Skip to main content
Top
Published in: BMC Pediatrics 1/2016

Open Access 01-12-2016 | Research article

Incidence of acute otitis media in children below 6 years of age seen in medical practices in five East European countries

Authors: Vytautas Usonis, Teresa Jackowska, Sigita Petraitiene, Alicja Sapala, Andrea Neculau, Izabella Stryjewska, Raghavendra Devadiga, Monica Tafalla, Katsiaryna Holl

Published in: BMC Pediatrics | Issue 1/2016

Login to get access

Abstract

Background

Although acute otitis media (AOM) remains a major public health problem worldwide and brings economic burden on health care system and caregivers, little information is available about its epidemiology in Eastern Europe.

Methods

We conducted an epidemiological, prospective, observational, multi-centre cohort study (NCT01365390) in five East European countries (Estonia, Lithuania, Poland, Romania and Slovenia) between June 2011 and January 2013 to determine the incidence and clinical characteristics of AOM among children aged < 6 years during 1 year.

Results

AOM incidence was 160.7 cases (95 % confidence interval [CI]: 144.7–177.9) per 1000 person-years (PY) being the lowest in the < 1 year age group (92.3 cases [95 % CI: 59.7–136.2] per 1000 PY) and the highest in the 3– < 4 years age group (208.9 cases [95 % CI: 165.1–260.7] per 1000 PY). AOM incidence was similar across the countries, with the exception of Slovenia (340.3 cases [95 % CI: 278.3–412.0] per 1000 PY). There was a lower risk in breastfed children and a higher risk in those attending school/childcare or with allergies. AOM required 521 visits to the doctor. Antibiotics were prescribed for 276 (74.8 %) episodes with the lowest prescription rate in Estonia (51.4 %) and the highest in Romania (83.7 %). Complications were rare and hospitalisations occurred in 2 % of the cases.

Conclusions

The disease burden of AOM in Eastern Europe is relevant and public health initiatives to reduce it should be considered.

Trial registration

ClinicalTrial.gov NCT01365390.
Literature
1.
go back to reference Teele DW, Klein JO, Rosner B. Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study. J Infect Dis. 1989;160:83–94.CrossRefPubMed Teele DW, Klein JO, Rosner B. Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study. J Infect Dis. 1989;160:83–94.CrossRefPubMed
2.
go back to reference Leibovitz E, Broides A, Greenberg D, Newman N. Current management of pediatric acute otitis media. Expert Rev Anti Infect Ther. 2010;8:151–61.CrossRefPubMed Leibovitz E, Broides A, Greenberg D, Newman N. Current management of pediatric acute otitis media. Expert Rev Anti Infect Ther. 2010;8:151–61.CrossRefPubMed
3.
go back to reference Taylor S, Marchisio P, Vergison A, Harriague J, Hausdorff WP, Haggard M. Impact of pneumococcal conjugate vaccination on otitis media: a systematic review. Clin Infect Dis. 2012;54:1765–73.CrossRefPubMedPubMedCentral Taylor S, Marchisio P, Vergison A, Harriague J, Hausdorff WP, Haggard M. Impact of pneumococcal conjugate vaccination on otitis media: a systematic review. Clin Infect Dis. 2012;54:1765–73.CrossRefPubMedPubMedCentral
4.
go back to reference Monasta L, Ronfani L, Marchetti F, Montico M, Vecchi Brumatti L, Bavcar A, et al. Burden of disease caused by otitis media: systematic review and global estimates. PLoS One. 2012;7:e36226.CrossRefPubMedPubMedCentral Monasta L, Ronfani L, Marchetti F, Montico M, Vecchi Brumatti L, Bavcar A, et al. Burden of disease caused by otitis media: systematic review and global estimates. PLoS One. 2012;7:e36226.CrossRefPubMedPubMedCentral
6.
go back to reference Dubé E, De Wals P, Ouakki M. Quality of life of children and their caregivers during an AOM episode: development and use of a telephone questionnaire. Health Qual Life Outcomes. 2010;8:75.CrossRefPubMedPubMedCentral Dubé E, De Wals P, Ouakki M. Quality of life of children and their caregivers during an AOM episode: development and use of a telephone questionnaire. Health Qual Life Outcomes. 2010;8:75.CrossRefPubMedPubMedCentral
7.
go back to reference Grzegorowski M, Szydlowski J. [Acute otitis media in children]. Pol Merkur Lekarski. 2005;19:494–6.PubMed Grzegorowski M, Szydlowski J. [Acute otitis media in children]. Pol Merkur Lekarski. 2005;19:494–6.PubMed
8.
go back to reference Falup-Pecurariu O, Leibovitz E, Mercas A, Bleotu L, Zavarache C, Porat N, et al. Pneumococcal acute otitis media in infants and children in central Romania, 2009–2011: microbiological characteristics and potential coverage by pneumococcal conjugate vaccines. Int J Infect Dis. 2013;17:e702–6.CrossRefPubMed Falup-Pecurariu O, Leibovitz E, Mercas A, Bleotu L, Zavarache C, Porat N, et al. Pneumococcal acute otitis media in infants and children in central Romania, 2009–2011: microbiological characteristics and potential coverage by pneumococcal conjugate vaccines. Int J Infect Dis. 2013;17:e702–6.CrossRefPubMed
9.
go back to reference Friedman NR, McCormick DP, Pittman C, Chonmaitree T, Teichgraeber DC, Uchida T, et al. Development of a practical tool for assessing the severity of acute otitis media. Pediatr Infect Dis J. 2006;25:101–7.CrossRefPubMed Friedman NR, McCormick DP, Pittman C, Chonmaitree T, Teichgraeber DC, Uchida T, et al. Development of a practical tool for assessing the severity of acute otitis media. Pediatr Infect Dis J. 2006;25:101–7.CrossRefPubMed
10.
go back to reference Liese JG, Silfverdal SA, Giaquinto C, Carmona A, Larcombe JH, Garcia-Sicilia J, et al. Incidence and clinical presentation of acute otitis media in children aged <6 years in European medical practices. Epidemiol Infect. 2014;142:1778–88.CrossRefPubMed Liese JG, Silfverdal SA, Giaquinto C, Carmona A, Larcombe JH, Garcia-Sicilia J, et al. Incidence and clinical presentation of acute otitis media in children aged <6 years in European medical practices. Epidemiol Infect. 2014;142:1778–88.CrossRefPubMed
11.
go back to reference Joki-Erkkilä VP, Laippala P, Pukander J. Increase in paediatric acute otitis media diagnosed by primary care in two Finnish municipalities--1994-5 versus 1978–9. Epidemiol Infect. 1998;121:529–34.CrossRefPubMedPubMedCentral Joki-Erkkilä VP, Laippala P, Pukander J. Increase in paediatric acute otitis media diagnosed by primary care in two Finnish municipalities--1994-5 versus 1978–9. Epidemiol Infect. 1998;121:529–34.CrossRefPubMedPubMedCentral
12.
go back to reference Prymula R, Peeters P, Chrobok V, Kriz P, Novakova E, Kaliskova E, et al. Pneumococcal capsular polysaccharides conjugated to protein D for prevention of acute otitis media caused by both Streptococcus pneumoniae and non-typable Haemophilus influenzae: a randomised double-blind efficacy study. Lancet. 2006;367:740–8.CrossRefPubMed Prymula R, Peeters P, Chrobok V, Kriz P, Novakova E, Kaliskova E, et al. Pneumococcal capsular polysaccharides conjugated to protein D for prevention of acute otitis media caused by both Streptococcus pneumoniae and non-typable Haemophilus influenzae: a randomised double-blind efficacy study. Lancet. 2006;367:740–8.CrossRefPubMed
13.
go back to reference Marchisio P, Cantarutti L, Sturkenboom M, Girotto S, Picelli G, Dona D, et al. Burden of acute otitis media in primary care pediatrics in Italy: a secondary data analysis from the Pedianet database. BMC Pediatr. 2012;12:185.CrossRefPubMedPubMedCentral Marchisio P, Cantarutti L, Sturkenboom M, Girotto S, Picelli G, Dona D, et al. Burden of acute otitis media in primary care pediatrics in Italy: a secondary data analysis from the Pedianet database. BMC Pediatr. 2012;12:185.CrossRefPubMedPubMedCentral
14.
go back to reference Coker TR, Chan LS, Newberry SJ, Limbos MA, Suttorp MJ, Shekelle PG, et al. Diagnosis, microbial epidemiology, and antibiotic treatment of acute otitis media in children: a systematic review. JAMA. 2010;304:2161–9.CrossRefPubMed Coker TR, Chan LS, Newberry SJ, Limbos MA, Suttorp MJ, Shekelle PG, et al. Diagnosis, microbial epidemiology, and antibiotic treatment of acute otitis media in children: a systematic review. JAMA. 2010;304:2161–9.CrossRefPubMed
15.
go back to reference Schnabel E, Sausenthaler S, Brockow I, Liese J, Herbarth O, Michael B, et al. Burden of otitis media and pneumonia in children up to 6 years of age: results of the LISA birth cohort. Eur J Pediatr. 2009;168:1251–7.CrossRefPubMed Schnabel E, Sausenthaler S, Brockow I, Liese J, Herbarth O, Michael B, et al. Burden of otitis media and pneumonia in children up to 6 years of age: results of the LISA birth cohort. Eur J Pediatr. 2009;168:1251–7.CrossRefPubMed
16.
go back to reference Xenellis J, Paschalidis J, Georgalas C, Davilis D, Tzagaroulakis A, Ferekidis E. Factors influencing the presence of otitis media with effusion 16 months after initial diagnosis in a cohort of school-age children in rural Greece: a prospective study. Int J Pediatr Otorhinolaryngol. 2005;69:1641–7.CrossRefPubMed Xenellis J, Paschalidis J, Georgalas C, Davilis D, Tzagaroulakis A, Ferekidis E. Factors influencing the presence of otitis media with effusion 16 months after initial diagnosis in a cohort of school-age children in rural Greece: a prospective study. Int J Pediatr Otorhinolaryngol. 2005;69:1641–7.CrossRefPubMed
17.
go back to reference Kontiokari T, Koivunen P, Niemelä M, Pokka T, Uhari M. Symptoms of acute otitis media. Pediatr Infect Dis J. 1998;17:676–9.CrossRefPubMed Kontiokari T, Koivunen P, Niemelä M, Pokka T, Uhari M. Symptoms of acute otitis media. Pediatr Infect Dis J. 1998;17:676–9.CrossRefPubMed
18.
go back to reference Abrahams SW, Labbok MH. Breastfeeding and otitis media: a review of recent evidence. Curr Allergy Asthma Rep. 2011;11:508–12.CrossRefPubMed Abrahams SW, Labbok MH. Breastfeeding and otitis media: a review of recent evidence. Curr Allergy Asthma Rep. 2011;11:508–12.CrossRefPubMed
19.
go back to reference McNiel ME, Labbok MH, Abrahams SW. What are the risks associated with formula feeding? A re-analysis and review. Breastfeed Rev. 2010;18:25–32.PubMed McNiel ME, Labbok MH, Abrahams SW. What are the risks associated with formula feeding? A re-analysis and review. Breastfeed Rev. 2010;18:25–32.PubMed
20.
go back to reference Sabirov A, Casey JR, Murphy TF, Pichichero ME. Breast-feeding is associated with a reduced frequency of acute otitis media and high serum antibody levels against NTHi and outer membrane protein vaccine antigen candidate P6. Pediatr Res. 2009;66:565–70.CrossRefPubMedPubMedCentral Sabirov A, Casey JR, Murphy TF, Pichichero ME. Breast-feeding is associated with a reduced frequency of acute otitis media and high serum antibody levels against NTHi and outer membrane protein vaccine antigen candidate P6. Pediatr Res. 2009;66:565–70.CrossRefPubMedPubMedCentral
22.
23.
go back to reference Greenberg D, Hoffman S, Leibovitz E, Dagan R. Acute otitis media in children: association with day care centers--antibacterial resistance, treatment, and prevention. Paediatr Drugs. 2008;10:75–83.CrossRefPubMed Greenberg D, Hoffman S, Leibovitz E, Dagan R. Acute otitis media in children: association with day care centers--antibacterial resistance, treatment, and prevention. Paediatr Drugs. 2008;10:75–83.CrossRefPubMed
Metadata
Title
Incidence of acute otitis media in children below 6 years of age seen in medical practices in five East European countries
Authors
Vytautas Usonis
Teresa Jackowska
Sigita Petraitiene
Alicja Sapala
Andrea Neculau
Izabella Stryjewska
Raghavendra Devadiga
Monica Tafalla
Katsiaryna Holl
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2016
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-016-0638-2

Other articles of this Issue 1/2016

BMC Pediatrics 1/2016 Go to the issue