INCREASING PREVALENCE OF RECURRENT OTITIS-MEDIA AMONG CHILDREN IN THEUNITED-STATES

Background. The number of visits for otitis media, the most common dia gnosis among preschool children, has increased during the past decade. This study was undertaken to determine whether there has been a concu rrent increase in the prevalence of recurrent otitis media among child ren in the United States and to identify risk factors or demographic c hanges to explain the increase. Methods. Secondary analyses of cross-s ectional data from the Child Health Supplement to the 1981 and 1988 Na tional Health Interview Surveys (n = 5189 [1981] and n = 6209 [1988]) were done to identify temporal changes in the prevalence and any assoc iated risk factors of recurrent otitis media among children <6 years o f age. Results. Recurrent otitis among preschool children increased fr om 18.7% in 1981 to 26% in 1988 (odds ratio [OR] = 1.6, 95% confidence interval [CI] = 1.4, 1.7). Although the prevalence of recurrent otiti s increased with age, the greatest increase in recurrent otitis media occurred in infants (OR = 1.9, CI = 1.3, 2.9). Factors independently a ssociated with recurrent otitis were any allergic condition (OR = 1.9, CI = 1.7, 2.2); survey year (OR = 1.7, CI = 1.5, 1.9); Black race (OR = .6, CI = .5, .7); Hispanic ethnicity (OR = .8, CI = .6, .9); day ca re (OR = 1.5, CI = 1.3, 1.7); out-of-home care by an unrelated sitter (OR = 1.3, CI = 1.1, 1.6); and male gender (OR = 1.2, CI = 1.1, 1.3). From 1981 to 1988, there were significant increases in some risk facto rs associated with recurrent otitis media, including day care (11% vs 21%) and allergic conditions (14% vs 18%). Conclusions. We conclude th at there has been a significant increase in the prevalence of recurren t otitis media among children in the United States, particularly in in fants. The increased prevalence of recurrent otitis media was associat ed with an increase in the use of child care and a higher prevalence o f allergic conditions among children.