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Article << Previous     |     Next >>   Contents Vol 20(3)

Household number associated with middle ear disease at an urban Indigenous health service: a cross-sectional study

Geoffrey K. P. Spurling A B G, Deborah A. Askew A B, Philip J. Schluter C D, Fiona Simpson E and Noel E. Hayman B F

A Discipline of General Practice, The University of Queensland, Royal Brisbane and Women’s Hospital, Herston, Qld 4029, Australia.
B Inala Indigenous Health Service, Queensland Health, 64 Wirraway Parade, Inala, Qld 4077, Australia.
C School of Health Sciences, University of Canterbury, Christchurch 8140, New Zealand.
D School of Nursing and Midwifery, The University of Queensland, Brisbane, Qld 4072, Australia.
E Princess Alexandra Hospital, Queensland Health, Brisbane, Qld 4102, Australia.
F School of Medicine, The University of Queensland, Herston, Qld 4029, Australia.
G Corresponding author. Email: g.spurling@uq.edu.au

Australian Journal of Primary Health 20(3) 285-290 http://dx.doi.org/10.1071/PY13009
Submitted: 23 August 2012  Accepted: 7 May 2013   Published: 28 May 2013

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Few epidemiological studies of middle ear disease have been conducted in Aboriginal and Torres Strait Islander populations, yet the disease is common and causes hearing impairment and poorer educational outcomes. The objective of this study is to identify factors associated with abnormal middle ear appearance, a proxy for middle ear disease. Aboriginal and Torres Strait Islander children aged 0–14 years receiving a Child Health Check (CHC) at an urban Indigenous Health Service, Brisbane, Australia were recruited from 2007 to 2010. Mixed-effects models were used to explore associations of 10 recognised risk factors with abnormal middle ear appearance at the time of the CHC. Ethical approval and community support for the project were obtained. Four hundred and fifty-three children were included and 54% were male. Participants were Aboriginal (92%), Torres Strait Islander (2%) or both (6%). Abnormal middle ear appearance was observed in 26 (6%) children and was significantly associated with previous ear infection (odds ratio (OR), 8.8; 95% confidence interval (CI), 3.2–24.0) and households with eight or more people (OR, 3.8; 95% CI, 1.1–14.1) in the imputed multivariable mixed-effects model. No significant associations were found for the other recognised risk factors investigated. Overcrowding should continue to be a core focus for communities and policy makers in reducing middle ear disease and its consequences in Aboriginal and Torres Strait Islander peoples.


Australian Bureau of Statistics (2006) ‘Indigenous status by age by sex for 4077 postal area, Qld.’ Cat. no. 2068.0, 2006 census tables. (Australian Bureau of Statistics: Canberra)

Australian Bureau of Statistics (2007) ‘Population distribution, Aboriginal and Torres Strait Islander Australians, 2006.’ Cat. no. 4705.0. (Australian Bureau of Statistics: Canberra)

Australian Government (2012) ‘Closing the Gap Prime Minister’s Report.’ (Department of Families Housing Community Services and Indigenous Affairs: Canberra)

Australian Institute of Health and Welfare (2008) ‘Housing circumstances: overcrowding.’ 4704.0 – The Health and Welfare of Australia’s Aboriginal and Torres Strait Islander Peoples. (Australian Bureau of Statistics: Canberra)

Bailie R, Stevens M, McDonald E, Brewster D, Guthridge S (2010) Exploring cross-sectional associations between common childhood illness, housing and social conditions in remote Australian Aboriginal communities. BMC Public Health 10, 147
CrossRef | PubMed |

Bailie RS, Stevens M, McDonald EL (2012) The impact of housing improvement and socio-environmental factors on common childhood illnesses: a cohort study in Indigenous Australian communities. Journal of Epidemiology and Community Health 66, 821–831.
CrossRef | PubMed |

Couzos S, Metcalf S, Murray R (2001) ‘Systematic review of existing evidence and primary care guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations.’ (OATSI: Canberra) Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/health-oatsih-pubs-Syst+review [Verified 13 August 2012]

Engel J, Anteunis L, Volovics A, Hendriks J, Marres E (2000) Predictive value of parent-reported symptoms in the assessment of otitis media with effusion during infancy. Scandinavian Journal of Primary Health Care 18, 25–29.
CrossRef | CAS | PubMed |

Hayman NE, Kanhutu J, Brady J (2002) ‘Urban Aboriginal and Torres Strait Islander Health and Nutrition Survey, South Brisbane, Inala.’ (Queensland Health: Brisbane)

Hill AB (1965) The environment and disease: association or causation? Proceedings of the Royal Society of Medicine 58, 295–300.

Jacoby PA, Coates HL, Arumugaswamy A, Elsbury D, Stokes A, Monck R, Finucane JM, Weeks SA, Lehmann D (2008) The effect of passive smoking on the risk of otitis media in Aboriginal and non-Aboriginal children in the Kalgoorlie-Boulder region of Western Australia. The Medical Journal of Australia 188, 599–603.

Jacoby P, Carville KS, Hall G, Riley TV, Bowman J, Leach AJ, Lehmann D (2011) Crowding and other strong predictors of upper respiratory tract carriage of otitis media-related bacteria in Australian Aboriginal and non-Aboriginal children. The Pediatric Infectious Disease Journal 30, 480–485.

Kong K, Coates HL (2009) Natural history, definitions, risk factors and burden of otitis media. The Medical Journal of Australia 191, S39–S43.

Labout JA, Duijts L, Lebon A, de Groot R, Hofman A, Jaddoe VV, Verbrugh HA, Hermans PW, Moll HA (2011) Risk factors for otitis media in children with special emphasis on the role of colonization with bacterial airway pathogens: the Generation R study. European Journal of Epidemiology 26, 61–66.
CrossRef | PubMed |

Morris PS, Leach AJ, Silberberg P, Mellon G, Wilson C, Hamilton E, Beissbarth J (2005) Otitis media in young Aboriginal children from remote communities in Northern and Central Australia: a cross-sectional survey. BMC Pediatrics 5, 27
CrossRef | PubMed |

Paradise JL, Rockette HE, Colborn DK, Bernard BS, Smith CG, Kurs-Lasky M, Janosky JE (1997) Otitis media in 2253 Pittsburgh-area infants: prevalence and risk factors during the first two years of life. Pediatrics 99, 318–333.
CrossRef | CAS | PubMed |

Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR (1996) A simulation study of the number of events per variable in logistic regression analysis. Journal of Clinical Epidemiology 49, 1373–1379.
CrossRef | CAS | PubMed |

Roberts JE, Rosenfeld RM, Zeisel SA (2004) Otitis media and speech and language: a meta-analysis of prospective studies. Pediatrics 113, e238–e248.
CrossRef | PubMed |

Rosenkranz S, Abbott P, Reath J, Gunasekera H, Hu W (2012) Promoting diagnostic accuracy in general practitioner management of otitis media in children: findings from a multimodal, interactive workshop on tympanometry and pneumatic otoscopy. Quality in Primary Care 20, 275–285.

Schluter P, Carter S, Kokaua J (2007) Indices and perception of crowding in Pacific households domicile within Auckland, New Zealand: findings from the Pacific Islands Family Study. The New Zealand Medical Journal 120, U2393

Spurling GK, Askew DA, Schluter PJ, Simpson F, Hayman NE (2012) Conventionally accepted risk factors do not appear to explain higher rates of middle ear disease in remote Indigenous children: an ecological study. Australian and New Zealand Journal of Public Health 36, 491–492.
CrossRef | PubMed |

Uhari M, Mäntysaari K, Niemelä M (1996) A meta-analytic review of the risk factors for acute otitis media. Clinical Infectious Diseases 22, 1079–1083.
CrossRef | CAS | PubMed |

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