Incidence of acute otitis media in children below 6 years of age seen in medical practices in five East European countries

Abstract

BackgroundAlthough acute otitis media (AOM) remains a major public health problem worldwide and brings economic burden on health care system and caregivers, little information is available about its epidemiology in Eastern Europe.MethodsWe conducted an epidemiological, prospective, observational, multi-centre cohort study (NCT01365390) in five East European countries (Estonia, Lithuania, Poland, Romania and Slovenia) between June 2011 and January 2013 to determine the incidence and clinical characteristics of AOM among children aged < 6 years during 1 year.ResultsAOM incidence was 160.7 cases (95 % confidence interval [CI]: 144.7–177.9) per 1000 person-years (PY) being the lowest in the < 1 year age group (92.3 cases [95 % CI: 59.7–136.2] per 1000 PY) and the highest in the 3– < 4 years age group (208.9 cases [95 % CI: 165.1–260.7] per 1000 PY). AOM incidence was similar across the countries, with the exception of Slovenia (340.3 cases [95 % CI: 278.3–412.0] per 1000 PY). There was a lower risk in breastfed children and a higher risk in those attending school/childcare or with allergies. AOM required 521 visits to the doctor. Antibiotics were prescribed for 276 (74.8 %) episodes with the lowest prescription rate in Estonia (51.4 %) and the highest in Romania (83.7 %). Complications were rare and hospitalisations occurred in 2 % of the cases.ConclusionsThe disease burden of AOM in Eastern Europe is relevant and public health initiatives to reduce it should be considered.Trial registrationClinicalTrial.gov NCT01365390.

The LuxS/AI-2 Quorum-Sensing System of Streptococcus pneumoniae Is Required to Cause Disease, and to Regulate Virulence- and Metabolism-Related Genes in a Rat Model of Middle Ear Infection

“…Otitis media (OM) is one of the main reasons antibiotics are prescribed for children in both developing and developed countries (Grijalva et al, 2009 ; Arguedas et al, 2010 ). More than 80% of children up to the age of 3 year experience at least one episode of acute OM (AOM), and the health and economic burdens associated with AOM are significant (Pichichero, 2013 ; Usonis et al, 2016 ). Streptococcus pneumoniae ( S. pneumoniae ) is the most important bacteria that causes AOM in children (Bergenfelz and Hakansson, 2017 ).…”

Ambulantna poraba antibiotikov pri otrocih v Sloveniji

“…V Sloveniji bistveno pogosteje diagnosticiramo AVSU kot Nizozemci, ki imajo incidenco AVSU pri bolnikih <18 let 75/1000 prebivalce/leto (23). Tudi v raziskavi otrok pod 6 let starosti v 5 vzhodnoevropskih državah je bila najvišja incidenca AVSU (455,4/1000 otrok na leto) in najvišji delež predpisanih antibiotikov v Sloveniji (92,8 %) (24). Ti podatki kažejo, da je bilo AVSU v Sloveniji prepogosto diagnosticirano in prepogosto zdravljeno z antibiotiki.…”

Acute Otitis Media in Childhood - Use of Guidelines for Diagnosis and Treatment in Emergency Rooms

“…The low incidence in children up to six months of age is explained by the presence of transplacental antibodies, less exposure to pathogens and the position used for breastfeeding. [6] Socialization in schools and day-care centres is the factor that most contributes to the occurrence of AOM, [7] particularly because the children share enclosed spaces as well as accessories such as feeding bottles and pacifiers, perpetuating a recurrent cycle of upper respiratory tract infections. The risk of recurrence appears to be associated with the age at which the first episode appears: 60% of children with a recurrence during childhood had their first episode prior to completing six months of age.…”