Incidence of acute otitis media from 2003 to 2019 in children ≤ 17 years in England

Abstract

Background The 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in 2006 and the 13-valent pneumococcal conjugate vaccine (PCV13) in 2010 in the UK. PCVs are active immunization for the prevention of invasive disease, pneumonia and acute otitis media (AOM) caused by Streptococcus pneumoniae in children. The aim of this observational study was to estimate incidence rates (IRs) of AOM in children ≤17 years from 2003 to 2019 in England, before and after the introduction of pneumococcal conjugate vaccines (PCVs). Methods AOM episodes were identified using Read diagnosis codes in children aged ≤17 years in the Clinical Practice Research Datalink (CPRD) Gold database from 2003 to 2019. Annual IRs with 95% confidence intervals (CI) by age group were calculated as the number of episodes/person-years (PY) at risk. Interrupted time series analyses were conducted to estimate incidence rate ratios (IRR) across post-PCV7 (2007–2009), early post-PCV13 (2011–2014) and late post-PCV13 (2015–2019) periods compared to the pre-PCV7 period (2003–2005) using generalized linear models. Results From 2003 to 2019, 274,008 all-cause AOM episodes were identified in 1,500,686 children. The overall AOM IR was 3690.9 (95% CI 3677.1-3704.8) per 100,000 PY. AOM IRs were highest in children aged < 5 years and decreased by age; < 2 years: 8286.7 (95% CI 8216.8-8357.1); 2–4 years: 7951.8 (95% CI 7902.5-8001.4); 5–17 years: 2184.4 (95% CI 2172.1–2196.8) (per 100,000 PY). Overall AOM IRs declined by 40.3% between the pre-PCV7 period and the late-PCV13 period from 4451.9 (95% CI 4418.1-4485.9) to 2658.5 (95% CI 2628.6-2688.7) per 100,000 PY, and across all age groups. IRRs indicated a significant decrease in AOM IRs in all the post-vaccination periods, compared to the pre-PCV7 period: post-PCV7 0.87 (95% CI 0.85–0.89), early post-PCV13 0.88 (95% CI 0.86–0.91), and late post-PCV13 0.75 (95% CI 0.73–0.78). Conclusions The AOM IRs declined during the 2003–2019 period; however, the clinical burden of AOM remains substantial among children ≤17 years in England.

The Unneglectable Disease Burden of Otitis Media Among Children in China: A Systematic Review and Meta-analysis

“…Our study can serve as a valuable complement to the limited data of OM, while is important to adequately assess the interventions aimed at reducing its health, social and economic burden. We found that the annual incidence rate of OM in underfives in China was 11.32 per 100 person-years, which is comparable to studies from England (7.95 per 100 person-years), 21 Brazil (9.57 per 100 person-years), 22 America (14.98 per 100 person-years) 13 and the Netherlands (15.3 per 100 person-years), 23 and suggests the validity of our result. However, our estimated OM incidence rate was relatively lower than studies from Europe (25.6 per 100 person-years), 24 possibly due to different case definitions, study designs and healthcare policies.…”

Prevalence and Outpatient Clinical Diagnostic Approaches for Common Acute Respiratory Tract Infections in Children Under Five Years of Age: A Cross-Sectional Study

“…This is similar to the prevalence in other African countries and higher than the prevalence rates in developed countries such as Norway, England, and the United States, probably due to better pneumococcal conjugate vaccination rates in the developed world. [25][26][27][28][29] Although mostly ignored and under-looked by most physicians, acute otitis media, which is the inflammation of the structures of the middle ear, is common and associated with longterm complications such as hearing loss when diagnosis and treatment are delayed. 26,30 Outpatient diagnosis is possible through visualization of inflammation or whitish discharge in an outpatient visual inspection using an otoscope.…”

Estimating the Cost-Effectiveness of Switching to Higher-Valency Pediatric Pneumococcal Conjugate Vaccines in the United Kingdom

“…d Mohanty et al [ 21 ] (for ages 0–17 years); and HES (for ages ≥18 years) [ 24 ]. e Mohanty et al [ 25 ] (for ages 0–17 years); and The Health Improvement Network (THIN) database (for ages ≥18 years) [ 26 ]. f Mohanty et al [ 25 ] (for ages 0–17 years); and THIN database (for ages ≥18 years) [ 26 ].…”

“…e Mohanty et al [ 25 ] (for ages 0–17 years); and The Health Improvement Network (THIN) database (for ages ≥18 years) [ 26 ]. f Mohanty et al [ 25 ] (for ages 0–17 years); and THIN database (for ages ≥18 years) [ 26 ]. g Mohanty et al [ 21 ] (for ages 0–17 years); and Miller et al [ 27 ] (for ages ≥18 years).…”