotonsillar hypertrophy by determining its specificity and sensitivity. Results The majority (54.8%) of the participants were female with a male to female ratio of 0.82 to 1. The youngest participant was 2 years old while the oldest was 7 years with a mean age of 4.6 years. The mean BMI was 15.9. The prevalence of OSA was found to be 88.5% (95% CI of 82.2-94.7) and the OSA-5 Questionnaire was found to have a sensitivity, specificity, positive predictive value and negative predictive value of 100%. Conclusions The OSA 5 questionnaire is a simpler and highly sensitive tool that can be adopted for screening of OSA in children with adenotonsillar hypertrophy. However, a case control study needs to be carried out to assess the tool’s performance in general populations.