Complications of otitis media in Indigenous and non‐Indigenous children

Abstract

In Australia, three to five children die each year because of otitis media complications, and 15 children will suffer permanent hearing loss each year as a result of otitis media. Extracranial complications occur most commonly, and include mastoiditis, cholesteatoma and otitis media with perforation. Intracranial complications are less common, and include meningitis, brain abscess and lateral sinus thrombosis. In Australia, approximately 60% of extracranial and intracranial complications of otitis media occur in children. The contrasting rates of childhood otitis media among Indigenous and non‐Indigenous children have implications for the frequency and types of complications occurring in both groups. Otitis media with effusion and acute otitis media predominate among non‐Indigenous children, whereas chronic suppurative otitis media (CSOM) occurs most commonly among Indigenous children. The incidence of mastoiditis in Australia is low by international standards (2/100 000 children), but cholesteatoma rates among Indigenous children in Australia are higher than previously estimated (up to 10% in CSOM). A high rate of chronic tympanic membrane perforation occurs among Indigenous children, estimated to be as high as 80%. Intracranial complications of otitis media are uncommon, but are potentially life‐threatening and are more likely to occur among Indigenous than non‐Indigenous children. Reduced access to medical care, lower socioeconomic status and remote living conditions mean that levels of early childhood hearing loss among Indigenous children are likely to be underestimated. This has implications for early childhood speech and language development and education.

Ear Infection and Its Associated Risk Factors, Comorbidity, and Health Service Use in Australian Children

“…Our prevalence of ear infection was 7.9% among children aged 4 to 5 years and 3.3% among children aged 10 to 11 years. Incidence and prevalence rate of ear infections varied depending on age groups (highest in the first three years); however, differences in definitions and diagnostic measures make comparisons between studies very difficult [16, 18, 28]. For example, a US study of children aged 1–8 years using weekly otoscopy reported prevalence ranging from 7–30% for children aged 5 years and above.…”

“…The prevalence of ear infection, whereby Australian indigenous children had at least an episode in the first year of life, is among the highest in the world and has resulted in a wide range of complications [16, 17]. According to data from Aboriginal Medical Service, rural and remote practitioners manage a greater caring burden than their urban counterparts; hence, affected children have less access to specialist ear health services and longer waiting times [18].…”

Australian Aboriginal Children with Otitis Media Have Reduced Antibody Titers to Specific Nontypeable Haemophilus influenzae Vaccine Antigens

“…Australian Aboriginal children experience an excessive burden of otitis media (OM) and associated hearing loss, which causes difficulties in language acquisition and learning and has long-term effects on their life course (1–3). While 10 to 20% of nonindigenous children develop chronic or recurrent OM, the condition is almost universal among Australian Aboriginal children by 12 months of age and persists to school age (4–6).…”

‘Doing the hard yards’: carer and provider focus group perspectives of accessing Aboriginal childhood disability services

“…The disproportionately high prevalence of middle ear disease and its complications in Aboriginal children can lead to disabling chronic ear disease, hearing impairment and negatively affect education, social circumstances and quality of life [10,11]. In 2004–05, rates of middle ear disease were four times as high among Aboriginal children aged 0–14 years as non-Aboriginal children in the same age group [3].…”