Ear health

Abstract

[Extract] Otitis media in childhood, and its important consequences such as hearing loss, are more common in the Aboriginal population than in the broader Australian population. According to the World Health Organization, the burden of chronic suppurative otitis media (CSOM)in Aboriginal children constitutes a massive public health problem. Hearing loss may well be a major contributor to poor education and to unemployment, which are in themselves risk factors for contact with the justice system. Early bacterial (respiratory pathogens) colonisation of the nasopharynx strongly predicts early otitis media and this in turn predicts the recurrence of otitis media in childhood. Early otitis media has been related to poverty and overcrowding. Bottle-feeding and passive smoking are also recognised risk factors. The key prevention issues involve environmental modifications that address overcrowding and passive smoking, a small role for influenza vaccine, polysaccharide and conjugate pneumococcal vaccine, prolonged antibiotic use in those children with documented recurrences, appropriate treatment of CSOM, surgery for otitis media with effusion (OME) and for CSOM, and the early detection of hearing loss in order to implement treatment and rehabilitative systems. There is some evidence that surgical and rehabilitative needs are not being met for the Aboriginal population, particularly in remote Australia, and these issues need to be addressed.