Natural history, definitions, risk factors and burden of otitis media

Kelvin Kong and Harvey L C Coates
Med J Aust 2009; 191 (9): 39.
  • Kelvin Kong1
  • Harvey L C Coates2,3

  • 1 John Hunter Hospital, Newcastle, NSW.
  • 2 University of Western Australia, Perth, WA.
  • 3 Princess Margaret Hospital for Children, Perth, WA.



We especially acknowledge the nurses and Indigenous health workers who work tirelessly for the benefit of our patients in urban, rural and remote Australia.

Competing interests:

Harvey Coates has been a consultant for GlaxoSmithKline and Alcon Laboratories.

  • 1. Teele DW, Klein JO, Rosner B. Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study. J Infect Dis 1989; 160: 83-94.
  • 2. Morris PS, Leach AJ, Silberberg P, et al. Otitis media in young Aboriginal children from remote communities in Northern and Central Australia: a cross-sectional survey. BMC Pediatrics 2005; 5: 27.
  • 3. Gunasekera H, Knox S, Morris P, et al. The spectrum and management of otitis media in Australian Indigenous and non-Indigenous children: a national study. Pediatr Infect Dis J 2007; 26: 689-692.
  • 4. Baxter JD. Otitis media in Inuit children in the Eastern Canadian Arctic — an overview — 1968 to date. Int J Pediatr Otorhinolaryngol 1999; 49 Suppl 1: S165-S168.
  • 5. Glasziou PP, Del Mar CB, Sanders SL, Hayem M. Antibiotics for acute otitis media in children. Cochrane Database Syst Rev 2004; (1): CD000219.
  • 6. American Academy of Pediatrics Subcommittee on Management of Acute Otitis Media. Diagnosis and management of acute otitis media. Pediatrics 2004; 113: 1451-1465.
  • 7. Bezáková N, Damoiseaux RA, Hoes AW, et al. Recurrence up to 3.5 years after antibiotic treatment of acute otitis media in very young Dutch children: survey of trial participants. BMJ 2009; 338: b2525.
  • 8. Australian Institute of Health and Welfare. Australian hospital statistics 2006–07. Health services series no. 31. Canberra: AIHW, 2008. (AIHW Cat. No. HSE 55.)
  • 9. Rosenfeld RM, Kay D. Natural history of untreated otitis media. In: Rosenfeld RM, Bluestone CD. Evidence-based otitis media. 2nd ed. Hamilton, Ont: BC Decker, 2003: 180-198.
  • 10. Williams CJ, Coates HL, Pascoe EM, et al. Middle ear disease in Aboriginal children in Perth: analysis of hearing screening data,1998–2004. Med J Aust 2009; 190: 598-600. <MJA full text>
  • 11. Leach AJ, Morris PS, McCallum G, et al. What will Prevnar do for chronic suppurative otitis media in Indigenous Australian children? 3rd International Symposium on Pneumococci and Pneumococcal Diseases; 2002 May 4; Anchorage, Alaska.
  • 12. World Health Organization. Chronic suppurative otitis media: burden of illness and management options. Geneva: WHO, 2004.
  • 13. Leach A, Morris P. Annotation perspectives on infective ear disease in Indigenous Australian children. J Paediatr Child Health 2001; 37: 529-530.
  • 14. Morris PS, Leach AJ, Halpin S, et al. An overview of acute otitis media in Australian Aboriginal children living in remote communities. Vaccine 2007; 25: 2389-2393.
  • 15. Coates HL, Morris PS, Leach AJ, et al. Otitis media in Aboriginal children: tackling a major health problem [editorial]. Med J Aust 2002; 177: 177-178. <MJA full text>
  • 16. Coates H, Thornton R, Langlands J, et al. The role of chronic infection in children with otitis media with effusion: evidence for intracellular persistence of bacteria. Otolaryngol Head Neck Surg 2008; 138: 778-781.
  • 17. Jacoby P, Coates H, Arumugaswamy A, et al. The effect of passive smoking on the risk of otitis media in Aboriginal and non-Aboriginal children in the Kalgoorlie-Boulder region of Western Australia. Med J Aust 2008; 188: 599-603. <MJA full text>
  • 18. National Health and Medical Research Council. How to review the evidence: systematic identification and review of the scientific literature. Endorsed November 1999. Canberra: NHMRC, 2000.
  • 19. Neto JFL, Hemb L, de Silva DB. Systematic literature review of modifiable risk factors for recurrent acute otitis media in childhood. Jornal de Pediatria 2006; 82: 87-96.
  • 20. Uhari M, Mäntysaari K, Niemelä M. A meta-analytic review of the risk factors for acute otitis media. Clin Infect Dis 1996; 22: 1079-1083.
  • 21. Watson K, Carville K, Bowman J, et al; Kalgoorlie Otitis Media Research Project Team. Upper respiratory tract bacterial carriage in Aboriginal and non-Aboriginal children in a semi-arid area of Western Australia. Pediatr Infect Dis J 2006; 25: 782-790.
  • 22. Boswell JB, Nienhuys TG. Patterns of persistent otitis media in the first year of life in Aboriginal and non-Aboriginal infants. Ann Otol Rhinol Laryngol 1996; 105: 893-900.
  • 23. Doyle WJ, A functional-anatomic description of eustachian tube vector relations in four ethnic populations: an osteologic study [PhD dissertation]. Pittsburgh: University of Pittsburgh, 1977.
  • 24. Engel J, Anteunis L, Volovics A, et al. Prevalence rates of otitis media with effusion from 0 to 2 years of age: healthy-born versus high-risk-born infants. Int J Pediatr Otorhinolaryngol 1999; 47: 243-251.
  • 25. Tomonaga K, Krono Y, Mogi G. The role of nasal allergy in otitis media with effusion: a clinical study. Acta Otolaryngol Suppl 1988; 458: 41-47.
  • 26. Pukander J, Luotonem J, Timonen M, Karmap. Risk factor affecting the occurrence of acute otitis media among 2-3-year-old urban children. Acta Otolaryngol 1985; 100: 260-265.
  • 27. Prellner K, Kalm O, Harsten G, et al. Pneumococcal serum antibody concentration during the first three years of life: a study of otitis prone and non-otitis prone children. Int J Pediatr Otorhinolaryngol 1989; 17: 267-279.
  • 28. Kvaerner KJ, Harris JR, Tambs K, et al. Distribution and heritability of recurrent ear infections. Ann Otol Rhinol Laryngol 1997; 106: 624-632.
  • 29. Kalm O, Johnson U, Preliner K, Ninn K. HLA frequency in patients with recurrent acute otitis media. Arch Otolaryngol Head Neck Surg 1991; 117: 1296-1299.
  • 30. Balkany TJ, Downs MP, Jafek BW, et al. Otologic manifestations of Down syndrome. Surg Forum 1978; 29: 582-585.
  • 31. Kadhim AL, Spilsbury K, Semmens JB, et al. Adenoidectomy for middle ear effusion: a study of 50,000 children over 24 years. Laryngoscope 2007; 117: 427-433.
  • 32. Tasker A, Dettmar PW, Panetti M, et al. Is gastric reflux a cause of otitis media with effusion in children? Laryngoscope 2002; 112: 1930-1934.
  • 33. Antonelli PJ, Lloyd KM, Lee JC. Gastric reflux is uncommon in acute post-tympanostomy otorrhea. Otolaryngol Head Neck Surg 2005; 132: 523-526.
  • 34. Wald ER, Dashefsky B, Byers C, et al. Frequency and severity of infections in daycare. J Pediatr 1988; 112: 540-546.
  • 35. Ruuskanen O, Heikkinen T. Viral-bacterial interaction in acute otitis media. Pediatr Infect Dis J 1994; 13: 1047-1049.
  • 36. Alho OP, Laara E, Oja H. Public health impact of various risk factors for acute otitis media in northern Finland. Am J Epidemiol 1996; 143: 1149-1156.
  • 37. Access Economics. The cost burden of otitis media in Australia. Perth: GlaxoSmithKline, 2009: 49-50. (accessed Sep 2009).


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.