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Otitis media (OM) is highly prevalent among Aboriginal Australians, in whom eardrum perforations with discharge have been reported in the first 3 months of life. Only one published study, however, has described middle ear status at birth or prior to eardrum perforation in young Aboriginal infants. This prospective study used otoscopy, tympanometry, and hearing tests to compare middle ear status and hearing sensitivity in Aboriginal and non-Aboriginal neonates. Immobile eardrums were observed immediately after birth, but mobility generally appeared within the first week. At examinations at 6 to 8 weeks of age, OM with effusion or acute OM was observed in 95% of 22 Aboriginal infants, but OM with effusion was seen in only 30% of 10 non-Aboriginal infants. There was a clinic record of unilateral perforation in 1 Aboriginal infant only. Hearing impairment was demonstrated by auditory brain stem response in 5 ears, all with evidence of middle ear abnormalities. Improved knowledge and diagnosis of the signs and symptoms of OM will contribute to improvements in the provision of early medical intervention to populations at high risk for early OM.

Australian Aboriginal infants experience very early otitis media (OM). A previous study reported that OM with effusion (OME) or acute OM (AOM) was observed in the first 8 weeks of life in 95% of 22 Aboriginal infants, but that OME was seen in only 30% of 10 non-Aboriginal infants. Tympanic membrane perforation was reported for 1 Aboriginal subject at 8 weeks of age. This requires further investigation, because early OM onset has been demonstrated in non-Aboriginal groups to increase the risk of chronic and persistent ear disease in later childhood. This prospective study used otoscopy and tympanometry to describe the course of OM in infants examined repeatedly from soon after birth. Disease course was described in two ways, based upon earlier findings from other studies of Aboriginal schoolchildren. First, patterns of disease in the first year were identified; non-Aboriginal infants had occasional episodes of OME or AOM from which they recovered spontaneously, usually within 1 month; Aboriginal infants had persistent AOM, OME, or tympanic membrane perforation with discharge that rarely, if ever, resolved to normal. Second, conditional probabilities were calculated for ear state transitions at consecutive ear examinations, and a model of the course of OM was proposed for the Aboriginal infants. Results also suggested that binaural patterns of chronic OM described previously in Aboriginal schoolchildren may already be established in the first year of life. These findings will help service providers determine when to intervene to avoid the chronic consequences of early OM.

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Otitis media is

Poor compliance with prescribed treatment is a problem that all health tare providers have to manage on a daily basis as it directly influences patient outcome to treatment. This takes on even greater significance in the context of Australian Aboriginal health where poor compliance is an important factor limiting health advancement along with many other social and economic factors. This paper describes educational and other strategies used to maximise and monitor compliance in the context of an antibiotic treatment trial for infants with otitis media (OM) in a remote, traditionally‐oriented Aboriginal community. It uses a model of interaction that recognises that positive cross‐cultural interactions facilitate mutual cooperation. A maximum compliance rate with antibiotic treatment of 54 per cent was achieved in a group of 23 infants.

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