Pacific Islands Families Study: risk factors associated with otitis media with effusion among Pacific 2-year-old children.

OBJECTIVE: This study examined the risk factors associated with middle ear disease in a cohort of Pacific 2-year-old children residing in New Zealand.

METHODS: The data were gathered as part of the Pacific Island Families: first 2 years of life (PIF) study in which 656 2-year-old were screened using tympanometry to identify children at risk for otitis media with effusion (OME) and other otological disorders.

RESULTS: Within this 2-year-old cohort of Pacific children, one set of factors significantly associated with OME was clustered around the respiratory and auditory health of the child over the past year. OME was more likely for children who were regularly suffering from fluid/pus discharge from ears (OR=2.10, 95% CI: 1.01-4.35), children with five or more coughs/colds in the last year (OR=1.90, 95% CI: 1.22-3.00), and children who frequently/constantly snored (OR=2.60, 95% CI: 1.09-6.23) to have OME. Those children who were treated at home for breathing problems were more that two times more likely to have OME (OR=2.61, 95% CI: 1.55-4.42). A second set of factors was clustered around environmental risks that exposed children to a large number of other children. Children who attended a day care centre for more than 20h were five times more likely (OR=5.21, 95% CI: 2.90-9.35) and those who regularly attended church (OR=2.78, 95% CI: 1.05-7.40) were almost three times more likely to have OME.

CONCLUSIONS: These findings portray a child compromised by persistent ear infections and general coughs and colds as being at increased risk of contracting OME. In line with international research these findings raise questions about the negative child health effects associated with the day care environment for young children.