Multi-institutional Assessment of Otitis Media Epidemiology Using Real-world Data

Area of Science:

• Pediatrics
• Epidemiology
• Otolaryngology

Background:

• Otitis media (OM) is a common childhood infection.
• Understanding OM incidence and risk factors is crucial for public health.
• Real-world data can provide valuable insights into OM epidemiology.

Purpose of the Study:

• To determine the incidence rates of pediatric otitis media (OM).
• To identify sociodemographic and health-related risk factors for OM.
• To analyze trends in OM following key public health interventions.

Main Methods:

• Retrospective cohort study utilizing PEDSnet electronic health record data (2009-2021).
• Included children <6 months old at initial visit, followed longitudinally.
• Time-to-event analysis with Cox proportional hazards models used to assess risk factors.

Main Results:

• The cohort comprised 910,265 children; 39.6% experienced at least one OM episode by age 3.
• OM rates decreased post-pneumococcal-13 vaccination (PCV-13) and COVID-19 pandemic.
• Higher OM incidence associated with young age, minority race/ethnicity, public insurance, male sex, cleft palate, primary ciliary dyskinesia, trisomy 21, atopic dermatitis, and gastroesophageal reflux.

Conclusions:

• Nearly 40% of children have OM by age 3.
• PCV-13 and COVID-19 correlated with decreased OM rates.
• Children with craniofacial anomalies (e.g., cleft palate) and impaired ciliary function face the highest OM risk.