International Union for Circumpolar Health Ministry of Public Health and Social Development of RF Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Sciences Medical Polar Fund “Science” The Northern Forum

Abstracts

Northern Epidemiology

Objectives: The incidence of chronic otitis media is among the highest in the world. Studies from 1984 and 1994 have shown prevalences of 20% of chronic otitis media among 3-8 year old children in Greenland. On average the disease appeared established before 3 years of age, but the exact age was unknown. Similarly risk factors for chronic otitis media in Greenlandic children are generally unknown. The objectives of the present study were to determine age-specific incidence, age at debut and risk factors for chronic otitis in young children in Greenland.

Methods: A population-based cohort of children aged 0-4 was formed in the West Greenlandic town of Sisimiut and followed by regular visits for a two-year period from 1996 to 1998. Medical history was obtained at the visits and in case of symptoms a clinical examination including oto-scopy and tympanometry was carried out. Furthermore, a clinical examination was carried out at fixed intervals. Information of risk factors was obtained at the beginning of the study and time de-pendent variables updated regularly.

Results: In total 465 children participated in the study. Hereof developed 55 children chronic otitis media, 30 (55%) unilaterally and 25 (45%) bilaterally. Cumulative risk at 4 years of age was 14%. The median age at debut was 11 months with the highest risk between 6 and 15 months of age. Risk factors were Greenlandic/mixed ethnicity (no Danish children developed chronic otitis media), ma-ternal reporting of own ear discharge, attending child care centres, and for children below 1 year of age having smokers in the household. Measured by population-attributable risk percent the most important risk factors were ethnicity, attending childcare centres, and having smokers in the house.

Discussion: While Inuit children may be at higher risk of chronic otitis media due to genetic fac-tors, environmental factors that modify this risk are most important from a public health perspec-tive, as these factors are modifiable. The findings of smokers in more than 80% of homes and more than 60% of children attending childcare centres suggest that intervention may reduce the far too high burden of chronic otitis media.

Conclusions: The cumulative risk of chronic otitis media at age 4 years was 14% with ethnicity, childcare centre attendance and passive smoking being important risk factors. Public health meas-ures may reduce the burden of chronic otitis media in Greenland.

Note. Abstracts are published in author's edition

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Last update: 06-Jul-2012 (11:52:05)