This study investigates and identifies risk factors, comorbidity, and health service use related to ear infection in Australian children. Two cross-sectional analyses of the Longitudinal Study of Australian Children (LSAC) involved 4,983 children aged 4 to 5 years in 2004 and aged 10 to 11 years in 2010. Odds ratios (ORs) were analysed using bivariate logistic regression. The prevalence of parent-reported ear infection was 7.9% (394) among children aged 4 to 5 years and 3.3% (139) at 10 to 11 years. Our study found that risk factors associated with ear infection were indigenous status, not being breastfed, mother or father smoking at least once a day, and father’s school completion at year 9 or lower. By age 10 to 11 years significantly reported comorbidities were tonsillitis (OR 4.67; ), headache (OR 2.13; ), and asthma (OR 1.67; ) and ear infection was found to be associated with the use of pediatrician (OR 1.83; ), other specialist (OR 2.12; ), and early intervention services (OR 3.08; ). This empirical evidence can be used to inform the development of intervention and management programs for ear infection. 1. Introduction Middle ear infection is a common, yet treatable disease and is a major cause of morbidity in children. If left untreated, long-term consequences of persistent severe ear infection can arise including speech development disorders [1], academic and educational development [2, 3], and lower overall quality of life [4, 5]. Subsequent hearing loss is one of the long-term implications of ear infection found to be associated with behavioural disorders and subsequent risks for longer-term mental health problems in children [6, 7]. Increased knowledge of the risk factors associated with ear infection is important in identifying children at risk for recurrent and persistent episodes [8]. Reviews of several European countries, the United States, Canada, and Australia have shown risk factors for ear infection to be childcare arrangement, breastfeeding, birth weight, socioeconomic status, and air pollution [9–11]. In a study of a birth cohort in Canada, the strongest risk factors for ear infection were being male, of Aboriginal status, and the child’s mother aged less than 20 years [12]. A recent study in Australia has shown poor living conditions, exposure to cigarette smoke, and lack of access to medical care are all major risk factors for ear infection [13]. Ear infections are often mild and frequently resolve themselves within a short period of time. However, the frequency of infection and its associated comorbidity (e.g., fevers and
References
[1]
J. E. Roberts, R. M. Rosenfeld, and S. A. Zeisel, “Otitis media and speech and language: a meta-analysis of prospective studies,” Pediatrics, vol. 113, no. 3, pp. e238–e248, 2004.
[2]
J. A. Thorne, “Middle ear problems in Aboriginal school children cause developmental and educational concerns,” Contemporary Nurse, vol. 16, no. 1-2, pp. 145–150, 2003.
[3]
P. W. Zinkus, M. I. Gottlieb, and M. Schapiro, “Developmental and psychoeducational sequelae of chronic otitis media,” American Journal of Diseases of Children, vol. 132, no. 11, pp. 1100–1104, 1978.
[4]
I. Baumann, B. Gerendas, P. K. Plinkert, and M. Praetorius, “General and disease-specific quality of life in patients with chronic suppurative otitis media—a prospective study,” Health and Quality of Life Outcomes, vol. 9, article 48, 2011.
[5]
C. N. M. Brouwer, A. R. Maillé, M. M. Rovers, D. E. Grobbee, E. A. M. Sanders, and A. G. M. Schilder, “Health-related quality of life in children with otitis media,” International Journal of Pediatric Otorhinolaryngology, vol. 69, no. 8, pp. 1031–1041, 2005.
[6]
V. Yiengprugsawan, A. Hogan, and L. Strazdins, “Longitudinal analysis of ear infection and hearing impairment: findings from 6-year prospective cohorts of Australian children,” BMC Pediatrics, vol. 13, no. 1, article 28, 2013.
[7]
A. Hogan, M. Shipley, L. Strazdins, A. Purcell, and E. Baker, “Communication and behavioural disorders among children with hearing loss increases risk of mental health disorders,” Australian and New Zealand Journal of Public Health, vol. 35, no. 4, pp. 377–383, 2011.
[8]
I. J. M. Dhooge, “Risk factors for the development of otitis media,” Current Allergy and Asthma Reports, vol. 3, no. 4, pp. 321–325, 2003.
[9]
M. M. Rovers, I. M. C. M. de Kok, and A. G. M. Schilder, “Risk factors for otitis media: an international perspective,” International Journal of Pediatric Otorhinolaryngology, vol. 70, no. 7, pp. 1251–1256, 2006.
[10]
N. M. P. Hetzner, R. A. Razza, L. M. Malone, and J. Brooks-Gunn, “Associations among feeding behaviors during infancy and child illness at two years,” Maternal and Child Health Journal, vol. 13, no. 6, pp. 795–805, 2009.
[11]
T. W. Morrissey, “Multiple child care arrangements and common communicable illnesses in children aged 3 to 54 months,” Maternal and Child Health Journal, 2012.
[12]
E. A. MacIntyre, C. J. Karr, M. Koehoorn et al., “Otitis media incidence and risk factors in a population-based birth cohort,” Paediatrics and Child Health, vol. 15, no. 7, pp. 437–442, 2010.
[13]
K. Kong and H. L. C. Coates, “Natural history, definitions, risk factors and burden of otitis media,” Medical Journal of Australia, vol. 191, no. 9, supplement, pp. S39–S43, 2009.
[14]
P. S. Morris, “Upper respiratory tract infections (including otitis media),” Pediatric Clinics of North America, vol. 56, no. 1, pp. 101–117, 2009.
[15]
G. Karevold, E. Kvestad, P. Nafstad, and K. J. Kv？rner, “Respiratory infections in schoolchildren: co-morbidity and risk factors,” Archives of Disease in Childhood, vol. 91, no. 5, pp. 391–395, 2006.
[16]
T. E. O'Connor, C. F. Perry, and F. J. Lannigan, “Complications of otitis media in indigenous and non-Indigenous children,” Medical Journal of Australia, vol. 191, no. 9, supplement, pp. S60–S64, 2009.
[17]
P. S. Morris, A. J. Leach, P. Silberberg et al., “Otitis media in young Aboriginal children from remote communities in Northern and Central Australia: a cross-sectional survey,” BMC Pediatrics, vol. 5, article 27, 2005.
[18]
H. Gunasekera, P. S. Morris, J. Daniels, S. Couzos, and J. C. Craig, “Otitis media in Aboriginal children: the discordance between burden of illness and access to services in rural/remote and urban Australia,” Journal of Paediatrics and Child Health, vol. 45, no. 7-8, pp. 425–430, 2009.
[19]
L.-A. S. Kirkham, S. P. Wiertsema, H. C. Smith-Vaughan et al., “Are you listening? The inaugural Australian Otitis Media (OMOZ) workshop—towards a better understanding of otitis media,” Medical Journal of Australia, vol. 193, no. 10, pp. 569–571, 2010.
[20]
P. S. Morris, P. Richmond, D. Lehmann, A. J. Leach, H. Gunasekera, and H. L. C. Coates, “New horizons: otitis media research in Australia,” Medical Journal of Australia, vol. 191, no. 9, supplement, pp. S73–S77, 2009.
[21]
M. Gray and D. Smart, “Growing Up in Australia. The Longitudinal Study of Australian Children is now walking and talking,” Family Matters, vol. 79, pp. 5–13, 2008.
[22]
J. M. Nicholson and A. Sanson, “A new longitudinal study of the health and wellbeing of Australian children: how will it help?” Medical Journal of Australia, vol. 178, no. 6, pp. 282–284, 2003.
[23]
S. Misson and M. Sipthorp, “Wave 2 weighting and non-response,” LSAC Technical Paper 5, Australian Institute of Family Studies, Melbourne, Australia, 2005.
[24]
A. Sanson, S. Misson, M. Wake, et al., “Summarising children’s wellbeing: the LSAC Outcome Index,” LSAC Technical Paper 2, Australian Institute of Family Studies, Melbourne, Australia, 2005.
[25]
C. Soloff, D. Lawrence, M. Sebastian, and R. Johnstone, “Wave 1 weighting and non-response,” LSAC Technical Paper 3, Australian Institute of Family Studies, Melbourne, Australia, 2006.
[26]
ABS, “An Introduction to Socio-Economic Indexes for Areas (SEIFA) ABS Catalogue Number 2039.0,” Commonwealth of Australia: Australian Bureau of Statistics, 2006.
[27]
StataCorp, “Stata 12.0 for Windows,” College Station, Tex, USA, Stata Corporation, 2011.
[28]
R. Rosenfeld and C. Bluestone, Evidence-Based Otitis Media, BC Decker, Hamilton, Ontario, Canada, 2003.
[29]
ABS, “National Aboriginal and Torres Strait Islander Health Survey, Australia, 2004-05,” ABS Catalogue Number 4715.0. Canberra, Australia, Australian Bureau of Statistics, 2006.
[30]
Access Economics, The cost burden of otitis media in Australia, Access Economics Pty Limited, GlaxoSmithKline, The Department of Otolaryngology, Head and Neck Surgery, Princess Margaret Hospital for Children, Perth, Australia, 2008.
[31]
E. Kvestad, K. J. Kv？rner, E. R？ysamb, K. Tambs, J. R. Harris, and P. Magnus, “The reliability of self-reported childhood otitis media by adults,” International Journal of Pediatric Otorhinolaryngology, vol. 70, no. 4, pp. 597–602, 2006.
[32]
K. Dedhia, D. Kitsko, D. Sabo, and D. H. Chi, “Children with sensorineural hearing loss after passing the newborn hearing screen,” JAMA Otolaryngology-Head & Neck Surgery, vol. 139, pp. 119–123, 2013.
[33]
M. Uhari, K. M？ntysaari, and M. Niemel？, “A meta-analytic review of the risk factors for acute otitis media,” Clinical Infectious Diseases, vol. 22, no. 6, pp. 1079–1083, 1996.
[34]
O.-P. Alho, E. L？？r？, and O. Hannu, “How should relative risk estimates for acute otitis media in children aged less than 2 years be perceived?” Journal of Clinical Epidemiology, vol. 49, no. 1, pp. 9–14, 1996.
[35]
P. Jacoby, K. S. Carville, G. Hall et al., “Crowding and other strong predictors of upper respiratory tract carriage of otitis media-related bacteria in Australian aboriginal and non-aboriginal children,” Pediatric Infectious Disease Journal, vol. 30, no. 6, pp. 480–485, 2011.
