Number Of Otitis Media Episodes Research Articles

Burden of otitis media and pneumonia in children up to 6 years of age: results of the LISA birth cohort

Infections play an important role in childhood. For Germany, few data are available on the epidemiology of infectious diseases such as otitis media and pneumonia in children. We therefore described the prevalence, first episode proportions and recurrence of these childhood infection diseases in selected regions of Germany in children up to 6 years of age. The analysis was based on data from the LISA Study, a prospective population-based birth cohort study including 3,097 full-term infants. Information was collected by parent questionnaire. The first episode proportions for the first 6 years of life were high for otitis media (66.7%; 95%CI 0.65-0.69) and pneumonia (13.5%; 95%CI 0.12-0.15). The annual first episode proportions for otitis media ranged from 7.3% to 25.6% and for pneumonia from 1.4% to 3.4%; both peaked during the second year. The average number of otitis media episodes was 2.2 (SD 2.0) episodes per child within the first 2 years. During the first 2 years of life, hospitalisations due to otitis and pneumonia occurred in up to 7.8 per thousand and 3.0 per thousand of the children, respectively. On average, 50.6% of the children with otitis media were treated with antibiotics during the first year of life. In conclusion, this analysis shows that infectious diseases, especially otitis media, are very frequent childhood diseases in Germany. Thus, parents and physicians should not per se worry about a high frequency of otitis media during early childhood.

The reliability of self-reported childhood otitis media by adults

To estimate reliability of retrospective questionnaire data on childhood recurrent otitis media, and to identify factors influencing inconsistency in self-report. Retrospective questionnaire data from a population-based sample of 4430 Norwegian twins who participated in two questionnaire surveys, 6 years apart, containing identical questions on otitis media. Main outcome measure was individual consistency in reporting of otitis media. The tetrachoric correlation and Cohen's Kappa were used to measure reliability. Inconsistent and consistent responders were compared on medical history and mental distress. The use of twin data made it possible to test whether inconsistent responders represent a group with intermediate levels of otitis media severity. The test-retest tetrachoric correlation was 0.82 and Kappa was 0.53. Inconsistency in response was not associated with mental distress, but related to reported number of otitis media episodes per year, use of medical services and history of ear surgery. Retrospective self-reported otitis media is a relatively reliable measure. The study suggests that reporting inconsistency is likely to be associated with less severe disease. The finding that reporting pattern is related to disease severity is in accordance with the proposed need for a uniform agreement on the definition of the term "recurrent otitis media" for research purposes.

Adenoidectomy Does Not Significantly Reduce the Incidence of Otitis Media in Conjunction With the Insertion of Tympanostomy Tubes in Children Who Are Younger Than 4 Years: A Randomized Trial

To evaluate the efficacy of adenoidectomy in reducing the incidence of otitis media among children who are younger than 4 years and receive tympanostomy tubes. A randomized trial was conducted at a tertiary center clinic. A total of 217 children who were aged 12 to 48 months and had recurrent acute otitis media (>3 episodes during the past 6 months) or chronic otitis media with effusion, no obstructive symptoms as a result of adenoid enlargement, and no previous surgical intervention were enrolled in the study. Adenoidectomy in conjunction with the insertion of tympanostomy tubes or insertion of tympanostomy tubes without adenoidectomy was studied. The number of otitis media episodes during the follow-up period of 12 months was measured. During the follow-up, the mean number of otitis media episodes was 1.7 among children who underwent adenoidectomy with concurrent insertion of tympanostomy tubes and 1.4 among children who received tympanostomy tubes only. The risk for recurrent otitis media (>or=3 episodes) could not be reduced by adenoidectomy (odds ratio: 1.66; 95% confidence interval: 0.80-3.46). Adenoidectomy does not significantly reduce the incidence of acute otitis media in otitis prone children who are younger than 4 years and receive tympanostomy tubes.

Association of early‐onset otitis media in infants and exposure to household mould

Otitis media is one of the most common infections of early childhood. Children who first experience acute otitis media at an early age (before 6 months) are at increased risk for recurrent otitis media. This prospective study investigated exposure to measured levels of airborne household mould and the risk of early otitis media in the first 6 months of life among a cohort of infants at high risk for asthma. Between September 1996 and December 1998, women were invited to participate if they had at least one other child with physician-diagnosed asthma. Mothers were given a standardised questionnaire within 4 months of their infant's birth. Airborne mould samples were also taken at this time, and culturable fungi were categorised into four levels according to the report of the Commission of European Communities: 0 (undetectable), 1-499 colony forming units (CFU)/m(3) (low), 500-999 CFU/m(3) (medium), > or =1000 CFU/m(3) (high). Infant respiratory symptoms were collected during quarterly telephone interviews at 6, 9 and 12 months of age. Of the 806 children in the study, 27.8% experienced otitis media before six months of age. Household levels of Penicillium and Cladosporium were modestly associated with the number of otitis media episodes (P = 0.056 and 0.081 respectively). After controlling for potential confounders, Penicillium and Cladosporium were not associated with early otitis media. High levels of 'other' mould (defined as total spore count minus counts for Penicillium, Cladosporium, and yeast) were associated with early otitis media (OR 3.49; 95% CI [1.38, 8.79]). We also found associations between day-care outside of the home and birth during the summer or fall season with early otitis media. This study is suggestive of a relationship between otitis media and mould that warrants further study.

Gender and Teachers’ Rating of Linguistic Skills among Second-Grade Schoolchildren

The aim of the study was to evaluate the possible differences in linguistic skills and school achievement between girls and boys. In a nation-wide study, the achievement of 1,936 second-grade Finnish girls and boys was appraised according to the teachers’ rating. The results were compared with the linguistic test performance of 364 pupils from the nearby area. The mean rates of girls in writing, reading, oral performance and attention were significantly higher than those of boys as evaluated by the teachers (p < 0.01). Also, the risk of boys to be below the median in their achievement rates compared with girls was higher (risk ratios 1.3–1.6, 95% confidence intervals 1.2–1.7, p < 0.01). In multiple regression analysis where birth order, duration of nursery day care, number of otitis media episodes and parental education were controlled for, male gender proved to be a risk factor for linguistic skills as graded by the teachers. Yet, performance in linguistic tests did not support the superiority of girls in linguistic skills. Professionals taking care of linguistic problems in children should be aware that teachers’ evaluations are influenced by the gender of the pupil.

The surprisingly high acceptability of low-efficacy vaccines for otitis media: A survey of parents using hypothetical scenarios: Wischnack L.L.; Jacobson R.M.; Poland G.A.; Jacobsen S.J.; Harrison J.M.; Murtaugh P.A.Pediatrics (USA) (1995) 95/3 (350–354)

To determine parental thresholds for accepting vaccines for otitis media prevention given tradeoffs of efficacy, adverse effects, and administration mode.We interviewed 601 randomly selected parents with children 0 through 6 years of age presenting to our community pediatric clinic. For each of five hypothetical vaccines, which varied administration mode from nasal spray to two injections and adverse effects from mild to severe, parents indicated the lowest number of otitis media episodes that the vaccine had to prevent in the next 6 months for them to accept the vaccine.About half the parents would accept any one of the vaccines if it would prevent three or more infections in the next 6 months. When the vaccine would prevent one episode of otitis media over the next 6 months, 33% of parents would accept the medial vaccine (one injection in the thigh, with some children getting a red, sore injection site and a few having a fever of < or = 102 degrees F for one day). Seventeen percent accepted a vaccine requiring two injections (influenza vaccine-like) or having increased adverse effects (pneumococcal vaccine-like) despite the vaccine only preventing one episode of otitis media over the next 6 months. No substantial differences in these proportions were found when compared among groups by reason-for-visit, recent occurrence of otitis media, or a history of recurrent otitis media in a sibling.Many parents will accept low efficacy vaccines for otitis media prevention. Parental acceptance does not vary with the child's otitis media experience but does vary with severity of adverse effects and administration mode of the vaccine.

Letter to the Editor

We would like to thank Dr Heery for his comments on our paper "Exclusive Breast-Feeding for at Least 4 Months Protects Against Otitis Media."1 The first finding he mentions refers to a decrease in the mean number of otitis media (OM) episodes with increasing duration and exclusivity of breast-feeding. Dr Heery is correct that this part of the analysis did not control for other potential risk factors. We had preferred to give the actual mean number of otitis media episodes by breast-feeding status (Table 2), which most clearly expresses the data in its raw form, rather than deriving predicted or adjusted means, which are more removed from the data. See table in the PDF file

LONG-TERM EFFECTS OF OTITIS MEDIA A TEN-YEAR COHORT STUDY OF ALASKAN ESKIMO CHILDREN

Histories of ear disease, otoscopic examinations, and audiologic, intelligence, and achievement tests were obtained from a cohort of 489 Alaskan Eskimo children who have been followed through the first ten years of life. Seventy-six per cent had experienced one or more episodes of otitis media since birth. Of these, 78% had their first attack during their first two years of life. Perforations and scars were present in 41%. A hearing loss of 26 decibels or greater was present in 16%, and an additional 25% were in the normal range but had a measurable air-bone gap. Children with a history of otitis media prior to 2 years of age and a hearing loss of 26 decibels or greater had a statistically significant loss of verbal ability and were behind in total reading, total math, and language. In addition, children who had an early onset of otitis media but now had normal hearing with a conductive component were also adversely affected in verbal areas. The number of otitis media episodes was related to tympanic membrane abnormalities, hearing loss, and low verbal and achievement scores. These findings indicate that otitis media has been a significant cause of morbidity in Alaskan Eskimo children, and its onset during the critical years of language development as well as the number of episodes play an important role in impairing verbal development.