This survey examines the age at onset of acute otitis media (AOM) in 591 un
selected Greenlandic children aged 3, 4, 5 and 8 years from the two largest
towns in Greenland. The attendance rate was 86%. Parental information abou
t episodes of AOM was cross-checked in medical records, which were availabl
e for 95% of the children. AOM was defined as episodes with earache, otorrh
oea or previous treatment for AOM, with written otoscopic evidence of AOM r
esulting in treatment with weak analgetics or antibiotics. Recurrent AOM (r
AOM) was defined as greater than or equal to 5 AOM episodes since birth. In
total, 66% of the children had experienced AOM at least once. Of all child
ren. 40% had AOM during the first year of life. Median age of the first epi
sode was 10 months (range: 1-84 months), and there was no sex difference. C
hildren between 7 and 12 months of age were at highest risk of AOM I. Child
ren with rAOM had their first AOM episode at a significantly younger age th
an children with < 5 AOM episodes (median: 7 months, range: 2-48 months). I
n addition, 83% of children with rAOM had their first AOM? episode before 1
2 months of age compared with 53% Of children with < 5 episodes (p < 0.0001
). The relative risk of rAOM was eight times greater if the first episode o
f AOM occurred before six months of age compared to more than 24 months of
age. Thirty-five percent of children with rAOM had chronic otitis media as
well, compared to only 4% of children with < 5 AOM episodes. We conclude th
at early onset of AOM (before one year of age) occurs Frequently in Greenla
ndic children compared to others, and a high proportion of these children d
evelop rAOM.