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Acute otitis media and sociomedical risk factors among unselected children in Greenland.

Abstract

OBJECTIVE

To describe the sociomedical risk factors associated with episodes of acute otitis media (AOM), recurrent AOM (rAOM), and chronic otitis media (COM) in Greenlandic children and especially to point out children at high risk of rAOM (defined as > 5 AOM episodes since birth) and COM which are prevalent among Inuit children all over the Arctic.

METHODS

The study design was cross-sectional and included 740 unselected children, 3, 4, 5, and 8-years-old, living in two major Greenlandic towns, Nuuk and Sisimiut. All children were otologically examined and the parents answered a questionnaire containing sociomedical variables including ethnicity, family history of OM, housing, insulation, crowding, daycare, passive cigarette smoking, breast feeding, type of diet, allergy, and chronic diseases. Historical data were cross-checked in medical records which also formed the basis for the drop-out analyses. Statistical analyses included frequency tests, calculation of odds ratio (OR), and multiple logistic regression.

RESULTS

The attendance rate was 86%. Former episode of AOM was reported by 2/3 of the children, rAOM by 20%, and COM by 9%. The following variables were found significantly more often in children with AOM by simple frequency testing: Parental (OR = 1.83), sibling (OR = 1.62), and parental plus sibling (OR = 2.56) history of OM, crowding (OR = 5.55), long period of exclusive breast feeding ( > 4 months) (OR = 2.47), and recent acute disease (P = 0.034). The following variables were found significantly more often in children with rAOM or COM by simple frequency testing: Parental history of OM (OR = 1.60; OR = 2.11, respectively) and no recall of breast feeding (P = 0.005; P = 0.003, respectively). Also, COM was found significantly more often in children with two Greenlandic parents (OR = 3.07). A multiple logistic regression test denoted only parental history of OM (OR = 1.82) and long period of exclusive breast feeding (OR = 1.14) as significant predictors of AOM.

CONCLUSIONS

Many of the risk factors usually associated with AOM could not be confirmed as risk factors in this survey. Parental history of OM and long period of exclusive breast feeding were the strongest factors associated with AOM in Greenlandic children and ethnicity was associated with COM. However, the study confirms that AOM is a multifactorial disease determined by a number of genetic and environmental factors.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Otolaryngology, Head & Neck Surgery, Rigshospitalet, University of Copenhagen, Denmark. rh03259@rh.dk

    ,

    Source

    MeSH

    Acute Disease
    Child
    Child, Preschool
    Chronic Disease
    Cross-Sectional Studies
    Female
    Greenland
    Health Status
    Humans
    Male
    Otitis Media
    Prevalence
    Recurrence
    Risk Factors
    Social Environment
    Surveys and Questionnaires

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    10428404

    Citation

    Homøe, P, et al. "Acute Otitis Media and Sociomedical Risk Factors Among Unselected Children in Greenland." International Journal of Pediatric Otorhinolaryngology, vol. 49, no. 1, 1999, pp. 37-52.
    Homøe P, Christensen RB, Bretlau P. Acute otitis media and sociomedical risk factors among unselected children in Greenland. Int J Pediatr Otorhinolaryngol. 1999;49(1):37-52.
    Homøe, P., Christensen, R. B., & Bretlau, P. (1999). Acute otitis media and sociomedical risk factors among unselected children in Greenland. International Journal of Pediatric Otorhinolaryngology, 49(1), pp. 37-52.
    Homøe P, Christensen RB, Bretlau P. Acute Otitis Media and Sociomedical Risk Factors Among Unselected Children in Greenland. Int J Pediatr Otorhinolaryngol. 1999 Jun 15;49(1):37-52. PubMed PMID: 10428404.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Acute otitis media and sociomedical risk factors among unselected children in Greenland. AU - Homøe,P, AU - Christensen,R B, AU - Bretlau,P, PY - 1999/7/31/pubmed PY - 1999/7/31/medline PY - 1999/7/31/entrez SP - 37 EP - 52 JF - International journal of pediatric otorhinolaryngology JO - Int. J. Pediatr. Otorhinolaryngol. VL - 49 IS - 1 N2 - OBJECTIVE: To describe the sociomedical risk factors associated with episodes of acute otitis media (AOM), recurrent AOM (rAOM), and chronic otitis media (COM) in Greenlandic children and especially to point out children at high risk of rAOM (defined as > 5 AOM episodes since birth) and COM which are prevalent among Inuit children all over the Arctic. METHODS: The study design was cross-sectional and included 740 unselected children, 3, 4, 5, and 8-years-old, living in two major Greenlandic towns, Nuuk and Sisimiut. All children were otologically examined and the parents answered a questionnaire containing sociomedical variables including ethnicity, family history of OM, housing, insulation, crowding, daycare, passive cigarette smoking, breast feeding, type of diet, allergy, and chronic diseases. Historical data were cross-checked in medical records which also formed the basis for the drop-out analyses. Statistical analyses included frequency tests, calculation of odds ratio (OR), and multiple logistic regression. RESULTS: The attendance rate was 86%. Former episode of AOM was reported by 2/3 of the children, rAOM by 20%, and COM by 9%. The following variables were found significantly more often in children with AOM by simple frequency testing: Parental (OR = 1.83), sibling (OR = 1.62), and parental plus sibling (OR = 2.56) history of OM, crowding (OR = 5.55), long period of exclusive breast feeding ( > 4 months) (OR = 2.47), and recent acute disease (P = 0.034). The following variables were found significantly more often in children with rAOM or COM by simple frequency testing: Parental history of OM (OR = 1.60; OR = 2.11, respectively) and no recall of breast feeding (P = 0.005; P = 0.003, respectively). Also, COM was found significantly more often in children with two Greenlandic parents (OR = 3.07). A multiple logistic regression test denoted only parental history of OM (OR = 1.82) and long period of exclusive breast feeding (OR = 1.14) as significant predictors of AOM. CONCLUSIONS: Many of the risk factors usually associated with AOM could not be confirmed as risk factors in this survey. Parental history of OM and long period of exclusive breast feeding were the strongest factors associated with AOM in Greenlandic children and ethnicity was associated with COM. However, the study confirms that AOM is a multifactorial disease determined by a number of genetic and environmental factors. SN - 0165-5876 UR - https://www.unboundmedicine.com/medline/citation/10428404/Acute_otitis_media_and_sociomedical_risk_factors_among_unselected_children_in_Greenland_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-5876(99)00044-0 DB - PRIME DP - Unbound Medicine ER -