“…[3] The epidemiology of otitis media, and reasons for regional differences in incidence and prevalence are complex, with risk factors involving multiple host-related factors (age, gender, race, allergy, immune competence specifically related to HIV status, malnutrition, craniofacial abnormalities, genetic predisposition) and environmental factors (upper respiratory infection, seasonality, daycare, presence of siblings, tobacco smoke exposure, breastfeeding, socioeconomic status). [1,3,4,6] HIV-positive children are more prone to, and more severely affected by, otitis media than immunocompetent children. [7] An estimated 3 million of the 3.3 million children worldwide who are HIV-positive (0 -14 years of age) live in SSA.…”