Incidence and economic burden of acute otitis media in children aged up to 5 years in three Middle Eastern countries and Pakistan: a multinational, retrospective, observational study

ABSTRACT

Epidemiological data on acute otitis media [AOM], an infectious disease frequently affecting children, are lacking in some countries. This study was undertaken to assess the incidence of AOM in children 5 years in Saudi Arabia, Oman, Pakistan, and Turkey, as well as the economic burden from a parent/caregiver perspective. Medical records of 4043 children [Saudi Arabia = 1023, Oman = 998, Pakistan = 1022, Turkey = 1000] were retrospectively reviewed and the incidence of AOM episodes calculated from suspected and confirmed cases. Using a standardized Health Economics Questionnaire, parents recorded resource use and expenses incurred per AOM episode [in local currency and converted to US dollars [USD]]. The overall incidence of AOM episodes per 1000 person-years was Saudi Arabia, 207 [95% confidence interval [CI] 178-238]; Oman, 105 [95% CI 85-127]; Pakistan, 138 [95% CI 116-163]; and Turkey, 99 [95% CI 79-123]. The mean total out-of-pocket healthcare expense incurred by parents/caregivers per episode was Saudi Arabia USD67.1 [standard deviation [SD] = 93.0], Oman USD16.1 [SD = 16.4], Pakistan USD22.1 [SD = 20.5], and Turkey USD33.6 [SD = 44.9]. The incidence of AOM episodes varied across all four countries, probably due to different diagnostic and management practices. Nevertheless, our results confirm that AOM causes a substantial burden to public health, reinforcing the need for cost-effective prevention strategies