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. 2005 Jul 20:5:27.
doi: 10.1186/1471-2431-5-27.

Otitis media in young Aboriginal children from remote communities in Northern and Central Australia: a cross-sectional survey

Peter S Morris  1 , Amanda J Leach, Peter Silberberg, Gabrielle Mellon, Cate Wilson, Elizabeth Hamilton, Jemima Beissbarth
Affiliations

Otitis media in young Aboriginal children from remote communities in Northern and Central Australia: a cross-sectional survey

Peter S Morris et al. BMC Pediatr. .

Abstract

Background: Middle ear disease (otitis media) is common and frequently severe in Australian Aboriginal children. There have not been any recent large-scale surveys using clear definitions and a standardised middle ear assessment. The aim of the study was to determine the prevalence of middle ear disease (otitis media) in a high-risk population of young Aboriginal children from remote communities in Northern and Central Australia.

Methods: 709 Aboriginal children aged 6-30 months living in 29 communities from 4 health regions participated in the study between May and November 2001. Otitis media (OM) and perforation of the tympanic membrane (TM) were diagnosed by tympanometry, pneumatic otoscopy, and video-otoscopy. We used otoscopic criteria (bulging TM or recent perforation) to diagnose acute otitis media.

Results: 914 children were eligible to participate in the study and 709 were assessed (78%). Otitis media affected nearly all children (91%, 95%CI 88, 94). Overall prevalence estimates adjusted for clustering by community were: 10% (95%CI 8, 12) for unilateral otitis media with effusion (OME); 31% (95%CI 27, 34) for bilateral OME; 26% (95%CI 23, 30) for acute otitis media without perforation (AOM/woP); 7% (95%CI 4, 9) for AOM with perforation (AOM/wiP); 2% (95%CI 1, 3) for dry perforation; and 15% (95%CI 11, 19) for chronic suppurative otitis media (CSOM). The perforation prevalence ranged from 0-60% between communities and from 19-33% between regions. Perforations of the tympanic membrane affected 40% of children in their first 18 months of life. These were not always persistent.

Conclusion: Overall, 1 in every 2 children examined had otoscopic signs consistent with suppurative ear disease and 1 in 4 children had a perforated tympanic membrane. Some of the children with intact tympanic membranes had experienced a perforation that healed before the survey. In this high-risk population, high rates of tympanic perforation were associated with high rates of bulging of the tympanic membrane.

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Figures

Figure 1
Figure 1
Percentage of children examined with a perforation in each of the 29 communities at the time of examination. (Number at top of bar represents the total number of children examined).
Figure 2
Figure 2
Percentage of young children from remote communities in Northern and Central Australia with severe otitis media by health region (error bars represent 95% confidence intervals adjusted for the clustering effect of living in the same community).
Figure 3
Figure 3
Time in days to 1st perforation recorded in medical records in young Aboriginal children from 29 remote communities in Northern and Central Australia.
See this image and copyright information in PMC

References

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