The Kalgoorlie Otitis Media Research Project: rationale, methods, population characteristics and ethical considerations

Abstract

Otitis media (OM) is one of the most common paediatric illnesses for which medical advice is sought in developed countries. Australian Aboriginal children suffer high rates of OM from early infancy. The resultant hearing loss can affect education and quality of life. As numerous factors contribute to the burden of OM, interventions aimed at reducing the impact of single risk factors are likely to fail. To identify key risk factors and understand how they interact in complex causal pathways, we followed 100 Aboriginal and 180 non-Aboriginal children from birth to age 2 years in a semi-arid zone of Western Australia. We collected demographic, obstetric, socio-economic and environmental data, breast milk once, and nasopharyngeal samples and saliva on seven occasions. Ear health was assessed by clinical examination, tympanometry, transient evoked otoacoustic emissions and audiometry. We considered the conduct of our study in relation to national ethical guidelines for research in Aboriginal and Torres Strait Islander health. After 1 year of community consultation, the study was endorsed by local committees and ethical approval granted. Fieldwork was tailored to minimise disruption to people's lives and we provided regular feedback to the community. We saw 81% of non-Aboriginal and 65% of Aboriginal children at age 12 months. OM was diagnosed on 55% and 26% of routine clinical examinations in Aboriginal and non-Aboriginal children respectively. Aboriginal mothers were younger and less educated, fewer were employed and they lived in more crowded conditions than non-Aboriginal mothers. Sixty-four per cent of Aboriginal and 40% of non-Aboriginal babies were exposed to environmental tobacco smoke. Early consultation, provision of a service while undertaking research, inclusion of Aboriginal people as active members of a research team and appropriate acknowledgement will assist in ensuring successful completion of the research.

Ear-related problems among children attending the paediatric and otorhinolaryngology out-patients clinics of the University of Nigeria Teaching Hospital, Enugu

“…1,2 In the United States of America, diseases of the ear in children cause much concern in the medical and non-medical world because of the huge financial implications and loss of school and work days for both children and parents. The psychologi-cal stress posed by this group of diseases is not quantifiable as the complications of ear-related illnesses could be devastating.…”

Diversity of Nontypeable Haemophilus influenzae Strains Colonizing Australian Aboriginal and Non-Aboriginal Children

“…A limitation of this study is the difference in complete follow-up of children to 2 years of age (21). An increase in complete follow-up for Aboriginal children would result in an increased number of Haemophilus isolates and more unique ribotypes; however, these are unlikely to alter the strain richness, which is proportional to the carriage rate.…”

“…Twenty-seven percent of the Aboriginal and 48% of the non-Aboriginal children had 7 NPAs collected (18). Fifty-one percent of the Aboriginal children and 66% of the non-Aboriginal children completed 2 years of follow-up (21).…”

“…The KOMRP study population has been well described (18,21). Briefly, 100 Aboriginal and 180 non-Aboriginal children living in the Kalgoorlie-Boulder region were recruited into the study soon after birth between April 1999 and January 2003.…”

“…We have previously described nasopharyngeal colonization (18) and OM (19,20) in Aboriginal and non-Aboriginal children living in the Kalgoorlie-Boulder area of the Goldfields in Western Australia as part a prospective longitudinal cohort study known as the Kalgoorlie Otitis Media Research Project (KOMRP) (21). Aboriginal children in the KOMRP had higher NTHI carriage rates than non-Aboriginal children (42.0% versus 11.1%) in the first 2 years of life.…”