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Epidemiology of otitis media in children
Insights
Otitis media (OM) affects 71% of children by age three, with recurrent cases linked to family history and genetics. Persistent middle ear effusion after OM is notably associated with bottle-feeding in bed.
Area of Science:
- Pediatrics
- Epidemiology
- Otolaryngology
Background:
- Otitis media (OM) is a common childhood illness.
- Understanding its epidemiology in early life is crucial for prevention and management.
Purpose of the Study:
- To investigate the incidence and risk factors of otitis media during the first three years of life.
- To identify factors associated with recurrent otitis media and persistent middle ear effusion.
Main Methods:
- Prospective follow-up of 2,565 children from birth.
- Recording of pneumatic otoscopy results and epidemiological data at each visit.
Main Results:
- By age three, 71% of children experienced at least one episode of acute otitis media (OM); 33% had three or more episodes.
- Risk factors for first OM episode included siblings with OM, white race, and male sex. Allergies in siblings also predisposed children.
- Recurrent OM was associated with similar factors plus parental history of recurrent OM. Persistent middle ear effusion was linked to bottle-feeding in bed.
Conclusions:
- Otitis media is highly prevalent in early childhood, with significant recurrence rates.
- Family history, genetics, and environmental factors like bottle-feeding influence OM development and persistence.
Abstract:
To determine the epidemiology of otitis media (OM) during the first three years of life, physicians participating in the Greater Boston Collaborative Otitis Media Program followed prospectively from birth 2,565 children. At every visit we recorded results of pneumatic otoscopy and epidemiology data. By three years of age 71% of the children had had one or more episodes of acute otitis media including 33% who had three or more episodes. Features associated significantly with first episode of OM were: sibling with recurrent OM, race (white > black), and sex (male > female). Having a sibling with allergy disposed propositi to first episode. Features associated significantly with recurrent OM (greater than or equal to three episodes) were those noted above. A parent with recurrent OM disposed propositi to recurrent OM. Middle ear effusion (MEE) persisted for prolonged periods after OM; after the first episode of OM, 70% of children still had MEE at two weeks, 40% had fluid at one month, 20% had fluid at two months, and 10% had fluid at three months. The sole feature associated significantly with persistent effusion in the middle ear after the first episode of OM was the practice of giving a child a bottle in bed.