Risk factors for otitis media in children with special emphasis on the role of colonization with bacterial airway pathogens: the Generation R study

Abstract

Acute otitis media is the most frequent diagnosis in children visiting physicians’ offices. Risk factors for otitis media have been widely studied. Yet, the correlation between bacterial carriage and the development of otitis media is not entirely clear. Our aim was to study in a population-based prospective cohort the risk factors for otitis media in the second year of life with special emphasis on the role of colonization with Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. The study was embedded in the Generation R Study. Data on risk factors and doctor-diagnosed otitis media were obtained by midwives, hospital registries and postal questionnaires in the whole cohort (n = 7,295). Nasopharyngeal swabs were obtained at the age of 1.5, 6 and 14 months in the focus cohort (n = 1,079). Of these children, 2,515 (47.2%) suffered at least one period of otitis media in their second year of life. The occurrence of otitis media during the follow-up period in the first 6 months of life and between 6 and 12 months of age was associated with the risk of otitis media in the second year of life (aOR, 1.83 95% CI 1.24–2.71 and aOR 2.72, 95% CI 2.18–3.38, respectively). Having siblings was associated with an increased risk for otitis media in the second year of life (aOR 1.42, 95% CI 1.13–1.79). No associations were found between bacterial carriage in the first year of life and otitis media in the second year of life. In our study, otitis media in the first year of life is an independent risk factor for otitis media in the second year of life. Surprisingly, bacterial carriage in the first year of life did not add to this risk. Moreover, no association was observed between bacterial carriage in the first year of life and otitis in the second year of life.

Household number associated with middle ear disease at an urban Indigenous health service: a cross-sectional study

“…Like the higher rate of overcrowding, we have previously reported a higher rate of middle ear disease, detected using CHCs, in remote communities compared with the urban IIHS (5.5 times) (Spurling et al 2012). This study's findings regarding the association between middle ear disease and previous episodes of ear infection and increasing household number are consistent with large international cohort studies (Labout et al 2011), one of which also identified low socioeconomic status as a risk factor (Paradise et al 1997). However, our findings differ from the two other epidemiological studies involving Aboriginal populations in rural and remote areas (Jacoby et al 2008;Bailie et al 2010) and a meta-analysis examining risk factors for middle ear disease (Uhari et al 1996), which found that environmental tobacco smoke and childcare attendance were important risk factors.…”

“…Large birth cohort studies in the Netherlands and the United States of American (USA) found that significant predictors of otitis media at 2 years of age were male gender, otitis media in the first year of life, socioeconomic disadvantage and exposure to other children in the house (Paradise et al 1997;Labout et al 2011). Higher rates of otitis media among Aboriginal and Torres Strait Islander children have been attributed to early nasopharyngeal bacterial colonisation, chronic upper respiratory tract infections and social factors such as poverty, overcrowding and exposure to cigarette smoke (Kong and Coates 2009).…”

Breastfeeding and childhood acute otitis media: a systematic review and meta‐analysis

“…Ever vs never breastfeeding and outcome of AOM during the first 24 months was reported by five cohort studies . Four included studies’ quality ranged from ‘satisfactory’ to ‘good’ (Table S4).…”

Breastfeeding and Otitis Media: A Review of Recent Evidence

“…Using data collected from a population-based prospective birth cohort in Rotterdam in The Netherlands, researchers found no association between 3 or more months of breastfeeding and AOM in the second year of life [19]. AOM was defined by parental report of at least one occurrence of fever accompanied by earache for which a physician was visited.…”