[01] Arshad Hassen Mohamed, Faculty of Medicine, Manipal University College Malaysia (MUCM), Manipal Academy of Higher Education (MAHE), Melaka, Malaysia. [02] Chew Hai Tang, Faculty of Medicine, Manipal University College Malaysia (MUCM), Manipal Academy of Higher Education (MAHE), Melaka, Malaysia. [03] Sarvin Nambiar Mohan, Faculty of Medicine, Manipal University College Malaysia (MUCM), Manipal Academy of Higher Education (MAHE), Melaka, Malaysia. [04] Aisha Binti Zamani, Faculty of Medicine, Manipal University College Malaysia (MUCM), Manipal Academy of Higher Education (MAHE), Melaka, Malaysia.

Cerumen (earwax) is a substance that provides a protective mechanism to the ear against infection and is also a defense mechanism that acts against substances such as water as well as organisms like insects. There is widespread belief that this earwax is unhygienic, and many people practice the habits of self-ear cleaning in the misguided belief that it maintains ear hygiene. This cross-sectional study aims to determine the prevalence of self-ear cleaning habit among undergraduate medical students in Manipal University College Malaysia, as well as the associated risks and related symptoms. An online questionnaire was distributed, and 144 responses were collected in total. Statistical analysis was done using Epi Info version 7.2.4.0. The findings of the data revealed that 80.7% of students practiced self-ear cleaning. However, there was differing levels of knowledge on the dangers of self-ear cleaning with 84.42% of those who practiced self-ear cleaning having good knowledge on the dangers of self-ear cleaning and just 15.58% of the students who did not practice self-ear cleaning having good knowledge about the dangers of self-ear cleaning. With the result obtained, there is a high percentage (94.3%) in the level of awareness on danger associated with self-ear cleaning. Nevertheless, students still perceive self-ear cleaning as beneficial (47.14%). This study shows that there was a significant positive association between student’s beneficial perception with respect to self-ear cleaning practices (95% CI for OR 1.7-52.8; P-value: 0.003). Besides that, there was positive but insignificant association between knowledge and practice (95% CI for OR 0.73-3.94; P-value: 0.220). Furthermore, sociodemographic factors and self-ear cleaning practices were found to be statistically insignificant. There was no significance between sociodemographic factors and knowledge. In summary, our study revealed that majority of the students practice self-ear cleaning. Despite those who perceive it as harmful/not beneficial, the number of students from this group still practicing self-ear cleaning irrespective of their awareness shows the fact that personal hygiene is one of the main factors to practicing self-ear cleaning along with knowledge and perception towards self-ear cleaning. Hence, we recommend raising awareness on discouraging self-ear cleaning practice due to many harmful risks which may lead to ear damage.

Knowledge, Practice, Perception, Awareness, Self-ear Cleaning, Undergraduate Students

[01] Dosemane D, Ganapathi K, Kanthila J. Knowledge, attitude and practice of ear care in coastal Karnataka. Journal of clinical and diagnostic research: JCDR. 2015 Dec; 9 (12): MC01. [02] Amutta SB, Yunusa MA, Iseh KR, Obembe A, Egili E, Aliyu D, Abdullahi M. Sociodemographic characteristics and prevalence of self ear cleaning in Sokoto metropolis. Int J Otolaryngol Head Neck Surg. 2013 Nov 8; 2: 276-9. [03] Oladeji SM, Babatunde OT, Babatunde LB, Sogebi OA. Knowledge of cerumen and effect of ear self-cleaning among health workers in a tertiary hospital. Journal of the West African College of Surgeons. 2015 Apr; 5 (2): 117. [04] Gadanya M, Abubakar S, Ahmed A, Maje AZ. Prevalence and attitude of self- ear cleaning with cotton bud among doctors at aminu Kano teaching hospital, Northwestern Nigeria. Nigerian Journal of Surgical Research. 2016 Jul 1; 17 (2): 43. [05] Alrajhi MS, Alim BM, Aldokhayel SD, Zeitouni LM, Al Tawil LK, Alzahrani FA. Knowledge, attitudes, and practices pertaining to cotton-bud usages and the complications related to their misuse among outpatients in an ear, nose, and throat clinic. Journal of Nature and Science of Medicine. 2019 Oct 1; 2 (4): 220. [06] Ghauth SB, Raman R, Wee CA. Use of cotton bud in Malaysia. [07] Aldawsari SA, Aldawsari AA, Aljthalin AA, AlDossari FM, Alhammad MA, Al Shatri MS. Knowledge, attitudes and practices of self-ear cleaning among medical students, Majmaah University, Saudi Arabia. Int J Med Res Prof. 2018; 4 (4): 155-61. [08] Adegbiji WA, Olajide TG, Nwawolo CC. Patterns of Self Ear Cleaning among Otorhinolaryngology Patients in Developing Country. Asian Journal of Science and Technology. 2018; 9 (4): 1-5. [09] Khan NB, Thaver S, Govender SM. Self-ear cleaning practices and the associated risk of ear injuries and ear-related symptoms in a group of university students. Journal of public health in Africa. 2017 Dec 31; 8 (2): 56. [10] Olaosun AO, Ayeni O, Fawole OI, Olaosun OA. Self Ear Cleaning among Educated Young Adults in Nigeria. Otolaryngology–Head and Neck Surgery. 2012; 147 (2_suppl): P50-P50. doi: 10.1177/0194599812451438a44. [11] Roland PS, Marple BF, Mayerhoff WL. Hearing loss (2nd ed). New York: Thieme Medical Publishers, Inc.; 1997. [12] Alshehri, A. A. A., Asiri,. K. A., Alahmari,. M. S. D., Alwabel,. H. H. A., Alahmari,. Y. D. & Mahmood,. S. E. (2020) Knowledge, attitudes, and practices of self-ear cleaning among medical and nonmedical students at King Khalid University, Abha, Saudi Arabia. International Journal of Medicine in Developing Countries, 4 (6), 960-967. doi: 10.24911/IJMDC.51-1584110722. [13] Lee LM, Govindaraju R, Hon SK. Cotton bud and ear cleaning--a loose tip cotton bud? Med J Malaysia. 2005 Mar; 60 (1): 85-8. PMID: 16250286. [14] David Machin, Michael Campbell, Peter Fayers, Alain Pinol, Sample size tables for clinical studies, 2nd edition, Blackwell Science, Oxford, 1997. [15] Afolabi OA, Kodiya A, Ahmad BM, Bakari AM. Attitude of Self Ear Cleaning in Black Africans Any benefit? [16] Alruwaili HA, Dar UF, Amjad Turayhib S, Alshammari SF, Alrubayyi SF, Alruwaili HS, Aljabbab NK. Knowledge and practices regarding ear hygiene among Saudi adolescents. [17] Adoga AA, Nimkur TL. Ear care: Knowledge, attitude and practice amongst health professionals at the Jos university teaching hospital. East Afr J Public Health. 2013; 10 (1): 3. [18] Hobson JC, Lavy JA. Use and abuse of cotton buds. Journal of the Royal Society of Medicine. 2005 Aug; 9 8 (8): 360-1. [19] Adegbiji WA, Olajide GT, Olubi O, Aluko AA. A Study Profile of Self Ear Cleaning in Nigerian Rural Community. International Journal of Recent Scientific Research. 2018 Jul 28; 9 (7): 1-5. [20] Adhikari TR, Jamtsho S. Prevalence of ear cleaning and its characteristic physical findings in patients visiting tertiary care center in Bhutan. Bhutan Health Journal. 2018 May 13; 4 (1): 42-5. [21] Ogah SA. Attitude and awareness of the health hazards associated with self- ear cleaning using cotton buds amongst adult patients attending Federal Medical Centre Lokoja, North central Nigerian. The Nigerian Health Journal. 2018 Apr 29; 18 (1): 8-13. [22] Olajide TG, Usman AM, Eletta AP. Knowledge, Attitude and Awareness of Hazards Associated with Use of Cotton Bud in a Nigerian Community. International Journal of Otolaryngology and Head & Neck Surgery. 2015; 4: 248-53. [23] Oladeji SM, Babatunde OT, Adenekan AK, Nwawolo CC, Uche-Okonkwo KC, Johnson KJ. Self-ear cleaning among health workers in Nigeria. J Dental Med Sci. 2015; 14: 122-6. [24] Mahfoz TM. Cerumen knowledge and ear cleaning practices among medical students in Saudi Arabia: An observational study. Majmaah Journal of Health Sciences. 2021; 9 (1): 80-94.