Long-Term Effects of Otitis Media a Ten-Year Cohort Study of Alaskan Eskimo Children

Abstract

Histories of ear disease, otoscopic examinations, and audiologic, intelligence, and achievement tests were obtained from a cohort of 489 Alaskan Eskimo children who have been followed through the first ten years of life. Seventy-six per cent had experienced one or more episodes of otitis media since birth. Of these, 78% had their first attack during their first two years of life. Perforations and scars were present in 41%. A hearing loss of 26 decibels or greater was present in 16%, and an additional 25% were in the normal range but had a measurable air-bone gap. Children with a history of otitis media prior to 2 years of age and a hearing loss of 26 decibels or greater had a statistically significant loss of verbal ability and were behind in total reading, total math, and language. In addition, children who had an early onset of otitis media but now had normal hearing with a conductive component were also adversely affected in verbal areas. The number of otitis media episodes was related to tympanic membrane abnormalities, hearing loss, and low verbal and achievement scores. These findings indicate that otitis media has been a significant cause of morbidity in Alaskan Eskimo children, and its onset during the critical years of language development as well as the number of episodes play an important role in impairing verbal development.

Prevalence of middle ear disease in Chilean natives and the impact of development over 14 years

“… 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 The influence of these factors in middle ear pathology has been previously published with diverse results. Likewise, a higher prevalence of middle ear disease in Inuit and Eskimos has been described, 14 , 15 , 27 , 28 , 29 , 30 indigenous American 31 , 32 , 33 and Hispanic children. 34 The relevance of this factor in middle ear pathology has been previously proven in the literature.…”

Mobile health school screening and telemedicine referral to improve access to specialty care in rural Alaska: a cluster- randomised controlled trial

“…Although some referrals were due to false positives, this large proportion reflects the high burden of hearing loss and middle ear disease in this rural Alaska Native population and is consistent with previous studies demonstrating higher otitis media visit rates in rural Alaska Native children than urban Alaska Native children. 4,5,[7][8][9] We hypothesised that the prevalence of hearing loss would improve in the telemedicine group because the majority of hearing loss in this rural Alaska Native population is infectionrelated, and interven tions such as tympanostomy tube placement and tympanoplasty can improve this type of hearing loss. However, we found no differences in hearing loss prevalence between the groups.…”

“…Childhood hearing loss has well known, profound implications for language development, school achievement, and future employment opportunities. [1][2][3][4] Some populations experience a disproportionately high burden of childhood hearing loss, including rural Alaska Native children, among whom there is a prevalence of up to 31% compared with 1•7-5% in the general US population. 5,6 Similar to low-resource settings globally, the majority of hearing loss in Alaska is related to infection, with otitis media 4-5 times more prevalent in rural Alaska Native children despite pneumococcal vaccination.…”

“…5,6 Similar to low-resource settings globally, the majority of hearing loss in Alaska is related to infection, with otitis media 4-5 times more prevalent in rural Alaska Native children despite pneumococcal vaccination. 4,5,[7][8][9] WHO estimates that 60% of all childhood hearing loss is preventable, and 75% is preventable in low-income and middle-income countries, where infection-related causes are common. 10 School-based health programmes often provide the only access to preventive services for underserved children who live in rural areas, and school hearing screening is mandated in Alaska.…”

Expanding Clinical Trials Designs to Extend Equitable Hearing Care

“…For example, historical data suggest the prevalence of childhood hearing loss in rural Alaska Native children is 31%, compared to 1.7 to 5% prevalence in the general US population ( Reed et al 1967 ; Mehra et al 2009 ). The majority of hearing loss in Alaska is related to infection, arising from otitis media that is 4 to 5 times more prevalent in rural Alaska Native children than in the general US despite pneumococcal vaccination ( Reed et al 1967 ; Kaplan et al 1973 ; Curns et al 2002 ; Singleton et al 2009 ; Singleton et al 2018 ). Furthermore, children who suffer socioeconomic deprivation have been shown to be at higher risk for otitis media ( Smith & Boss 2010 ).…”