Otitis media in Indigenous Australian children: review of epidemiology and risk factors

Jervis-Bardy, Joshua; Sanchez, Linnett; Carney, A. Simon

doi:10.1017/s0022215113003083

Cited by 62 publications

(82 citation statements)

References 62 publications

(145 reference statements)

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“…6 While indigenous Australian children have mostly acute otitis media, indigenous Filipino children have chronic otitis media as early as 2 years of age, particularly among A2ML1 variant carriers (Figure 2A). Carriers of the A2ML1 variant appear to have not just earlier onset but also a more protracted course of otitis media (Figure 2).…”

Section: Discussionmentioning

confidence: 99%

“…Some wildtype individuals do have persistently chronic otitis media beyond 13 years old (Figure 2C), and for these specific individuals the possibility of a second otitis media susceptibility variant is currently being investigated. Thus among indigenous populations where socio-economic background may favor an increase in prevalence of otitis media, 5–6 the indigenous Filipino population is unique in having at least one rare mutation that confers susceptibility to otitis media and favors carriage of specific middle ear pathogens, 10,12 and which also influences disease patterns including chronicity and onset.…”

Section: Discussionmentioning

confidence: 99%

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Genetic and Environmental Determinants of Otitis Media in an Indigenous Filipino Population

Santos‐Cortez

Reyes-Quintos

Tantoco

et al. 2016

Otolaryngol.--head neck surg.

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Objective To identify genetic and environmental risk factors for otitis media in an indigenous Filipino population Study Design Cross-sectional study Setting Indigenous Filipino community Subjects and Methods Clinical history and information on breastfeeding, tobacco smoke exposure and swimming were obtained from community members. Heads of households were interviewed for family history and personal beliefs on ear health. Height and weight were measured. Otoscopic findings were described for presence and character of perforation or discharge. An A2ML1 duplication variant that confers otitis media susceptibility was Sanger-sequenced in all DNA samples. Co-occurrence of middle ear bacteria detected by 16S rRNA gene sequencing was determined according to A2ML1 genotype and social cluster. Results The indigenous Filipino population has a ~50% prevalence of otitis media. Young age was associated with otitis media (4 age strata; p=0.004), however age was non-significant as a bi-stratal or continuous variable. There was no association between otitis media and gender, body mass index, breastfeeding, tobacco exposure or deep swimming. In multivariate analyses, A2ML1 genotype is the strongest predictor of otitis media, with an odds ratio of 3.7 (95%CI: 1.3, 10.8; p=0.005). When otitis media diagnoses were plotted across ages, otitis media was observed within the first year of life and chronic otitis media persisted up to adulthood, particularly in A2ML1 variant carriers. Conclusion Among indigenous Filipinos, A2ML1 genotype is the primary risk factor for otitis media and main determinant of disease progression, although age, the middle ear microbiome and social clusters might modulate the effect of the A2ML1 genotype.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Genetic and Environmental Determinants of Otitis Media in an Indigenous Filipino Population

Santos‐Cortez

Reyes-Quintos

Tantoco

et al. 2016

Otolaryngol.--head neck surg.

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“…There are many reports on the influence of socioeconomic factors on the occurrence of OM in various populations with challenging living conditions [14–18]. These studies present results on the whole panorama of OM.…”

Section: Preventionmentioning

confidence: 97%

Recurrent Acute Otitis Media: What Are the Options for Treatment and Prevention?

Granath

2017

Curr Otorhinolaryngol Rep

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Purpose of ReviewTo survey current strategies for treatment and prevention of recurrent acute otitis media (rAOM).Recent FindingsTreatment with systemic antibiotics is required in recurrent episodes of acute otitis media. A cautious attitude is recommended due to antibiotic resistance. Antibiotics also provide effective prophylaxis for rAOM. Topical treatment with ear drops is recommended in rAOM with otorrhea from tympanostomy tubes. Pneumococcal conjugated vaccines seem to have a moderate reductive effect on overall otitis media. The effect on rAOM is still unclear. Different administrations of immunoglobulins have not been effective against rAOM. Breastfeeding had a protective effect against rAOM. A recommendation against cigarette smoke exposure as a measure to prevent otitis seems warranted. An effect for adenoidectomy in children <2 years old with rAOM has been suggested. There is a strong genetic connection with rAOM. Probiotics and nasal spray with Streptococci might offer future opportunities as prophylaxis. Too little is known about complimentary treatments to give any recommendations.SummarySystemic antibiotics are still needed as treatment against episodes of AOM in rAOM children. There are several preventive measures that can be taken to reduce the burden of AOM but they all have a small-moderate effect. Systemic antibiotics provide effective prophylaxis in rAOM, but must be used with extreme caution due to the emerging antibiotic resistance.

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“…The World Health Organisation have identified OM in its various forms as a major health issue for Aboriginal children, despite the fact that OM is preventable and treatable, and is far less common for non-Aboriginal children in Australia [1]. The gap in prevalence of OM between Aboriginal and non-Aboriginal children has consistently been associated with social determinants, particularly housing-related issues [2][3][4][5][6][7][8]. OM can impact upon educational outcomes and employability for Aboriginal people who are more likely to be socially and economically disadvantaged than non-Aboriginal Australians [5].…”

Section: Introductionmentioning

confidence: 99%

The social determinants of otitis media in Aboriginal children in Australia: are we addressing the primary causes? A systematic content review

2020

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Background: Aboriginal and Torres Strait Islander children experience some of the highest rates of otitis media in the world. Key risk factors for otitis media in Aboriginal children in Australia are largely social and environmental factors such as overcrowded housing, poverty and limited access to services. Despite this, little is known about how to address these risk factors. A scoping content review was performed to determine the relationship between social determinants of health and otitis media in Aboriginal and Torres Strait Islander children as described by peerreviewed and grey literature.Method: Search terms were established for location, population and health condition. The search terms were used to conduct a literature search using six health research databases. Following the exclusion process, articles were scoped, analysed and categorised using scoping parameters and a social determinants of health framework.Results: Housing-related issues were the most frequently reported determinants for otitis media (56%). Two articles (4%) directly investigated the impact of social determinants of health on rates of otitis media within Aboriginal and Torres Strait Islander children. The majority of the literature (68%) highlights social determinants as playing a key role in the high rates of otitis media seen in Aboriginal populations in Australia. There were no intervention studies targeting social determinants as a means to reduce otitis media rates among Aboriginal and Torres Strait Islander children. (Continued on next page)Conclusions: This review identifies a disconnect between otitis media drivers and the focus of public health interventions within Aboriginal and Torres Strait Islander populations. Despite consensus that social determinants play a key role in the high rates of otitis media in Aboriginal and Torres Strait Islander children, the majority of intervention studies within the literature are focussed on biomedical approaches such as research on vaccines and antibiotics. This review highlights the need for otitis media intervention studies to shift away from a purely biomedical model and toward investigating the underlying social determinants of health. By shifting interventions upstream, otitis media rates may decrease within Aboriginal and Torres Strait Islander children, as focus is shifted away from a treatment-focussed model and toward a more preventative model.

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Otitis media in Indigenous Australian children: review of epidemiology and risk factors

Abstract: Despite awareness of the epidemiological burden of otitis media and its risk factors in Indigenous children, studies undertaken since 1985 demonstrate that otitis media remains a significant public health concern in this population.

Cited by 62 publications

References 62 publications

Genetic and Environmental Determinants of Otitis Media in an Indigenous Filipino Population

Genetic and Environmental Determinants of Otitis Media in an Indigenous Filipino Population

Recurrent Acute Otitis Media: What Are the Options for Treatment and Prevention?

The social determinants of otitis media in Aboriginal children in Australia: are we addressing the primary causes? A systematic content review

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