Seasonal Distribution of Otitis Media Pathogens Among Costa Rican Children

Guevara, Silvia; Soley, Carolina; Arguedas, Adriano; Porat, Nurith; Dagan, Ron

doi:10.1097/inf.0b013e3181468643

Cited by 29 publications

(30 citation statements)

References 22 publications

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“…Seasonality may offer an explanation, as the rainy season, which takes place from May to December in Panama, occurred prior to the 3–6 months period before the study enrolment, while the dry season overlapped with the study period. Children who had experienced the rainy season might have been more likely to have AOM, or they might have had more severe episodes, hence leading to a higher chance of using healthcare facilities [18]. Recall bias could offer another explanation since caregivers might only remember mild episodes of AOM that were very recent, but not those that had occurred more than a few months ago and which would have not led to a healthcare facility visit.…”

Section: Discussionmentioning

confidence: 99%

Healthcare-seeking behaviour of primary caregivers for acute otitis media in children aged 6 months to <30 months in Panama: results of a cross-sectional survey

Villarreal

Turner²,

et al. 2017

BMC Pediatr

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BackgroundAcute otitis media (AOM) is the most common bacterial childhood infection. However, caregivers with children having mild episodes often do not seek healthcare services, which may lead to an under-appreciation of the disease experienced by the community. The objectives of this survey were to estimate the proportion of primary caregivers who went to a healthcare facility when they suspected that their child aged 6 to <30 months was having an AOM episode during the past 6 months and to assess what factors influenced their decision.MethodsThis observational, cross-sectional survey of primary caregivers (≥18 years), with at least one child aged 6 to <30 months was performed in 19 healthcare facilities in Panama (March to May 2013). A 28-item paper questionnaire was administered to assess demographic data, AOM symptoms, as well as potential healthcare-seeking behaviour and factors influencing this behaviour. Potential confounding effects were individually assessed using Chi-squared or Cochran-Mantel-Haenszel tests, and all together in logistic regression models.ResultsThe total number of eligible participants was 1330 (mean age 28.5 ± 8.0 years). Of these, 245 participants had at least one child whom they suspected had an AOM episode during the past 6 months. Of the 245 participants, 213 (86.9%) sought healthcare at a facility. Several factors were associated with healthcare usage: perceived severity of illness (p = 0.001), occupational status of the caregiver (p = 0.002), household income (p = 0.016) and length of time since the last suspected AOM episode (p = 0.032).ConclusionsWhen confronted with a child with obvious symptoms of AOM, the majority of caregivers reported seeking healthcare. This behaviour appeared to be associated with factors related to the severity of the illness, the length of time since the last episode, as well as with the income and occupational status of the caregivers themselves. As many episodes of AOM present with non-specific respiratory symptoms, our results apply only to caregivers who were confronted with children with an obvious symptom.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-016-0760-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Healthcare-seeking behaviour of primary caregivers for acute otitis media in children aged 6 months to <30 months in Panama: results of a cross-sectional survey

Villarreal

Turner²,

et al. 2017

BMC Pediatr

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“…Non-typeable Haemophilus influenzae (NTHi) and Streptococcus pneumoniae account for approximately 80% of OM cases worldwide [44], with NTHi becoming the new frontier as pneumococcal vaccination spreads [98]. These two pathogens are responsible for the more severe forms and sequelae of OM, so effective vaccination against them could materially reduce OM’s clinical impact and wider burden [68, 75].…”

Section: Public Information Campaignsmentioning

confidence: 99%

“…Where antibiotic consumption and other health costs for childhood OM are high, the cost-saving argument for vaccination explicitly against OM is already in place. Where antibiotic consumption is low, the vaccination scenario is more complex: cost-savings would need to be accumulated over several disease categories associated with the two main OM pathogens [44, 59] and the benefits, including indirect protection, may need to be measured and accumulated over the severities and prevalences of these same categories.…”

Section: Public Information Campaignsmentioning

confidence: 99%

Poor adherence to antibiotic prescribing guidelines in acute otitis media—obstacles, implications, and possible solutions

Haggard

2010

Eur J Pediatr

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Many countries now have guidelines on the clinical management of acute otitis media. In almost all, the public health goal of containing acquired resistance in bacteria through reduced antibiotic prescribing is the main aim and basis for recommendations. Despite some partial short-term successes, clinical activity databases and opinion surveys suggest that such restrictive guidelines are not followed closely, so this aim is not achieved. Radical new solutions are needed to tackle irrationalities in healthcare systems which set the short-term physician–patient relationship against long-term public health. Resolving this opposition will require comprehensive policy appraisal and co-ordinated actions at many levels, not just dissemination of evidence and promotion of guidelines. The inappropriate clinical rationales that underpin non-compliance with guidelines can be questioned by evidence, but also need specific developments promoting alternative solutions, within a framework of whole-system thinking. Promising developments would be (a) physician training modules on age-appropriate analgesia and on detection plus referral of rare complications like mastoiditis, and (b) vaccination against the most common and serious bacterial pathogens.

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“…M. catarrhalis is usually the third most frequent bacterium isolated (3-20%) and GAS makes up 1-5% of cases, although the incidence of GAS infection differs between countries, depending on when the study was performed, and whether severe cases of AOM were included ( Fig. 1) [18][19][20][21][22][23][24][25][26][27][28][29].…”

Section: Aetiology Of Aommentioning

confidence: 99%

Microbiology of otitis media: A moving target

Vergison

2008

Vaccine

106

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The microbiology of acute otitis media (AOM) is linked to the nasopharyngeal commensal flora. This respiratory ecosystem undergoes various selective pressures, such as antibiotic consumption and vaccine use. Socio-economic conditions also influence the bacterial composition of the nasopharynx. Streptococcus pneumoniae, non-encapsulated Haemophilus influenzae, Moraxella catarrhalis, and group A Streptococcus are the leading causes of bacterial AOM worldwide. This paper will discuss the causes and consequences of recent shifts in the underlying microbiology of AOM.

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Seasonal Distribution of Otitis Media Pathogens Among Costa Rican Children

Cited by 29 publications

References 22 publications

Healthcare-seeking behaviour of primary caregivers for acute otitis media in children aged 6 months to <30 months in Panama: results of a cross-sectional survey

Healthcare-seeking behaviour of primary caregivers for acute otitis media in children aged 6 months to <30 months in Panama: results of a cross-sectional survey

Poor adherence to antibiotic prescribing guidelines in acute otitis media—obstacles, implications, and possible solutions

Microbiology of otitis media: A moving target

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