Acute otitis media and age at onset among children in Greenland

This survey examines the age at onset of acute otitis media (AOM) in 591 unselected Greenlandic children aged 3, 4, 5 and 8 years from the two largest towns in Greenland. The attendance rate was 86%. Parental information about episodes of AOM was cross-checked in medical records, which were available for 95% of the children. AOM was defined as episodes with earache, otorrhoea or previous treatment for AOM, with written otoscopic evidence of AOM resulting in treatment with weak analgetics or antibiotics. Recurrent AOM (rAOM) was defined as > or = 5 AOM episodes since birth. In total, 66% of the children had experienced AOM at least once. Of all children, 40% had AOM during the first year of life. Median age of the first episode was 10 months (range: 1-84 months), and there was no sex difference. Children between 7 and 12 months of age were at highest risk of AOM. Children with rAOM had their first AOM episode at a significantly younger age than children with < 5 AOM episodes (median: 7 months, range: 2-48 months). In addition, 83% of children with rAOM had their first AOM episode before 12 months of age compared with 53% of children with < 5 episodes (p < 0.0001). The relative risk of rAOM was eight times greater if the first episode of AOM occurred before six months of age compared to more than 24 months of age. Thirty-five percent of children with rAOM had chronic otitis media as well, compared to only 4% of children with < 5 AOM episodes. We conclude that early onset of AOM (before one year of age) occurs frequently in Greenlandic children compared to others, and a high proportion of these children develop rAOM.