PROSPECTIVE SURVEILLANCE FOR OTITIS-MEDIA WITH EFFUSION AMONG BLACK INFANTS IN GROUP CHILD-CARE

Objective: To document the prevalence of otitis media with effusion (O ME) in 102 black children observed prospectively between 6 and 24 mont hs of age. Methods: Study children attended nine different center-base d child care facilities. Middle ear status was assessed by pneumatic o toscopy and tympanometry every 2 weeks. Results: All children, except one, had OME during the period of observation. The proportion of child -examinations revealing bilateral OME ranged from 76% between 6 and 12 months of age to 30% between 21 and 24 months of age. Effusions were considered purulent in only 13% of examinations revealing middle ear f luid. The mean incidence of purulent OME was 2.13 episodes per child p er year. Sixty-six children had at least 4 months of continuous bilate ral OME during the period of observation; 57 were followed without pla cement of tympanostomy tubes. Bilateral OME had resolved before the se cond birthday in 95% of these children, and within 3 months of achievi ng the 4-month criterion in 50% of subjects, Conclusions: Persistent b ilateral OME occurs commonly between 6 and 18 months of age in infants who enter group child care during the first year of life. In this stu dy, spontaneous resolution of bilateral effusion by 2 years of age was typical.