Allergic airway disease and otitis media in children.

The occurrence of allergic rhinitis, asthma and otitis media was examined in 395 Indian children living on two separate reservations in Arizona. The children were followed from birth to age 5 years in a study of otitis media. On retrospective review of medical records, 45% of the children at Parker had a clinical diagnosis of allergic airway disease, in contrast to only 6% at San Carlos. At each site, about 55% had recurring otitis media in infancy; of these otitis-prone infants, 40% at Parker and 36% at San Carlos persisted to have 3 or more episodes of otitis media after age 2 years. The only allergic airway disease correlate with otitis media was allergic rhinitis in children age 2-4 years.

Otitis media and language performance in a cohort of Apache Indian children.

Language performance was evaluated in 167 healthy Apache Indian children aged 6 to 8 years, who had contrasting histories of otitis media and who had been followed since birth. All children received pneumatic otoscopy, tympanometry, pure tone audiometry, and a battery of language measures. Groups were similar with respect to age, sex, school experience, family income, housing, primary language spoken, and nonverbal intelligence. No statistically or clinically significant differences in language performance were observed between groups of children with frequent episodes of otitis media and those from the same cohort with infrequent otitis. While frequent otitis media was associated with abnormalities on tympanometry and otoscopy, bilateral hearing loss (greater than 25 dB) was observed in only 1% of the children.

Observations on the relation of environmental and behavioral factors to the occurrence of otitis media among Indian children.

Studies were conducted to assess the relation of environmental and behaviora factors to occurrence of acute suppurative otitis media (ASOM) among four populations of Indian children in Arizona. Episodes of ASOM were recorded for 1,428 children observed during the first year of life. Data obtained on the households and premises of these children included number of persons in the household, number of sleeping rooms, type of water supply and sewage disposal, type of heating and cooling, availability of electricity, method of infant feeding, distance to a health facility, and mother's education. The rates of ASOM for the four populations ranged from 1.1 to 2.2 attacks per child and differed significantly from each other, with one exception. The differences between populations apparently were not related to any of the factors evaluated. Additional analyses to evaluate the association of each factor with occurrence of ASOM included (a) a comparison of rates among children living in homes having each factor with rates among children living in homes lacking the factor, (b) a comparison of the frequency of each factor in homes of children who had no recorded attacks of ASOM with the frequency in homes of children who had three or more attacks (high-risk children), and (c) an evaluation of the relation between frequency of encounters for ASOM and the environmental factors. Results did not indicate that any environmental or behavioral factor observed was consistently or strongly associated with either the incidence of ASOM or the frequency of attacks. Similarly, no differences were apparent in the frequency of adverse environmental conditions in homes of infants with contrasting rates of ASOM. Rates of ASOM during the first year of life were not associated with either the presence or the absence of adverse environmental conditions.

Distribution of otitis media among four Indian populations in Arizona.

More than 75 percent of the cases of acute suppurative otitis media (ASOM) among Indian children observed from May 1974 through March 1979 were experienced by preschool children. About 60 percent of the children observed during the first year of life had one or more attacks of ASOM, and 34 percent had two or more. Among those who had ASOM before their first birthday, 75 percent of the attacks occurred between 3 and 9 months of age. About 73 percent of the initial attacks were recorded during the first year of life among children observed from 3 to 5 years; almost 90 percent occurred before the second birthday. Approximately 75 percent of the second attacks occurred within 4 months of the first. More than 70 percent of the initial attacks before age 1 were followed by 1 or more subsequent attacks during the next 12 months. When the initial attack occurred during the second year of life, subsequent attacks were experienced by less than half as many children. Children at high risk of serious ear disease, including hearing loss, are characterized by having an attack of ASOM before their first birthday followed by a second attack within 4 months of the first. Efforts to control and prevent ASOM should selectively be directed toward this group.