Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021 Nov 1:11:768377.
doi: 10.3389/fcimb.2021.768377. eCollection 2021.

A Strong Decline in the Incidence of Childhood Otitis Media During the COVID-19 Pandemic in the Netherlands

Saskia Hullegie  1 , Anne G M Schilder  1   2   3 , Paola Marchisio  4   5 , Joline L H de Sévaux  1 , Alike W van der Velden  1 , Alma C van de Pol  1 , Josi A Boeijen  1 , Tamara N Platteel  1 , Sara Torretta  6   7 , Roger A M J Damoiseaux  1 , Roderick P Venekamp  1
Affiliations
Observational Study

A Strong Decline in the Incidence of Childhood Otitis Media During the COVID-19 Pandemic in the Netherlands

Saskia Hullegie et al. Front Cell Infect Microbiol. .

Abstract

Introduction: Recent reports have highlighted the impact of the COVID-19 pandemic on the incidence of infectious disease illnesses and antibiotic use. This study investigates the effect of the pandemic on childhood incidence of otitis media (OM) and associated antibiotic prescribing in a large primary care-based cohort in the Netherlands.

Material and methods: Retrospective observational cohort study using routine health care data from the Julius General Practitioners' Network (JGPN). All children aged 0-12 registered in 62 practices before the COVID-19 pandemic (1 March 2019 - 29 February 2020) and/or during the pandemic (1 March 2020 - 28 February 2021) were included. Data on acute otitis media (AOM), otitis media with effusion (OME), ear discharge episodes and associated antibiotic prescriptions were extracted. Incidence rates per 1,000 child years (IR), incidence rate ratios (IRR) and incidence rate differences (IRD) were compared between the two study periods.

Results: OM episodes declined considerably during the COVID-19 pandemic: IR pre-COVID-19 vs COVID-19 for AOM 73.7 vs 27.1 [IRR 0.37]; for OME 9.6 vs 4.1 [IRR 0.43]; and for ear discharge 12.6 vs 5.8 [IRR 0.46]. The absolute number of AOM episodes in which oral antibiotics were prescribed declined accordingly (IRD pre-COVID-19 vs COVID-19: -22.4 per 1,000 child years), but the proportion of AOM episodes with antibiotic prescription was similar in both periods (47% vs 46%, respectively).

Discussion: GP consultation for AOM, OME and ear discharge declined by 63%, 57% and 54% respectively in the Netherlands during the COVID-19 pandemic. Similar antibiotic prescription rates before and during the pandemic indicate that the case-mix presenting to primary care did not considerably change. Our data therefore suggest a true decline as a consequence of infection control measures introduced during the pandemic.

Keywords: COVID-19 pandemic; antibiotic; children; incidence; otitis media.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Incidence of AOM episodes per 1,000 childmonths (total and according to age) pre-COVID-19 era and COVID-19 era.
Figure 2
Figure 2
Incidence AOM and OME episodes per 1000 childmonths and government restrictions. (A) AOM, (B) OME.
See this image and copyright information in PMC

References

    1. Aldè M., Di Berardino F., Marchisio P., Cantarella G., Ambrosetti U., Consonni D., et al. (2021). Effects of COVID-19 Lockdown on Otitis Media With Effusion in Children: Future Therapeutic Implications [Published Online Ahead of Print, 2021 Jan 26]. Otolaryngol Head Neck Surg. 194599820987458. doi: 10.1177/0194599820987458 - DOI - PMC - PubMed
    1. Angoulvant F., Ouldali N., Yang D. D., Filser M., Gajdos V., Rybak A., et al. (2021). Coronavirus Disease 2019 Pandemic: Impact Caused by School Closure and National Lockdown on Pediatric Visits and Admissions for Viral and Nonviral Infections-A Time Series Analysis. Clin. Infect. Dis. 72 (2), 319–322. doi: 10.1093/cid/ciaa710 - DOI - PMC - PubMed
    1. Barschkett M., Koletzko B., Spiess C. K. (2021). COVID-19 Associated Contact Restrictions in Germany: Marked Decline in Children’s Outpatient Visits for Infectious Diseases Without Increasing Visits for Mental Health Disorders. Children 8 (9), 728. doi: 10.3390/children8090728 - DOI - PMC - PubMed
    1. Castagno L. A., Lavinsky L. (2002). Otitis Media in Children: Seasonal Changes and Socioeconomic Level. Int. J. Pediatr. Otorhinolaryngol 62 (2), 129–134. doi: 10.1016/S0165-5876(01)00607-3 - DOI - PubMed
    1. Fortanier A. C., Venekamp R. P., de Hoog M. L., Uiterwaal C. S., van der Gugten A. C., van der Ent C. K., et al. (2015). Parent-Reported Symptoms of Acute Otitis Media During the First Year of Life: What is Beneath the Surface? PloS One 10 (4), e0121572. doi: 10.1371/journal.pone.0121572 - DOI - PMC - PubMed

Publication types

Substances